Registered Nurse (RN) Clinical Educator, Risk Adjustment - FT/D (8hr) Eligible for $5K Sign On Bonus

MMF-Medical Foundation
Full Time
Day Job
Job Listing: 
Health- Information Management Transcription

Purpose Statement / Position Summary

This position will provide clinical expertise and education to physicians and physician staff regarding the CMS-HCC risk adjustment program. The Clinical Educator will develop tools and reports which assist physicians in improving documentation compliance and quality. Further, this position identifies strategies and workflow improvements which assist the organization in meeting our Risk Adjustment reimbursement goals.

Essential Job Outcomes & Functions

  • Learn the CMS-HCC risk model with the goal of complete working knowledge of the model and importance of accurate documentation and coding of ICD codes

  • Develop and maintain relationships with physician offices as a professional representative of MCMF to provider offices.

  • Educate physicians, physician staff, RAF staff using extensive clinical expertise on specific disease state guidelines.

  • In-depth analysis of medical practice workflow to discover optimization opportunities for physician offices

  • Analyze medical records and reports of physician coding/documentation

  • Eventual fluency in current CMS methodology and ability to keep up with future industry changes to the model

  • Conduct individual and group educational session with physicians

  • High level understanding and experience with HIPAA guidelines and processes.

  • Ability to work independently and make decisions regarding design, implementation and delivery of initiatives focused on improving the physician practice revenue stream and accuracy of coding related to their patient�s reported medical conditions and procedures.


Minimum Requirements / Work Experience

� At least 2-5 years of clinical experience necessary

� Experience with ICD coding preferred

� Ability to lead and manage through influence and change

� Strong interpersonal and communication skills

� Ability to deliver results for meeting organizational objectives

� Ability to master Medicare Risk Adjustment Factor compensation methodology and subsequent medical terminology/coding

� Effective presentation style

� Highly professional manner

� Excellent verbal and written skills

� Strong PC skills including Microsoft Word, Excel and PowerPoint

Education / Licensure / Certification

� RN with strong clinical background

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