Description
Bring your heart to CVS Health. Every 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.
Position Summary Schedule is Monday-Friday, standard business hours, 8:00am-5:00pm. Applicants may reside anywhere in the US, with flexibility for occasional evening meetings based on business needs/time to 10% Nurse Educator Consultant reporting to the Revenue Integrity Education and Outreach Team will work with internal partners to identify and coordinate education initiatives to providers. This position will be responsible for delivering risk adjustment documentation and coding education at the direction of the Revenue Integrity management and leadership.- Uses clinical and ICD-10 coding skills to assess, plan, monitor, and evaluate healthcare services in the provider office setting.- Responsible for educating providers on how to properly document medical services 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 audits of medical records to ensure all assigned ICD-10 codes are accurate and supported by written clinical documentation.- Identifies barriers utilizing critical thinking skills to identify improvement opportunities, communicate them to thenational 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 network practices . - Identifies and recommends opportunities for process improvements at the practice level to improve overall riskadjustment scores and gaps.- Identifies opportunities to promote quality.- Shares best practices in risk adjustment across all sites/regions.- Simultaneously manages multiple, complex projects. Please replace this section with the Job SummaryRequired Qualifications:
- RN with current unrestricted state licensure required; will also accept a compact RN license- Willing and able to to obtain the CRC (Certified Risk Adjustment Coder) certification within 6 months post hire required- 3+ years clinical experience- 1+ year experience computer proficiency with experience/understanding of electronic medical records/electronic health records in the office setting required
Preferred Qualifications
-Experience with MCO, Medicare, Medicaid, ACA- Experience working with training/education in corporate structure
- Experience in medical record documentation review, diagnosis coding, and/or auditingEducation-RN degree, Bachelor degree preferred
Pay Range
The typical pay range for this role is:
$54,095.60 - $116,760.80
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit
We anticipate the application window for this opening will close on: 08/12/2024
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
We are an equal opportunity and affirmative action employer. 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.
Compensation Information:
$54095.6 / Yearly - $54095.6 / Yearly
Starting At: 54095.6 Yearly
Up To: 116760.8 Yearly
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