Provider Educator

Job not on LinkedIn

🔥 2 minutes ago

🍂 Massachusetts – Remote

🍂 Massachusetts – Remote

💵 $68.8k - $80.8k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Community Care Cooperative (C3)

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2016

🏥 Healthcare

🤝 Non-profit

🌍 Social Impact

Healthcare • Non-profit • Social Impact

Community Care Cooperative (C3) is a rapidly growing non-profit created by Federally Qualified Health Centers (FQHCs) to strengthen primary care, improve financial performance, and advance racial justice. C3 unites health centers into FQHC-led accountable care networks, providing contracting, data, actuarial, and population-health capabilities to enable participation in value-based payment and care models. It also operates affiliates that deliver technology services (Community Technology Cooperative), pharmacy operations and 340B support (Community Pharmacy Cooperative), and a statewide telehealth consortium to help health centers integrate telehealth into primary and behavioral care.

📋 Description

• Design, develop, and deliver provider education programs focused on risk adjustment documentation, coding accuracy, clinical documentation integrity, and value-based care performance • Create educational materials, provider training curricula, presentations, job aids, coding reference tools, and provider-facing resources • Conduct educational provider documentation and coding reviews to identify improvement opportunities • Analyze coding, claims, RAF, quality, utilization, and population health data to identify performance trends and educational opportunities • Partner with participating health centers to improve documentation practices, coding outcomes, and value-based reimbursement performance • Provide individualized coaching, mentorship, and education to underperforming providers • Collaborate with the Senior Director of Risk Adjustment, Senior Medical Director, clinical leadership, and operational teams • Educate providers on CMS-HCC, DxCG, and other risk adjustment methodologies across Medicare, Medicaid, MSSP, ACO, and value-based care contracts • Educate providers and health center teams on the CMS-HCC Version 28 model and its documentation requirements • Deliver annual ICD-10-CM code update education • Support documentation and coding improvement initiatives across participating health centers • Monitor provider education effectiveness and recommend process improvements • Serve as a coding and documentation resource for providers, health center leadership, and internal stakeholders • Maintain current knowledge of CMS regulations, ICD-10-CM coding guidelines, risk adjustment methodologies, clinical documentation standards, and value-based care best practices • Support initiatives related to Medicare Advantage, MassHealth ACO, MSSP, Medicaid, and other value-based reimbursement programs

🎯 Requirements

• Bachelor's degree in Healthcare Administration, Public Health, Health Information Management, Nursing, Business Administration, or a related healthcare field required • AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS) required • AAPC Certified Risk Adjustment Coder (CRC) preferred • Minimum of 3–5 years of progressive experience in risk adjustment, medical coding, clinical documentation improvement, provider education, population health, value-based care, or healthcare consulting • Demonstrated experience educating physicians, advanced practice providers, and clinical teams on documentation and coding best practices • Demonstrated experience with CMS-HCC risk adjustment methodologies, including the Version 28 (V28) model, within a Medicare ACO (MSSP) or similar Medicare value-based care program required • Experience supporting Medicaid, ACO, or alternative risk adjustment models, including DxCG, strongly preferred • Advanced knowledge of ICD-10-CM coding principles, clinical documentation integrity, and risk adjustment methodologies • Strong understanding of CMS-HCC V28 and alternative risk adjustment methodologies, including the MassHealth DxCG model • Knowledge of Medicare, Medicaid, MSSP, ACO, and value-based reimbursement models • Experience conducting provider education, training, coaching, and performance improvement initiatives • Ability to interpret coding, claims, quality, utilization, and performance data • Ability to identify trends, performance gaps, and educational opportunities through data analysis • Excellent verbal, written, presentation, and facilitation skills • Strong relationship-building skills with providers, health center leadership, and multidisciplinary teams • Proficiency with electronic health records, coding software, reporting platforms, and population health tools • Equivalent combinations of education and experience may be considered • Employees must be vaccinated consistent with applicable law

🏖️ Benefits

• Salary range of $68,806–$80,847 annually • Vaccination consistent with applicable law required for infection control compliance