Clinical Risk Educator (US West Coast), Remote

Clinical Risk Educator

The Clinical Risk Educator is responsible for developing and delivering educational content designed to improve accurate and complete clinical documentation practices. This role supports the clinical audiences of our external partner practices as well as Aledade's clinical and non-clinical staff internally.

Key responsibilities include performing retrospective medical chart reviews to pinpoint areas for improvement, interpreting performance data to uncover learning opportunities, and leading diagnosis documentation education for clinical audiences. The Clinical Risk Educator collaborates with colleagues and leadership to design and implement educational materials that align with regulatory compliance and value-based care principles.

This position requires a deep understanding of clinical documentation concepts, clinical practice, and general outpatient practice workflows. It also demands a commitment to fostering education that promotes high-quality, compliant documentation practices within a value-based care framework.

Candidates should be comfortable working remotely/work from home anywhere within the US.

Primary Duties:

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 staffdelivered either in person or virtuallycovering 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.

Minimum Qualifications:

Bachelor's degree in a healthcare related field or equivalent work experience required

5+ years of clinical experience

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

Preferred KSA's:

Active nursing credential as Registered Nurse (RN), Licensed Practical Nurse (LPN), or international medical graduate (IMG)

Background in working directly with providers in an outpatient setting

Experience developing and delivering clinical education and training via Google Slides or Powerpoint presentations

Ability to use insights from clinical and quality data to address opportunities for improvement

Advanced knowledge of Medicare billing and coding regulations, along with a deep understanding of CMS compliance standards and guidelines

General understanding of the billing requirements and reimbursement structures for FQHCs/RHCs

Willingness to travel as needed to Aledade's headquarters or markets

Physical Requirements:

Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.

Willingness to travel as needed to Aledade's headquarters or markets (est. 10-20% across the year)

$69,000 - $90,000 a year

Salary Range: $69,000 - $90,000 base + bonus + equity

Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies and experience.

Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.

At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.

In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:

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!