Clinical Risk Educator

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🕒 May 20

🏄 California – Remote

🏄 California – Remote

💵 $69k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🎲 Risk

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Aledade, Inc.

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2014

⚕️ Healthcare Insurance

🏢 Enterprise

Healthcare Insurance • Enterprise

Aledade, Inc. is a public benefit corporation that operates as the largest network of independent primary care practices in the United States. The company specializes in Accountable Care Organizations (ACOs), which help primary care practices and health centers improve patient outcomes and generate sustainable revenue through value-based care solutions. Aledade offers data insights, support, and business solutions to achieve sustainability and clinical autonomy. It collaborates with a wide range of healthcare providers, including primary care practices, community health centers, and network ACOs, ensuring improved quality of care and patient satisfaction. With operations in 45 states and affiliations with over 20,000 clinicians serving more than 2. 5 million patients, Aledade is committed to reducing care fragmentation and enhancing the overall quality of life for clinicians and patients alike.

📋 Description

• The Clinical Risk Educator performs qualitative retrospective chart reviews for prioritized practices to ensure complete and accurate clinical documentation, utilizing quantitative measures to track the frequency and types of documentation errors and gaps. By analyzing review outcomes, they pinpoint specific areas for improvement in coding and clinical documentation while identifying trends and patterns that may indicate systemic issues or training needs. This role involves synthesizing concise, high-level summaries to illustrate findings, highlighting critical areas of concern, and prioritizing recommendations for improvement. Additionally, the Educator conducts educational sessions for Aledade ACO member practices and their key staff—delivered either in person or virtually—covering review findings, clinical documentation, and risk adjustment concepts. • Serve as an individual contributor on the Risk Education team, collaborating with team members to develop and update educational materials related to clinical documentation for both internal and external audiences, inclusive of reference guides, slide decks, and toolkits. Conduct ongoing annual reviews of repository content to ensure alignment with CMS regulatory updates. • Research, investigate and remain up to date on both clinical and coding guidelines as they relate to clinician documentation improvement. • Serve as a resource for appropriate clinical documentation and coding practices for assigned region.

🎯 Requirements

• Bachelor’s degree in a healthcare related field or equivalent work experience required • 5+ years of clinical experience (in particular nursing or 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 clinical documentation improvement experience • Extensive knowledge of ICD-10-CM, HCPCS and CPT coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology is required • Subject matter expertise on the CMS HCC Risk Adjustment program, methodology, and impact to value-based contracts • Comfortable presenting to large and small groups in person and in virtual format (Google Meet, Zoom, etc.) • Ability to work both independently and collaboratively • Flexible and able to multi-task and prioritize work load on a daily basis • Availability for market-specific events, including the execution of 1-2 Saturday events per year in select markets • Flexibility to work occasional evening hours, with the potential for 1-2 evenings per month on a national scale

🏖️ Benefits

• Flexible work schedules and the ability to work remotely are available for many roles • Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners • Robust time-off plan (21 days of PTO in your first year) • Two paid volunteer days and 11 paid holidays • 12 weeks paid parental leave for all new parents • Six weeks paid sabbatical after six years of service • Educational Assistant Program and Clinical Employee Reimbursement Program • 401(k) with up to 4% match • Stock options • And much more!