Provider Advisor, CDI Education

ArchWell Health•Nashville, TN

About The Position

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.

Requirements

MD, DO, NP or PA degree
Minimum of 3 years’ experience with Medicare Risk Adjustment
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

Nice To Haves

Certified Professional Coder (CPC) or Certified Risk Adjustment Coder (CRC) preferred

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