Risk Assessment Clinical Educator
Responsible for the delivery and implementation of all clinical education materials and initiatives to employed and contracted providers, as well as KPIs within their region designed to ensure appropriate practices related to risk adjustment activities, HEDIS measures, and any appropriate gaps in care. The Clinical Educator is also responsible for performing comprehensive chart reviews to inform primary care providers of potential inferred, embedded, out of date, inaccurate, and/or missed diagnoses not previously identified and aid in the education and discovery of opportunities for improved quality of care and compliance through accurate coding and documentation. The Clinical Educator is further responsible for keeping up to date on changes in the Medicare risk adjustment model or other documentation requirements.
The Clinical Educator works collaboratively with the Regional Medical Director, Risk Adjustment program director, other Clinical Educators, coding department, lead physicians, site administrators, primary care physicians, specialists, surgeons, and hospitalists to educate on and improve accurate coding and documentation skills, leading to a more complete patient record.
- Serve as a resource for the region, network, and national operations on proper coding and documentation.
- Provides education to employed and contracted physicians, PAs, and ARNPs on appropriate supporting documentation, assists in workflow development when requested, and ensures compliant documentation standards are met.
- Recommends ongoing chart review process to ensure continued high standards in documentation and coding.
- Responsible for onboarding, ongoing, and targeted education of all physicians on coding and documentation for Medicare risk adjustment.
- Be accountable for the overall improvement and performance in risk adjustment, HEDIS and any appropriate gaps in care metrics.
Posted October 5, 2020