People. Passion. Purpose.
At P3 Health Partners, our promise is to guide our communities to better health, unburden clinicians, align incentives and engage patients.
We are a physician-led organization relentless in our mission to overcome all obstacles by positively disrupting the business of health care, transforming it from sickness care into wellness guidance.
We are looking for a Clinical Reviewer. If you are passionate about your work; eager to have fun; and motivated to be part of a fast-growing organization in Las Vegas, Nevada, then you should consider joining our team.
The Clinical Reviewer is responsible for “data mining” medical records to look for Medicare Risk Adjusting diagnoses that have 1) been previously identified, 2) are embedded but not evaluated, and 3) inferred. The Clinical reviewer will create a clinical summary flag identifying the conditions and the support for those conditions. Additionally, the reviewer will abstract HEDIS quality gaps specific for the patient.
Education and Experience:
- Physician (DO, MD), Nurse Practitioner, Physician Assistant, Nurse (RN, LPN), Coder, CDI certification or experience
- Understanding of CMS Risk Adjustment compliance rules and regulations
- Current coding certification through AAPC or AHIMA preferred, but not required
- Able to meet production deadlines
- Strong written and verbal communication skills
- Computer skills, proficiency with Microsoft Office (Outlook, Excel)
Knowledge, Skills and Abilities:
- Clinical understanding
- Understanding of CMS Risk Adjustment models
- Organized, with focused attention to detail
- Ability to work independently and interact with coders, fellow clinical reviewers, practicing clinicians, and operations staff both at P3 and affiliate practices
- Excellent verbal, written, and interpersonal communication skills
- Dependable, highly motivated team player with a great attitude
Help and Support the providers in P3 community in delivering quality care to the Senior MA patient population
Help with improving accuracy and completeness of clinical documentation
Increase Provider engagement
Provide clinical tools and guidelines that would assist in appropriately updating the health status and acuity of the patients