Risk Adjustment Nurse
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Job Description
CDI Risk Adjustment Nurse reviewing inpatient documentation and risk adjustment gaps for Tendo's healthcare software customers. Querying physicians and educating providers to improve clinical accuracy, quality, and financial integrity.
Responsibilities:
- Conduct QDI review of assigned inpatient cases, identifying clinically supported documentation opportunities in real time
- Develop and follow up on compliant, physician-facing documentation queries
- Communicate directly with physicians and APPs regarding documentation and quality risk adjustment opportunities
- Manage and prioritize an assigned daily review queue to meet turnaround expectations
- Participate in provider education activities related to clinical documentation, risk adjustment, and quality outcomes
- Contribute to reviewer calibration and quality assurance activities
- Support customer-specific workflows and initiatives as new health system partners onboard
- Provide clinical documentation and risk adjustment review for Tendo's QDI Services customers
- Work closely with the Director of QDI Services and fellow reviewers on quality calibration
- Support provider education initiatives across Tendo's customer portfolio
Requirements:
- 6+ years of CDI/QDI experience
- 6+ years of acute-care nursing experience
- Active RN license, in good standing
- CCDS certification
- Epic experience
- Working knowledge of HCCs, Elixhauser comorbidities, and quality risk adjustment methodology
- Direct experience communicating and educating physicians and APPs on documentation opportunities
- Ability to work independently and manage a queue with minimal oversight
- Excellent written and verbal communication skills
Benefits:
- Full health benefits (medical, dental, and vision)
- Flexible spending and health savings accounts
- Company-paid life insurance
- Company-paid short-term and long-term disability
- Company equity
- Voluntary benefits
- 401(k)
- Company-paid holidays
- Flexible time off
- Employee wellness program ("Breathe")
- Annual bonuses
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