Risk Adjustment Provider Educator

Millennium Healthcare Management Serv LLC; Indiana (PA); Hybrid; USD 77,000 - 116,000; Full time

Benefits offered by this job

3 weeks PTO

Medical, Dental, Vision

401(k) with match

Employee Wellness

Life Insurance

Job summary

Millennium Physician Group seeks Risk Adjustment Provider Educators to deliver education across three Indiana regions. Hybrid role with travel to physician offices; responsibilities include transforming data into actionable insights, auditing coding patterns, and guiding best practices in documentation.

The role requires CRC certification, 2+ years in risk adjustment, and strong communication. Expect collaboration with clinical teams and ongoing education to improve HCC outcomes.

Qualifications

• 2+ years in training program design and development.
• 2+ years in risk adjustment and ICD-10 coding in the Medicare Risk Adjustment environment.
• CRC or similar certification.
• Strong critical thinking and analytical skills with extensive knowledge of HCC Risk Adjustment models.
• Proven ability to analyze data, present results through provider education, and monitor effectiveness of the education provided.
• Strong communication skills.
• Intermediate Excel skills (Pivot tables, VLOOKUP, Advanced formulas, etc.) and data visualization skills.
• Intermediate PowerPoint skills to transform analytical output into visuals.
• In-depth knowledge of ICD-10-CM diagnostic coding.
• Excellent time management, organization, self-motivation.
• Excellent customer service, problem-solving, attention to detail.
• Ability to follow through timely on tasks.
• Excellent written, verbal, and interpersonal communication skills.
• Initiative; tact; poise; neat appearance; and physical condition commensurate with the role.
• Project management of multiple initiatives with prioritization and deadlines.
• Ability to work independently in a fast-paced, cross-functional environment.

Responsibilities

• Transforms raw data into actionable intelligence to prioritize provider education and risk adjustment initiatives.
• Analyzes provider coding patterns and performs follow-up audits post-education to track documentation and coding improvement.
• Demonstrates knowledge and application of coding policies to the review process.
• Maintains accuracy and attention to detail in all analyses and reports.
• Builds relationships with clinical and clerical teams for open communication about the Risk Adjustment program.
• Promotes company values and supports providers and staff through education and guidance.
• Performs other related duties as assigned.

Skills

Training design

Risk adjustment

ICD-10 coding

Data analysis

Communication

Excel

PowerPoint

Time management

Customer service

Project management

Independence

Education

Bachelor’s degree or equivalent

CRC certification

Tools

Excel

PowerPoint

Job description

Job Description Summary

The Risk Adjustment Provider Educator provides Risk Adjustment education to providers and all support staff through a variety of mediums including direct interactive learning sessions individually or in group settings, written guides and protocols, audits, etc. This role will provide analytical interpretation of Risk Adjustment data to determine areas of focus and improvement opportunities. In addition, this role will facilitate and provide detailed analysis, reporting, training, education, and support to Providers and staff to promote accurate clinical documentation along with HCC opportunities identified via performed analysis.

Position is a hybrid role; work is remote with some travel to physician offices in the region.

We are looking for 3 Educators to cover 3 different regions: Central Region: Beech Grove, Camby, Carmel, Columbus, Greenwood, Indianapolis, Mooresville, & Plainfield West Region: Brook, Crawfordsville, Lafayette, Rensselaer, West Lafayette, & Wheatfield North Region: Cedar Lake, Chesterton, Crown Point, Dyer, Hammond, LaPorte, Lowell, Michigan City, Munster, Schererville, St. John, Valparaiso, & Winfield

Responsibilities

• Transforms raw data into actionable intelligence to prioritize provider education and risk adjustment initiatives.
• Possesses a proven ability to analyze, report, and provide data insights.
• Identifies documentation and coding improvement opportunities and gives guidance around best practice strategies in risk adjustment performance.
• Analyzes provider coding patterns and performs follow-up audits post-education to track documentation and coding improvement.
• Demonstrates knowledge and an ability to apply coding policies and guidelines to the provider documentation review process.
• Possesses excellent attention to detail.
• Stays current on applicable documentation guideline changes and rules.
• Works effectively and efficiently within a team environment.
• Adaptable to shifting priorities and demonstrates a willingness to do what it takes to meet team needs.
• Understands and complies with policies and procedures for confidentiality of all patient records, HIPAA, and security of systems.
• Promotes Millennium Physician Group’s values.
• Build relationships with the clinical and clerical teams to ensure open communication for questions concerning the Risk Adjustment program and its components
• Demonstrate excellent guest service to internal team members and patients.
• Perform other related duties as assigned.

Qualifications

• Bachelor’s Degree or equivalent work experience.
• 2+ years of experience in training program design and development
• 2+ years of experience in risk adjustment and ICD-10 coding in the Medicare Risk Adjustment environment
• Certified Risk Adjustment Coder (CRC) or similar.
• Possess strong critical thinking and analytical skills and an extensive, in-depth knowledge of the HCC Risk Adjustment models.
• Proven ability to analyze data, present results effectively through provider education, and monitor the effectiveness of the education provided.
• Strong communication skills.
• Intermediate Excel skills (Pivot tables, VLOOKUP, Advanced formulas, etc.) and data visualization skills.
• Intermediate Microsoft PowerPoint skills with the ability to transform analytical output into simpleto- understand visuals.
• In-depth knowledge of ICD-10-CM diagnostic coding.
• Must have excellent time management skills, be highly organized, self-motivated.
• Excellent customer service, problem-solving skills, and attention to detail.
• The ability to follow through timely on tasks is essential.
• Possess excellent written, verbal, and interpersonal communication skills.
• Must possess initiative; tact; poise; neat personal appearance; and physical condition commensurate with the requirements of the position.
• Project management of multiple initiatives with the ability to prioritize and meet deadlines.
• Ability to work independently in a fast-paced, cross-functional environment.

Benefits

• 3 weeks PTO & 8 paid holidays
• Medical, Dental, Vision
• Employer Paid Basic Life & Short Term Disability coverage (goes into effect after 1 year of full-time employment)
• 401(k) with match
• Employee Wellness
• Other Employee Discount programs like Tickets at Work and cell phone discounts
• Dependent Care FSA, Voluntary Life, Long Term Disability, Critical Illness, Pet Insurance, and more

Why Millennium?

Millennium Physician Group is one of the largest comprehensive primary care practices with healthcare providers throughout Florida. At Millennium Physician Group, you will find an organization that focuses on family and building a strong network of people to care for the communities we serve. We are always searching for employees who have a strong customer service attitude, fantastic teamwork skills and a willing smile ready to share. Our promise is to provide you with the tools to do your job successfully, as well as providing a team atmosphere that empowers you to seek better ways to deliver care to our patients and their families. We also promise to care for you as an individual, and help you grow in your role with Millennium Physician Group. If you are interested in joining an organization that puts an emphasis on team work and family, then Millennium Physician Group is the right choice.

Compensation Range

$77,417.00 to $116,126.00 The anticipated base salary range represents the Company's good-faith estimate of the compensation it reasonably expects to pay for this position at the time of posting. Actual compensation will be determined based on factors including experience, skills, qualifications, geographic location, internal equity, and business needs.