Registered Nurse RN Population Health Hybrid

Banner Health•Fort Collins, CO

1d•$36 - $60•Hybrid

About The Position

The Registered Nurse for Population Health provides clinical and operational coordination of Risk Adjustment efforts in support of Banner Medical Group’s strategic initiatives and program goals. The role serves as a resource on Medicare Advantage funding models, including risk adjustment, Hierarchical Condition Categories (HCCs), and HEDIS quality ratings. It collaborates with stakeholders across Banner Medical Group to implement program activities and identify opportunities to improve Risk Adjustment Factor (RAF) scores and HCC capture. The position supports the Northern Colorado patient population and physicians through thorough chart reviews and preparation of medical records and coding ahead of patients’ initial visits. The role is primarily remote in Northern Colorado, with on-site work as needed. A quiet home-office work area and reliable wired Ethernet internet connection are required. The schedule is Monday through Friday, eight-hour day shifts, with some flexibility following orientation; schedule and location details are discussed during the interview.

Requirements

Graduation from an accredited nursing program with an Associate’s, Bachelor’s, or Master’s degree in Nursing, or completion of a specialized nursing diploma program including at least two years of specialized training and/or experience.
Current, valid RN license in the state of practice, a temporary/interim RN license in the state of practice, or compact RN licensure applicable to the state of practice.
Current, valid RN license in the state of practice.
BLS certification.
Strong knowledge of healthcare provider relations, normally gained through 3–5 years of related healthcare experience.
Effective relationship development and communication skills in individual and group settings.
Attentive listening and polished presentation skills to educate providers and practices on Risk Adjustment tools.
Teamwork, critical-thinking, and project-management capabilities.
Proficiency with personal software applications, including word processing, spreadsheets, claims adjudication, and provider systems.
For remote work, reliable internet via Ethernet connection (Wi-Fi is not accepted) and a quiet work area/home office.

Nice To Haves

Additional related education and/or experience.

Responsibilities

Coordinate clinical and operational Risk Adjustment activities in support of organizational program goals.
Serve as a subject matter expert for Banner Medical Group RAF tools, including coordinating their design, testing, implementation, and ongoing availability.
Develop and deliver Risk Adjustment education and training for physicians and practices, including documentation and coding requirements, HCCs, and HEDIS quality ratings.
Build collaborative relationships with physicians, third-party vendors, and healthcare team members, and communicate timely clinical information to meet utilization and regulatory requirements.
Assess HCC recapture accuracy and comprehensiveness, and ensure diagnosis opportunities are identified promptly and appropriately.
Guide and train physicians and practices in the use of Risk Adjustment tools, including providing formal and day-to-day support.
Act as the primary contact for escalated issues involving Banner RAF tools; identify trends, escalate issues, and recommend process improvements.
Collaborate with ambulatory care management to communicate quality-performance expectations and help practices meet clinical targets.
Interpret data from multiple sources to identify Risk Adjustment trends and educational opportunities; review findings with workforce teams and develop improvement plans.
Partner with Risk Adjustment Quality Analysts and Educators to develop educational materials and support communication across workforce teams.
Participate in or lead projects to improve Risk Adjustment program offerings or address system limitations, including analysis of practice management systems, routing, vendors, and CMS submissions.
Monitor CMS Risk Adjustment data submissions for attestation; analyze reports to and from CMS to ensure accuracy and compliance; prepare, analyze, and present reports as needed.
Complete chart reviews and help prepare medical records and coding for providers ahead of patients’ initial visits.