Clinical Quality Consultant Virtual, CareBridge

Why consider this job opportunity

• Salary up to $150,800
• Comprehensive benefits package including medical, dental, and vision coverage
• Incentive and recognition programs, along with a 401(k) contribution
• Opportunity for career advancement and professional growth within the organization
• Flexible remote work arrangement with required in-person training sessions
• Commitment to equal pay opportunities for equal work

• Conduct chart reviews to ensure accurate diagnosis, documentation, and coding
• Review provider visit medical encounters and apply appropriate diagnosis codes
• Accountable for HCC/Risk Adjustment goals and workflows to support value capture initiatives
• Serve as liaison to the coding team and assist in closing HEDIS care opportunities
• Provide feedback to providers for improved documentation to support specific codes

• Master’s degree in Nursing and a minimum of 3 years of experience in applying appropriate diagnosis in the Medicare HCC model and/or CMS Risk Adjustment Model
• Current, active, valid, and unrestricted RN license and NP license in applicable state(s)
• Multi-state licensure required if providing services in multiple states
• Satisfactory completion of a Tuberculosis test is required for this position

• AAPC Certified Risk Adjustment Coder certification

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Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.