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Provider Advisor, CDI Education
Provider Advisor, CDI EducationArchWell Health • Nashville, TN, United States
Provider Advisor, CDI Education

Provider Advisor, CDI Education

ArchWell Health • Nashville, TN, United States
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  • [job_card.full_time]
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Provider Advisor - CDI Education

Job Summary

ArchWell Health Provider Advisor, CDI Education reporting to the Chief Clinical Officer, will be an integral part of the market clinical documentation education team. The Provider Advisor-CDI Education is responsible for advising and educating all aspects of Medicare Advantage Care. This role will supervise the Clinical Documentation (CDI) support team and support market assigned CCACPs, Market Medical Directors, Clinical Applications, Quality, Pharmacy, Compliance and operational teams. The Provider Advisor at ArchWell Health will be the subject matter expert on clinical documentation that improved value-based care over multiple markets and states in an outpatient senior-focused primary care setting.

Essential Duties / Responsibilities

  • Update ArchWell Health's onboarding and training materials to changes in ICD-10 and yearly CMS final notices of methodological changes for Medicare Advantage
  • Develop and maintain a documentation education schedule for all West market providers at ArchWell Health
  • Partner with the Clinical Application team to improve electronic documentation of member encounters
  • Analyze disease prevalence trends, suspect diagnosis assessments, redocumentation rates and report plans and outcomes to Senior Market Medical Director and SVP of Operations for the West.
  • Develop case reviews and training plans to improve prevalence rates
  • Provides live, in-market and virtual, introductory and ongoing training in clinical documentation to all new providers and CDI support team
  • Provide training to market providers on a monthly cadence, or more frequent, as needed.
  • Attend health plan JOCs as needed
  • Support providers, the CDI team and CCACPs regarding clinical diagnosis criteria and disease process recognition.
  • Serves as expert resource to coders and providers on clinical documentation
  • Develop programs that drive quality improvement in documentation integrity and compliance.
  • Work with Vendor-partners on supplemental education programs
  • Additional responsibilities and duties as requested and deemed necessary by the senior leadership team and Chief Clinical Officer

Required Education and Experience :

  • MD, DO, NP or PA degree
  • Minimum of 3 years' experience with Medicare Risk Adjustment
  • Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) preferred
  • Knowledge, Skills, and Abilities :

  • Experience with Electronic Medical Records
  • Proficient with Microsoft Office Suite products including Word, Excel, Power Point, and Outlook, and Teams
  • Ability to travel to visit centers to provide education
  • Excellent presentation, verbal, and written communication skills
  • Ability to exercise the use of independent judgement
  • Sensitivity to the diverse needs of culturally diverse staff, patients, and communities
  • Experience in the development and analysis of internal dashboards
  • Embodies and serves as a role model of ArchWell Health's Values :
  • Be compassionate
  • Strive for excellence
  • Earn trust
  • Show respect
  • Stay resilient
  • Always do the right thing
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