Accountable Care Organization REACH Health Education Consultant
Company: Nurses Co
Location: Tallahassee
Posted on: November 19, 2023
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Job Description:
Job DescriptionCandidates preferred in New York, Florida, and
Illinois. * Involved in ACO (Accountable Care Organization)
clinical documentation and coding initiative planning, ongoing
client relationship management and satisfaction for assigned
initiatives that impact the delivery of products and services to
the internal and external environment. * Collaborates with external
vendors, external consultants, consulting team members and/or
matrixed staff as required in support of initiatives. * Accountable
for transferring knowledge, best practices (external and internal),
methodology and tools to client organizations. * Participates as a
team member, may be responsible for concurrent initiatives or act
as team lead for less complex projects based on resource
requirements.* Supports holistic solutions and/or key strategic
plans. * Proactively identifies opportunities for improvement
within assigned initiatives* Conducts thorough business case and
external customer value analysis to determine selection,
prioritization positioning and approach for broadest range of
potential solutions (e.g., outsourcing, process improvements,
technology solutions)* Participates in influencing client
contracting process, builds optimal client relationship for results
and deliverables and manages relationship throughout engagement *
Participates and supports metrics integration and execution for
optimal results. Shares joint accountability for initiatives return
on investment * Communicates compelling and concise results to
empower client groups in decision making process regarding project
opportunities* Participates in initiative planning as required. *
Supports engagement using a disciplined repeatable methodology*
Designs, develops interventions, and facilitates work sessions. *
Develops and delivers all required analysis, reporting and
presentation materials Gathers, analyzes, and synthesizes business
intelligence to drive achievement of strategic business objectives*
Builds and utilizes diverse internal and external networks, as
appropriate, for data gathering and best practice identification. *
Leverages internal and external networking to drive optimal
initiative results and knowledge/best practice transfer*
Responsible for educating providers on how to properly document HCC
conditions and interventions received during face-to-face member
encounters, including proper coding and claim submission for
services rendered. * Serves as a liaison to peers to provide
in-depth clinical knowledge and expertise to support the education
of providers.* Performs reviews of medical records to ensure all
assigned ICD-10 codes are accurate and supported by written
clinical documentation for ACO REACH Model.* Identifies barriers
utilizing critical thinking skills to identify improvement
opportunities, communicate them to the l market team, and help
facilitate gains in efficiency and appropriate risk score capture.*
Leads work groups to develop learning strategies to improve health
care delivery performance. * Serves as the training resource and
subject matter expert to regionally aligned practices.* Identifies
and recommends opportunities for process improvements at the
practice level to improve overall risk adjustment scores and gaps.
* Identifies opportunities to promote quality.* Shares best
practices in accurate clinical documentation across all
sites/regions. * Simultaneously manages multiple, complex
projects.* Position is sedentary work involving periods of sitting,
talking, listening. Work requires sitting for extended periods,
talking on the telephone, and typing on the computer.* Work
requires the ability to perform close inspection of handwritten and
computer-generated documents as well as a PC monitor.Pay RangeThe
typical pay range for this role is:Minimum: 55,300Maximum:
118,900Please keep in mind that this range represents the pay range
for all positions in the job grade within which this position
falls. The actual salary offer will take into account a wide range
of factors, including location.Required Qualifications* CPC
(Certified Professional Coder) certification and CRC (Certified
Risk Adjustment Coder) certification * 5+ years of experience
navigating EHR (electronic health records), including medical
record documentation review, diagnosis coding, and auditing.*
Willing and able to travel to ACO REACH provider offices, clinics,
and facilities.* 5+ years of computer experience, which includes
navigating multiple systems and keyboardingCOVID
RequirementsCOVID-19 Vaccination RequirementCVS Health requires
certain colleagues to be fully vaccinated against COVID-19
(including any booster shots if required), where allowable under
the law, unless they are approved for a reasonable accommodation
based on disability, medical condition, religious belief, or other
legally recognized reasons that prevents them from being
vaccinated. You are required to have received at least one COVID-19
shot prior to your first day of employment and to provide proof of
your vaccination status or apply for a reasonable accommodation
within the first 10 days of your employment. Please note that in
some states and roles, you may be required to provide proof of full
vaccination or an approved reasonable accommodation before you can
begin to actively work.Preferred Qualifications* Bachelors degree
preferred* 5+ years experience with one or more of the following
methodologies: management consulting, project consulting, business
process consulting, financial strategic analysis, strategic
business planning, and/or risk coding management consulting.*
Experience with ICD-10 codes.* Experience with Medicare and/or
Commercial risk adjustment process.* Knowledge of
regulatory/accreditor guidelines* Knowledge of quality of care *
Demonstrated experience successfully implementing change in complex
organizations.* Operational experience in a relevant discipline*
Effective communication skills required, both verbal and written.*
Ability to multi-task, prioritize and effectively adapt to a
fast-paced changing environment* Team leadership and team building
skills. * Analytical and planning skills.* Negotiation/influencing
skills.* Relationship and change management skills. .* Time
management skills and critical thinking skills.Education-
Associates degree required, or, equivalent experience.Business
OverviewBring your heart to CVS HealthEvery one of us at CVS Health
shares a single, clear purpose: Bringing our heart to every moment
of your health. This purpose guides our commitment to deliver
enhanced human-centric health care for a rapidly changing world.
Anchored in our brand - with heart at its center - our purpose
sends a personal message that how we deliver our services is just
as important as what we deliver.Our Heart At Work Behaviors support
this purpose. We want everyone who works at CVS Health to feel
empowered by the role they play in transforming our culture and
accelerating our ability to innovate and deliver solutions to make
health care more personal, convenient and affordable. We strive to
promote and sustain a culture of diversity, inclusion and belonging
every day. CVS Health is an affirmative action employer, and is an
equal opportunity employer, as are the physician-owned businesses
for which CVS Health provides management services. We do not
discriminate in recruiting, hiring, promotion, or any other
personnel action based on race, ethnicity, color, national origin,
sex/gender, sexual orientation, gender identity or expression,
religion, age, disability, protected veteran status, or any other
characteristic protected by applicable federal, state, or local
law.
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Keywords: Nurses Co, Tallahassee , Accountable Care Organization REACH Health Education Consultant, Education / Teaching , Tallahassee, Florida
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