Remote RN: Clinical Documentation & Risk Adjustment

Dovetail Health Inc.; Worcester (MA); Remote; USD 40,000 - 72,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Job summary

Reliant Medical Group, part of UnitedHealth Group, is seeking a Registered Nurse to deliver and manage patient care within a population health risk-adjustment context. The role focuses on accurate coding, chart reviews, and clinician training to support CMS risk adjustment programs.

Based in Massachusetts with remote options for MA residents, this full-time position offers 40 hours weekly, with a schedule that supports work-life balance while addressing complex chronic disease populations in

Qualifications

• Graduate of a State-approved school of nursing.
• Current, unrestricted, license to practice professional nursing 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 in the position.
• American Heart Association Basic Life Support (BLS).
• 3+ years nursing experience with at least 3 years of clinical experience with chronic disease patient populations in an ambulatory or inpatient setting.

Responsibilities

• Reviews encounters in the electronic medical record to ensure accuracy and appropriateness of clinician documentation using relevant risk adjustment program standards.
• Utilizes abstract reports to substantiate HCC diagnoses that have been billed and/or are considered relevant but do not appear on the patient's problem list.
• Provides concurrent and retrospective abstraction for all Reliant Risk Adjustment programs.
• Independently conducts chart reviews for supporting documentation of diagnosis codes which can be added to Problem List; follows standard work for adding diagnoses to Problem List.
• Reviews new Reliant Medical Group patients for potential diagnoses supporting risk adjustment programs and updates problem list in the electronic medical record.
• With coding education team, provides clinician training for risk adjustment programs.
• Ad hoc visits to clinical sites may be scheduled to enhance coordination of team-based care and to facilitate clinician education.
• Participates in development, implementation, and monitoring of procedures that support organizational goals and business objective related to risk adjustment capture.
• Utilizes thorough understanding of CMS/Medicare coding regulations as well as technical knowledge of ICD-10 and CPT systems.

Skills

Nursing experience

Risk adjustment coding

EMR experience

Communication skills

Education

RN license MA

BLS certification

Tools

EMR systems

Job description

Reliant Medical Group, part of UnitedHealth Group, is seeking a Registered Nurse to deliver and manage patient care within a population health risk-adjustment context. The role focuses on accurate coding, chart reviews, and clinician training to support CMS risk adjustment programs.

Based in Massachusetts with remote options for MA residents, this full-time position offers 40 hours weekly, with a schedule that supports work-life balance while addressing complex chronic disease populations in