Job Title: Risk Adjustment Nurse Practitioner (Walk-in Clinic)
Job Category: Clinical
Department/Group: Medical Management Services / Risk Adjustment
Direct Report: Manager of Risk Adjustment
Location: On-site/Remote
Job Description: The Nurse Practitioner is responsible for performing Member health assessments to help improve prospective risk adjustment results and close care gaps.
Role and Responsibilities:
- Perform Walk-in/Telephonic/Telehealth Health Risk Assessments for assigned Health Plan Members.
- Complete an accurate and substantiated clinical profile of assessed members.
- Provide comprehensive and detailed documentation and notes that support updated clinical profile.
- Apply appropriate clinical coding to updated clinical profiles.
- Compliant with Performance Goals / Contract Deliverables of Health Plan.
- Timely management notification of any critical member issue/concern.
- Participates in all SCCP mandatory and CMS regulatory trainings.
- Attends all staff meetings – in person or telephonic.
- Other duties as assigned by Direct Report.
Qualifications and Education Requirements:
- A certified Nurse Practitioner (NP) with considerable clinical experience.
- Active State of Illinois Nurse Practitioner license.
- Experienced in conducting Risk Adjustments or Health Risk Assessments.
- Proficient with Diagnosis, Billing, and Quality Measures.
- Understanding of Medicare and Medicaid Health Plans.
- Experienced in using an EMR to input assessment data.
- Able to work a minimum of twenty (20) hours per week.
Preferred Skills:
- Good communication skills.
- Ability to interact with health care professionals in a professional manner.
- Experienced diagnostician and critical thinking
- Experienced with ICD-10 diagnostic codes and HCC codes
- Excellent organizational, written, and verbal communication, and interpersonal skills.
Job Type: Full-time
Pay: $110,000.00 - $124,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
Medical specialties:
Standard shift:
Supplemental pay types:
Weekly schedule:
- Monday to Friday
- Weekends as needed
Work setting:
- Clinic
- In-person
- Telehealth
Experience:
- Health Risk Screenings: 1 year (Required)
- EMR systems: 1 year (Required)
- Telehealth: 1 year (Preferred)
Language:
License/Certification:
- Certified Nurse Practitioner (Required)
- Impact (Preferred)
Work Location: In person