Clinical Risk Educator

This is a fully remote position, open to applicants in California.

📋 Description

• The Clinical Risk Educator is responsible for conducting qualitative retrospective chart reviews for prioritized practices to ensure comprehensive and precise clinical documentation, using quantitative measures to monitor the frequency and types of documentation errors and gaps. Through the analysis of review outcomes, they identify specific areas for enhancement in coding and clinical documentation while recognizing trends and patterns that may suggest systemic challenges or training requirements.

• This role requires the synthesis of concise, high-level summaries to convey findings, emphasizing critical areas of concern and prioritizing recommendations for improvement. Furthermore, the Educator organizes educational sessions for Aledade ACO member practices and their key personnel—delivered either in person or virtually—focused on review findings, clinical documentation, and risk adjustment concepts.

• Act as an individual contributor on the Risk Education team, partnering with team members to create and update educational resources related to clinical documentation for both internal and external audiences, including reference guides, slide presentations, and toolkits. Regularly conduct annual reviews of repository content to ensure compliance with CMS regulatory updates.

• Research, investigate, and stay informed about clinical and coding guidelines in relation to clinician documentation improvement.

• Serve as a resource for suitable clinical documentation and coding practices within the assigned region.

⛳️ Requirements

• A Bachelor’s degree in a healthcare-related field or equivalent work experience is required.

• 5+ years of clinical experience, particularly in nursing or with international medical backgrounds.

• Current medical coding certification such as Certified Professional Coder (CPC), Certified Coding Specialist - Physician-based (CCS-P), Certified Risk Adjustment Coder (CRC), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Expert Outpatient (CDEO), Certified Clinical Documentation Specialist-Outpatient (CCDS-O), etc., through AAPC, ACDIS, or AHIMA.

• 2+ years of experience in clinical documentation improvement.

• Comprehensive knowledge of ICD-10-CM, HCPCS, and CPT coding, medical terminology, human anatomy and physiology, and clinical indicators associated with disease processes and pharmacology is essential.

• Subject matter expertise in the CMS HCC Risk Adjustment program, its methodology, and its impact on value-based contracts.

• Comfortable presenting to both large and small groups in person and virtually (e.g., Google Meet, Zoom).

• Ability to work both independently and collaboratively.

• Flexible and capable of multitasking and prioritizing workload on a daily basis.

• Availability for market-specific events, including executing 1-2 Saturday events per year in select markets.

• Willingness to work occasional evening hours, with the potential for 1-2 evenings per month on a national scale.

🏝️ Benefits

• Flexible work schedules and the possibility of remote work are available for many positions.

• Health, dental, and vision insurance is covered up to 80% for employees, dependents, and domestic partners.

• Comprehensive time-off plan offering 21 days of PTO in your first year.

• Two paid volunteer days and 11 paid holidays.

• 12 weeks of paid parental leave for all new parents.

• Six weeks of paid sabbatical after six years of service.

• Educational Assistant Program and Clinical Employee Reimbursement Program.

• 401(k) plan with up to a 4% match.

• Stock options.

• And much more!