Compliance Medical Oncology Educator

McKesson-posted about 19 hours ago
Full-time • Mid Level
Remote • Usa, GA
5,001-10,000 employees
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McKesson is an impact-driven, Fortune 10 company that touches virtually every aspect of healthcare. We are known for delivering insights, products, and services that make quality care more accessible and affordable. Here, we focus on the health, happiness, and well-being of you and those we serve – we care. What you do at McKesson matters. We foster a culture where you can grow, make an impact, and are empowered to bring new ideas. Together, we thrive as we shape the future of health for patients, our communities, and our people. If you want to be part of tomorrow’s health today, we want to hear from you. Title: Compliance Medical Oncology Educator Remote/Hybrid/Onsite: REMOTE Position Summary: Under minimal supervision, the Compliance Medical Oncology Educator provides expert guidance on billing, coding, and reimbursement practices related to Medical Oncology, Hematology, and will specialize in Medicare Care Management services. This role ensures compliance with federal and state regulations and supports network practices through documentation reviews and education across a range of services, including evaluation and management (Medical Oncology and Hematology Services), infusion services, behavioral health, Remote Therapeutic Monitoring, licensed clinical social work, principal illness navigation, community health integration, care planning, and like services. As a McKesson employee, the educator will collaborate closely with The US Oncology Network administrative leadership and customer practices to deliver coding and billing support, manage educational projects, and foster strong relationships with providers, APPs, and other healthcare professionals. This position requires exceptional communication skills, a deep understanding of government regulations and reimbursement guidelines and a close working relationship with clinical, coding, and billing staff. Support and adhere to the US Oncology Network’s Compliance and Ethics program, including the Code of Conduct.

  • Serve as subject matter expert (SME) on coding and documentation for Care Management and Hematology initiatives providing guidance and support across departments.
  • Research, develop and deliver training and coding tools for The Network practice physicians, APPs, clinical staff and billing and coding staff on various healthcare related topics.
  • Topics include, but are not limited to risk adjustment, HCC coding and documentation best practices tailored to CMS – Care Management Services, behavioral health, principal illness navigation, community health integration, and other CMS-aligned services and programs.
  • Perform regular and on-going reviews of medical record documentation, for coding and documentation compliance.
  • Provide individualized education to physicians, APPs, and other clinical staff based on compliance audits, or third-party reviews.
  • Collaborate with compliance, revenue cycle management, transformation and shared services, and clinical teams to align education with regulatory requirements and organizational goals.
  • Assist with establishing a robust Coding/Training program across The Network.
  • Review, research, and respond to practice billing and coding questions within a designated deadline.
  • Collaboration with compliance auditors regarding medical record reviews and provide education for improvement.
  • Manage educational projects, including scheduling and coordinating sessions with practices, billing offices, and clinical teams.
  • Ensures strict confidentiality of patient information.
  • Accountable for meeting or exceeding both production and quality expectations.
  • Meets or exceeds short-term and long-term goals as established for the department.
  • Participates in staff meetings and attends other meetings and seminars as required.
  • Experience working in a dynamic environment where plans will be adjusted based on environmental and business drivers.
  • Ability to work independently and proactively with a sense of urgency and tact.
  • Extremely detail-oriented with the ability to identify and track requirements for work plans.
  • Knowledgeable of Microsoft Word, Excel, and PowerPoint
  • Other duties as assigned by leadership.
  • Degree or equivalent and typically requires 7+ years of relevant experience.
  • Four (4) + years of direct experience in CPT, ICD-10-CM, HCPCS, and HCC coding for Medical Oncology, Hematology Oncology, and CMS- Care Management Services.
  • Three (3) Years Compliance Auditing and Physician Education.
  • 2 years’ project management experience.
  • Current CPC required, CPMA and/or CCS-P certification a plus.
  • Bachelor’s degree in healthcare administration, health information management, or related field.
  • Strong understanding in behavioral health, risk adjustment models and hierarchical condition categories, and clinical documentation improvement.
  • Expertise in compliance and government regulations related to CMS Care Management, Value Base Care and Hematology/Medical Oncology in outpatient physician settings.
  • Thorough understanding of CPT, ICD-10-CM, HCPCS, and HCC coding standards.
  • Proficiency in Microsoft Office Suite (Outlook, Excel, Word, Teams, PowerPoint, CoPilot).
  • Experience with virtual meeting platforms (e.g., Webex, Microsoft Teams).
  • Proficiency in data analysis and reporting tools (e.g., SmartSheet)
  • Strong presentation and communication skills, with the ability to engage diverse clinical audiences.
  • Must be available for up to but not limited to 20% travel
  • Must be authorized to work in the US.
  • Sponsorship is not available for this position.
  • CPMA and/or CCS-P certification a plus.
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