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Claro, ProFee Clinical Consultant

1 month ago

Chicago IL United States Claro Healthcare, LLC Full time

Clinical Documentation Improvement Specialist - Pro Fee

The Organization
We help society’s foundational institutions—healthcare and higher education—to achieve their full potential in service to others.

We are our clients’ trusted partners in ever-changing times. For nearly 40 years, Kaufman Hall has provided independent, objective insights grounded in sound data and analysis to help clients fulfill their missions, achieve their goals, and tackle their toughest problems.

The Position
The Revenue & Operations Improvement practice is looking for a Clinical Documentation Improvement ProFee Consultant that would join a team-based environment and be responsible for ProFee opportunity identification, ProFee education and training, and general client support. They would also be engaged in assessments, implementations, and ongoing support, including HCC, E/M changes, Value-Based Purchasing and Population Health/ACO to ensure that we are positioning our clients for success in these areas.

The Consultant would be responsible for chart reviews and audits, creating or updating tools and educational materials, providing education and training, client mentoring, ProFee clinical documentation process reviews and enhancements, supporting the enhancement of the offering, and client support. Heavy involvement and role in overall client interaction and satisfaction. Partner with clients in all phases of CDI ProFee engagements to position them for success. Participate in multiple engagements with strong teamwork and time management required.

Qualifications
The ideal candidate will possess:

  • Clinical credential: RN or MD preferred, LPN or Coding professionals with the right level of experience
  • CPC (Certified Professional Coder), CRC (Certified Risk Adjustment), or CCS-P (Certified Coding Specialist- Physician Based) is desired
  • 3+ years in a healthcare setting with focus on physician-based documentation improvement and related issues is strongly preferred
  • Three or more years’ experience in a consulting/professional service setting is desired
  • Understanding and knowledge of clinical documentation improvement for ProFee, specifically the recent changes to the E/M guidelines which now more heavily rely on medical decision making (MDM)
  • Experience with HCC reviews/audits and understanding of reporting guidelines
  • Demonstrated written and verbal communication skills and the ability to manage and prioritize multiple projects
  • Prior experience developing and delivering physician education related to documentation improvement opportunities strongly desired
  • Ability to team effectively with people of various disciplines and backgrounds is essential
  • Demonstrated ability to work independently, exercise good judgment, and be resourceful
  • Demonstrated ability for developing strong working relationships with key stakeholders and/or clients
  • Experience/knowledge of regulatory compliance issues facing the healthcare industry
  • Experience/knowledge Epic’s Population Health modules and tools is a plus
  • Ability to travel regularly for project assignments is required (50% travel)
  • Applicants for employment must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the United States and with Kaufman Hall.
Education
  • BSN, BA, BS, MBA, MA or MS from an accredited college/university is preferred
Physical Requirements
  • Must be able to perform essential duties satisfactorily with reasonable accommodations
  • Work is generally done sitting, talking, hearing and typing. Visual acuity to use a keyboard, prepare and analyze data and figures; transcribing, viewing a computer terminal; extensive reading
Work Environment
  • Travel Required: Approximately 50%
  • The role is remotely based
  • Work is regularly performed in a combination of home office and client settings and routinely uses standard office equipment
  • It may require the maintenance of a home office and proximity to an airport for work related travel

Kaufman Hall is committed to providing equal opportunity for all employees and applicants. We recruit, hire, train, promote, pay, and administer all employment actions without regard to actual and also perceived or assumed protected group status as defined by law of an individual or that individual’s associates or relatives. Our policies and the law prohibit employment discrimination against any employee or applicant on the basis of any legally protected status.

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