Remote RN CDI Specialist – Risk Adjustment & Documentation

Optum; Worcester (MA); Remote; USD 40,000 - 72,000; Full time

Benefits offered by this job

Comprehensive benefits package

Equity stock purchase program

401k contribution

Job summary

Reliant Medical Group, part of the Optum family, seeks a Registered Nurse to manage risk adjustment documentation and coding within Population Health. Remote option for MA residents, full-time schedule, and strong emphasis on quality patient care.

Responsibilities include chart reviews, coding accuracy, clinician training, and collaboration with the coding education team. Requires MA RN license, BLS, and 3+ years in chronic disease care.

Qualifications

• Graduate of a State-approved school of nursing.
• Current, unrestricted nursing license in the Commonwealth of Massachusetts.
• Certification as professional coder (CPC, CCS-P, CCS, CPC-H, CRC-risk, AAPC) or ability to obtain certification while working.
• American Heart Association Basic Life Support (BLS).
• 3+ years nursing experience with chronic disease patient populations in ambulatory or inpatient settings.

Responsibilities

• Reviews encounters in the EMR to ensure accuracy and appropriate clinician documentation.
• Abstracts to substantiate HCC diagnoses billed or relevant but not listed.
• Provides concurrent and retrospective abstraction for Reliant Risk Adjustment programs.
• Reviews new Reliant patients for potential diagnoses supporting risk adjustment programs and updates the problem list.
• Collaborates with coding education team to train clinicians on risk adjustment programs.
• Participates in development and monitoring of procedures that support risk adjustment capture.

Skills

Nursing

Documentation

Critical thinking

Communication

Risk adjustment coding

Education

State-approved nursing program

BSN preferred

Tools

EMR systems

Microsoft Office

Job description

Reliant Medical Group, part of the Optum family, seeks a Registered Nurse to manage risk adjustment documentation and coding within Population Health. Remote option for MA residents, full-time schedule, and strong emphasis on quality patient care.

Responsibilities include chart reviews, coding accuracy, clinician training, and collaboration with the coding education team. Requires MA RN license, BLS, and 3+ years in chronic disease care.