Adventist Health System Population Management CDI Educator in MAITLAND, Florida

Description

Work Hours/Shift

Full-Time, Monday – Friday

Adventist Health System Corporate Office

Be part of the Adventist Health System family.

Where you work matters. Working here is like being part of a family. Not just with those you serve, but also with your team members. It’s about making a difference, saving lives, and helping others live a fuller one. You’ll be joining a family of tens of thousands of team members who understand that what they do is bigger than healthcare. It is living out our mission to Extend the Healing Ministry of Christ and being there for someone every step of the way-body, mind, and spirit.

This is more than a career. It is a calling.

With hospitals and facilities in 9 states, you’ll have endless opportunities to take your talents, develop your skills, and grow as a professional in a place that truly cares about your success. If you are driven, compassionate, someone who always wants to go above and beyond because you care and believe what you do makes a difference Adventist Health System is for you.

General Summary:

The purpose of this position is to provide basic Clinical Documentation Improvement (CDI) subject matter expertise, consultation and education to PHSO network providers by bringing education tailored specifically for Risk Adjustment Factor (RAF) & Hierarchical Condition Category (HCC) in correlation with Population Health related technologies. This position is also responsible for understanding and serving as an informative source on Medicare Advantage/Medicare Shared Savings (MSSP) funding models (Risk adjustment, HCCs, HEDIS quality Rate, etc.). Demonstrated ability with communicating complex educational topics in a way which facilitates understanding, for providers as well as other PHSO or AIT team staff. Uses demonstrated subject knowledge to help connect key concepts and expectations, ultimately presenting the technologies, educational opportunities, and efficiencies in a manner that is simple for providers to relate to and brings value to the ambulatory practice.

Qualifications

What you will be responsible for:

  • Serves as a subject matter resource in support of CDI. Coordinates the business design, testing and implementation of specialized technologies, tools and reports. Partners with other Risk Adjustment resources to provide guidance on utilization of Risk Adjustment tools.

  • Responsible for the development and implementation of Risk Adjustment education and training for network physicians and practices. Provides formal training and supports physicians and practices in the day to day utilization of Risk Adjustment tools throughout AHS PHSO supported practices.

  • Work in close correlation with AHS Partners (Health Plans, payers, etc.) to ensure complete, consistent coding practices.

  • Accesses and interprets data from a variety of sources to gain full understanding of Risk Adjustment trends and educational opportunities. Partners with Risk Adjustment Quality Analysts and Educators to develop educational materials. Meets regularly with workforce teams to support communication and promote partnership.

  • Participates in Risk Adjustment projects designed to improve program offerings or address system limitations.

  • Coordinates data extracts and data analysis interpretation in preparation of reports aimed to determine a provider’s Risk Adjustment Factor (RAF), and provides actionable solutions that will result in improved accuracy for documentation and coding practices.

  • Works seamlessly, effectively, and in harmony with all internal teams including, but not limited to, PHSO credentialing, provider resolution center, quality and care integration, provider education & optimization, analytics, and finance to ensure integrated operations that result in a superior consumer experience for the provider.

What you will need:

  • College Degree (B.A., B.S. or similar) in a field of study such as business, IS, education, or a healthcare related area

  • Yearly participation in ongoing education either formal or through conferences, active professional organization participation, or journal presentations.

  • 2+ years working with Clinical Documentation Improvement subject matter

  • 2+ years’ experience working collegially with physicians

  • 2+ years of experience coding

  • A basic understanding of Clinical Documentation Improvement (CDI), Risk Adjustment Factor (RAF), Hierarchical Coding Conditions (HCC’s) and chronic as well as acute conditions

  • A basic knowledge of health plan operations related to ambulatory providers

  • Basic coding experience

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.