Risk Adjustment Nurse - Value-Based Care & Documentation

Beth Israel Lahey Health; United States; On-site; USD 47,000 - 70,000; Full time

Job summary

Beth Israel Lahey Health is seeking a CDI Risk Adjustment Nurse to join our clinical team. This role focuses on chart review, data abstraction, and risk gap identification to improve HCC accuracy and documentation integrity across the network.

You will collaborate with CDI, coding, and quality teams, educate providers on documentation improvement, and support pre-visit planning to optimize risk capture within value-based care programs.

Qualifications

• Graduate of an accredited RN program; Bachelor’s preferred.
• Active RN license in MA and NH.
• 3–5 years clinical experience; CDI, risk adjustment, coding, or population health preferred.
• Strong knowledge of risk adjustment (HCC), chronic condition documentation, EMRs, and coding principles.

Responsibilities

• Chart review, abstraction, and risk gap identification to support HCC score accuracy.
• Identify missed or undocumented chronic conditions; ensure alignment with clinical evidence.
• Provide provider education on clinical documentation improvement and risk adjustment.
• Collaborate with CDI, coding, quality, population health, and physician leadership teams.
• Conduct chart audits to validate accuracy and completeness; monitor compliance with standards.

Skills

Risk adjustment (HCC)

Chronic condition documentation

EMRs

Analytical skills

Communication

Collaboration

Education

RN program graduate; Bachelor’s preferred

Tools

EMRs

Job description

Beth Israel Lahey Health is seeking a CDI Risk Adjustment Nurse to join our clinical team. This role focuses on chart review, data abstraction, and risk gap identification to improve HCC accuracy and documentation integrity across the network.

You will collaborate with CDI, coding, and quality teams, educate providers on documentation improvement, and support pre-visit planning to optimize risk capture within value-based care programs.