Licensed Provider Educator

A company is looking for a Provider Educator, Stars & Risk Adjustment.

Key Responsibilities

Analyze clinical, quality, and performance data to identify areas for improvement and develop actionable plans

Educate stakeholders on clinical and coding integrity findings and develop sustainable processes for risk evaluation

Serve as a subject matter expert in clinical and coding guidelines, ensuring compliance with regulatory requirements

Required Qualifications

Bachelor's degree or equivalent combination of education and / or experience

Active and unrestricted clinical license (LPN, RN, NP, PA, MD, DO, or related field)

Coding certificate required (CPC, CRC, CCS, or equivalent)

Minimum of three years of experience in Medicare Star Rating and Risk Adjustment

Proficiency in data analysis and experience with chart reviews