American Addiction Centers logo
American Addiction Centers

Leading nationwide provider of substance use treatment offering a full continuum of care. #FreedomFromAddiction

Condition Management & Documentation Consultant

ConsultantConsultantFull TimeRemoteMid LevelTeam 1,001-5,000Since 2012H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

7 days ago

Salary

$38 - $57 / hour

Seniority

Mid Level

No structured requirement data.

Job Description

Condition Management & Documentation Consultant

American Addiction Centers

Role Description The role involves developing, coordinating, and implementing the strategic direction of the CMD program related to education for Advocate Aurora Health and Advocate Physician Partners. Responsibilities include: - Providing education, consultation, and direction to providers and all levels of the organization regarding clinical risk management. - Developing, standardizing, maintaining, and implementing risk adjustment training programs, materials, websites, and workflows. - Serving as the subject matter expert for Condition Management and Documentation topics, maintaining knowledge of Medicare and risk-based reimbursement methodologies. - Collaborating with coding auditors to identify CMD-related focus areas and coordinate manual chart reviews. - Participating in risk-adjustment chart reviews and sharing findings as appropriate. - Engaging in EHR updates related to Risk Adjustment and troubleshooting informatics. - Data mining and synthesizing raw data to present key performance indicators and provide analysis on progress and results. - Collaborating with quality, operations, and providers to develop recommendations for improvement plans. - Working with stakeholders to develop new EHR tools and optimize existing functionality. Qualifications - Health Information Administrator (RHIA) registration, Registered Nurse license, or Certified Risk Adjustment Coder (CRC) required. - Bachelor's Degree in Health Information Management, Nursing, or related field. - Typically requires 5 years of experience in healthcare (payer, population health, quality, coding, managing healthcare clinical risk, or similar industry). Requirements - Ability to lead programs interacting with all levels of the organization. - Strong knowledge of Medicare Advantage, ICD diagnoses coding guidelines, and Medicare Risk Adjustment Payment Methodology. - Professional experience influencing changes in behavior. - Knowledge of payor plan requirements and their impact on RAF scores. - Knowledge of EPIC and reporting solutions. - Detail-oriented with strong initiative and problem-solving skills. - Intermediate proficiency in Word, PowerPoint, Excel, and Outlook. - Strong verbal/written communication skills and ability to present in front of a group. - Excellent organizational capabilities to execute projects and work effectively as a team player. - Strong aptitude for critical thinking and demonstrated analytical skills. Benefits - Comprehensive suite of Total Rewards including benefits and well-being programs. - Competitive compensation based on qualifications and experience. - Paid Time Off programs. - Health and welfare benefits including medical, dental, vision, life, and disability. - Flexible Spending Accounts for eligible health care and dependent care expenses. - Family benefits such as adoption assistance and paid parental leave. - Defined contribution retirement plans with employer match. - Educational Assistance Program.

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