Bilingual Risk Adjustment Nurse Practitioner
7 days ago
Southland Care Coordination Partners is seeking a skilled Risk Adjustment Nurse Practitioner to join our team. As a key member of our Medical Management Services department, you will play a critical role in improving prospective risk adjustment results and closing care gaps for our health plan members.
Key Responsibilities:- Perform comprehensive health risk assessments for assigned members to identify potential health risks and opportunities for improvement.
- Develop and maintain accurate and up-to-date clinical profiles for members, including relevant medical history, diagnoses, and treatment plans.
- Provide detailed documentation and notes to support clinical profiles, ensuring compliance with regulatory requirements and performance goals.
- Apply appropriate clinical coding to updated clinical profiles, ensuring accurate and timely data submission.
- Collaborate with direct report and other stakeholders to ensure timely management notification of critical member issues or concerns.
- Participate in mandatory and regulatory trainings, including SCCP and CMS requirements.
- Attend staff meetings and contribute to team discussions.
- Certified Nurse Practitioner (NP) with significant clinical experience.
- Active State of Illinois Nurse Practitioner license.
- Experience in conducting risk adjustments or health risk assessments.
- Proficiency in diagnosis, billing, and quality measures.
- Understanding of Medicare and Medicaid health plans.
- Experience using an EMR to input assessment data.
- Able to work a minimum of twenty (20) hours per week.
- Good communication skills.
- Ability to interact with healthcare professionals in a professional manner.
- Experienced diagnostician and critical thinker.
- Experienced with ICD-10 diagnostic codes and HCC codes.
- Excellent organizational, written, and verbal communication, and interpersonal skills.
- Competitive salary range: $110,000 - $124,000 per year.
- 401(k) plan.
- Dental insurance.
- Health insurance.
- Life insurance.
- Paid time off.
- Retirement plan.
- On-site/remote work arrangement.
- 1 year of experience in health risk assessment or risk adjustment.
- 1 year of experience using an EMR.
- Preferred: 1 year of experience in a related field.
- Spanish (preferred).
- Certified Nurse Practitioner (required).
- Impact (preferred).
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