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Clin Risk Adj Consultant

Advocate Physician Partners (APP) brings together more than 4,000 physicians who are committed to improving health care quality, safety, and outcomes for patients across Chicagoland and Central Illinois. APP is a leader in population health management and has garnered wide-spread national recognition for its innovative clinical integration program.  Formed as a care management collaboration with Advocate Health Care, APP supports its physician members in managing the health of their practices with contracting, medical management, electronic medical records and other value-added services.

CLINICAL RISK ADJUSTMENT CONSULTANT 

Site:- Advocate Physicians Partners 

Location: ILLINOIS/ INDIANA/ WISCCONSIN

Status: Fulltime

This role will primarily work with our Aligned Non Employee Physicians within Advocate Physician Partners.

 

OUR PURPOSE: 

We Help People Live Well

OUR VALUES:

  • Excellence: We are a top performing health system in all that we do and continually find new and better ways to improve.
  • Compassion: We unselfishly care for others.
  • Respect: We treat people in a way that value their unique needs and preferences.

 

Position Requirements:
Bachelor's Degree in Health Information Management, or
Bachelor's Degree in Nursing or related field.
Typically requires 5 years of experience in healthcare (payer, population health, quality, coding, managing health care clinical risk or similar industry)
Ability to lead programs interacting with all levels of the organization
Medicare Advantage knowledge strong preference
Strong knowledge of ICD diagnoses coding guidelines and Medicare Risk Adjustment Payment Methodology related to HCC/RAFs
Professional experience influencing changes in behavior.
Knowledge of payor plan requirements and impact to RAF scores as it relates to MSSP and Medicare Advantage programs
Knowledge of EPIC and reporting solutions
Ability to operate in a fast~paced, dynamic environment
Detail oriented possess strong initiative, problem solving skills and ability to set/manage multiple priorities to meet deadlines in an expedient and decisive manner with minimal supervision
Intermediate proficiency in Word, PowerPoint, Excel, Outlook including ability to create pivot tables, formatting, sorting, create sheets with formulas (sum, vlookup)
Strong verbal/written communication skills ability to present in front of a group ability to translate coding/EHR issues in plain language to providers via tip sheets, case studies, in person/emails
Excellent organizational capabilities to execute projects/program and work effectively as a team player
Strong aptitude for critical thinking and demonstrated analytical and data skills.

Willingness to acquire new knowledge from an unfamiliar domain Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA), or
Registered Nurse license issued by the state in which the team member practices, or
Certified Risk Adjustment Coder (CRC) issued by American Academy of Professional Coders (AAPC). needs to be obtained within 1 year.
Must be able to drive to various sites throughout the Advocate Aurora Health footprint so therefore will be exposed to weather and road conditions.

Ability to work from home or in office setting.
Operates all equipment necessary to perform the job.
Exposed to normal office environment.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Purpose:
Coordinates, facilitates, implements and participates as a subject matter expert within the organization for Clinical Risk Adjustment (CRA). The role is responsible for clinical risk adjustment education, performance improvement planning and monitoring the comprehensive Clinical Risk Adjustment plan for AAH. This is an enterprise role with primary focus on contracts held by APP and employed Medical Groups. The role partners closely with the Coding and Auditing teams. This role implements new and existing healthcare Risk Adjustment strategies, provides education and workflow recommendations to providers, identifies EHR. CRA related opportunities, troubleshoots and tests CRA related EHR enhancements and conducts data collection and is responsible for monitoring key performance measurement activities.

Accountabilities:
Develops, coordinates and implements the strategic direction of the CRA program as it relates to the education for Advocate Aurora Health and Advocate Physician Partners. This includes providing education, consultation and direction to the providers and all levels of the organization as it relates to managing clinical risk.
Develops, standardizes, maintains and implements risk adjustment training programs, materials, websites and workflow

About Advocate Health Care

 

Advocate Health Care, named among the nation’s Top 5 large health systems based on quality by Truven Analytics, is the largest health system in Illinois and one of the largest health care providers in the Midwest. Advocate operates more than 250 sites of care, including 12 hospitals that encompass 11 acute care hospitals, the state’s largest integrated children’s network, the state’s largest emergency and Level I trauma network, one of the area’s largest home health care companies, and the region’s largest medical group. Advocate Health Care has 4 teaching hospitals and is a not-for-profit, mission-based health system affiliated with the Evangelical Lutheran Church in America and the United Church of Christ.

Posted
04/05/2021
Salary Range
$59,000.00 - 100,000.00
per Year
Salary range estimated by
Location
Downers Grove, IL 60515, US