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Nurse Risk Adjustment Jobs in Colorado (NOW HIRING)

DaVita, Inc.

Nurse Practitioner Educator

Denver, CO · On-site +1

Expert-level knowledge of Medicare risk adjustment, documentation, and coding requirements. * 2+ years experience of experience providing risk adjustment education or management. * 4+ years ...

DaVita, Inc.

Nurse Practitioner Educator

Denver, CO · On-site +1

Expert-level knowledge of Medicare risk adjustment, documentation, and coding requirements. * 2+ years experience of experience providing risk adjustment education or management. * 4+ years ...

DaVita, Inc.

Clinical Support Auditor (IKC)

Denver, CO · On-site +1

$35.75 - $48/hr

A Shining Star for our Clinical Documentation Integrity (CDI) RN will have: * Expert-level knowledge of Medicare risk adjustment, documentation, and coding requirements. * 2+ years experience of ...

DaVita, Inc.

Clinical Support Auditor (IKC)

Denver, CO · On-site +1

$35.75 - $48/hr

A Shining Star for our Clinical Documentation Integrity (CDI) RN will have: * Expert-level knowledge of Medicare risk adjustment, documentation, and coding requirements. * 2+ years experience of ...

DaVita, Inc.

Clinical Support Auditor (IKC)

Denver, CO · On-site +1

$35.75 - $48/hr

A Shining Star for our Clinical Documentation Integrity (CDI) RN will have: * Expert-level knowledge of Medicare risk adjustment, documentation, and coding requirements. * 2+ years experience of ...

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Nurse Risk Adjustment information

How does a nurse risk adjustment professional typically collaborate with coding and provider teams to ensure accurate risk scoring?

Nurse Risk Adjustment professionals often work closely with medical coders and healthcare providers to review patient documentation and ensure diagnoses are captured accurately for risk adjustment purposes. They may participate in interdisciplinary meetings, provide education to providers on documentation best practices, and clarify coding queries. This collaborative approach helps optimize the accuracy of risk scores, which impacts reimbursement and quality metrics. Effective communication and teamwork are essential in this role to support compliance and achieve organizational goals.

What is a nurse risk adjustment?

Nurse risk adjustment nurses are specialized healthcare professionals who review patient medical records to ensure accurate documentation of diagnoses and health conditions. Their work supports the risk adjustment process, which helps health plans and providers receive appropriate compensation based on the health status of their patient populations. These nurses use their clinical expertise to identify missing or undocumented conditions, collaborate with providers to improve documentation accuracy, and help ensure compliance with federal guidelines. By doing so, they play a key role in improving patient care quality and the financial health of healthcare organizations.

What is the difference between Nurse Risk Adjustment vs Nurse Case Manager?

AspectNurse Risk AdjustmentNurse Case Manager
CertificationsRN license, risk adjustment trainingRN license, case management certification
Work EnvironmentInsurance companies, healthcare analyticsHospitals, clinics, patient homes
Employer & IndustryHealth plans, insurance providersHealthcare providers, hospitals

While both roles require RN licensure, Nurse Risk Adjustment focuses on analyzing and coding patient data for insurance risk models, whereas Nurse Case Managers coordinate patient care and manage treatment plans. Understanding these differences helps professionals choose the right career path within healthcare and insurance industries.

What are the key skills and qualifications needed to thrive as a nurse risk adjustment?

To thrive as a Nurse Risk Adjustment, you need a solid background in clinical nursing, comprehensive knowledge of medical coding (especially ICD-10), and familiarity with risk adjustment methodologies, typically supported by RN licensure and experience in case management or chart review. Proficiency with electronic health record (EHR) systems, coding software, and sometimes a Certified Risk Adjustment Coder (CRC) credential is valuable. Attention to detail, analytical thinking, and strong communication skills help nurses accurately review documentation and collaborate with providers. These skills ensure accurate coding and risk stratification, which directly impact healthcare reimbursement and quality reporting.
What are popular job titles related to Nurse Risk Adjustment jobs in Colorado? For Nurse Risk Adjustment jobs in Colorado, the most frequently searched job titles are:
What job categories do people searching Nurse Risk Adjustment jobs in Colorado look for? The top searched job categories for Nurse Risk Adjustment jobs in Colorado are:
Nurse Risk Adjustment jobs near you

Nurse Practitioner Educator

DaVita, Inc.

Denver, CO • On-site, Remote

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 28 days ago

DaVita rating

7.0

Company rating: 7.0 out of 10

Based on 1,171 frontline employees who took The Breakroom Quiz

416th of 887 rated healthcare providers

Job description

Posting Date
07/10/2026
2000 16th St, Denver, Colorado, 80202-5117, United States of America
We are in need of a detail-oriented, clinically trained Advanced Practice Provider (APP) that can provide expertise, education, coaching, and guidance on clinical practice and documentation to improve our clinical outcomes and increase the quality of provider documentation for diagnosis evaluation and quality metrics. This individual will serve as a role model and facilitator within the clinical documentation integrity team and support the leadership team with the execution of the department's strategic goals. They are self-directed and possess advanced analytical skills, critical thinking, creativity, and the ability to anticipate and identify opportunities and potential problems.
Key Responsibilities:
  • Performs clinical chart reviews to ensure documentation accuracy by applying established clinical criteria for diagnosing medical conditions.
  • Applies their clinical knowledge to evaluate how provider documentation, lab results, diagnostic information, and treatment plans translate into coded data.
  • Analyzes and interprets clinical data to identify gaps, inconsistencies, and/or opportunities for improvement in the clinical documentation and queries the provider using a concurrent query process following ACDIS/AHIMA Guidelines for Compliant Query Writing.
  • Communicate with providers and other healthcare team members to clarify information or provide additional documentation when needed.
  • Work directly with clinicians to improve the overall quality and completeness of documentation through the query process and/or provider education (correct disease processes and disease severity, complexity, and acuity with an eye towards accurate medical coding).
  • Collaborates with team members as part of the clinical review process to promote high accuracy and consistency of results.
  • Meets accuracy and productivity metrics to ensure the team achieves established departmental goals.
  • Communicates with DaVita leaders to address documentation issues and trends.
  • Actively participates in all department meetings as scheduled.
  • Conduct individual and large group educational sessions for clinicians and medical coders (or other staff as applicable).
  • Partner with data analytics, coding, compliance and education departments for onboarding, ongoing and targeted education for all IKC APPs and IKC partner providers on documentation requirements for Medicare risk adjustment.
  • Flexible and able to adapt to change based on departmental needs.
  • Excellent analytical and critical thinking skills.
  • Excellent verbal/written communication and interpersonal skills.
  • Ability to work independently and as part of a team in a fast-paced environment.
  • Fully remote with the ability to travel as needed to present in-person training (travel is 2-4 times per year).

Preferred Qualifications:
  • Master's degree with a current active clinical license (APRN or PA) (required)
  • Current Nurse Practitioner (NP) or Physician Assistant (PA) licensure without restriction in state of residence (required)
  • CCDS-O or CDIP (required or must be obtained within six months of hire)
  • CRC (required or must be obtained within one year of hire)
  • 5+ years of clinical experience as a Nurse Practitioner (adult-geriatric or family) or Physician Assistant (preferred)
  • 3+ years of clinical documentation improvement experience, coding experience, or equivalent (required)
  • 1+ year of experience working with advanced practice providers as well as other clinical and non-clinical staff (required)
  • Solid clinical background in evidence-based medicine, including chronic disease management and prevention.
  • Experience in ICD-10 coding and documentation requirements and risk adjustment.
  • Knowledge of compliant query writing/process.
  • Ability to perform a comprehensive chart review of 20-30 medical records daily, with workload variations based on daily tasks.
  • Technical experience using EMR systems.
  • Proficiency in MS applications (Excel, Outlook, Teams, PowerPoint, Word)
  • Ability to travel for on-site meetings 2-4 times per year.
  • Motivated self-starter and creative problem-solver who is comfortable working in a fast-paced, dynamic environment.
  • Candidate will reside or work Mountain Standard Time (MST) or Pacific Standard Time (PST) (preferred), IF EST or CST needs to be open to 1-2 days a week on MST/PST.

A Shining Star for our Clinical Documentation Integrity (CDI) APP will have:
  • Expert-level knowledge of Medicare risk adjustment, documentation, and coding requirements.
  • 2+ years experience of experience providing risk adjustment education or management.
  • 4+ years experience developing educational content for clinical professionals, including NPs, PAs, RNs, and/or physicians, pharmacists, etc.
  • Master's degree in Business, Education, Instructional design, Nursing or related fields.
  • Doctoral degree may include but is not limited to: Doctor of Nursing Practice (DNP); Doctoral Degree in Nursing; Doctorate of Education (Ed.D) or other education Preferred
  • Comfortable presenting via Teams or in-person
  • Possess strong technical skills, including Excel, Word, PowerPoint and Outlook.
  • Coding certification from AAPC or AHIMA professional coding association or additional coursework/experience in coding and Risk Adjustment. These include but are not limited to:
  • CPC, CRC, CCDS-O or CDIP.
  • Expert experience working with Medicare Advantage programs and CMS Risk Adjustment model.
  • Previous work experience in clinical documentation review or a clinical quality program.
  • Experience developing and delivering clinical education and training.

What We'll Provide:
More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings.
  • Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out
  • Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more
  • Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita's online training platform StarLearning.

#LI-CM5
At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic.
This position will be open for a minimum of three days.
The Salary Range for the role is $98,000.00 - $155,000.00 per year.
If a candidate is hired, they will be paid at least the minimum wage according to their geographical jurisdiction and the exemption status for the position.
New York Exempt: New York City and Long Island: $66,300.00/year, Nassau, Suffolk, and Westchester counties: $66,300.00/year, Remainder of New York state: $62,353.20/year New York Non-exempt: New York City and Long Island: $17.00/hour, Nassau, Suffolk, and Westchester counties: $17.00/hour, Remainder of New York state: $16.00/hour
Washington Exempt: $80,168.40/year Washington Non-exempt: Bellingham: $19.13/hour, Burien: $21.71/hour, Everette: $20.77/hour, Unincorporated King County: $20.82/hour, Renton: $21.57/hour, Seattle: $21.30/hour, Tukwila: $21.65/hour, Remainder of Washington state: $17.13/hour
For location-specific minimum wage details, see the following link: DaVita.jobs/WageRates
Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits
Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.

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About DaVita

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DaVita is a healthcare company that provides compassionate, quality healthcare. The company’s mission is to be the Provider, Partner, and Employer of Choice. DaVita serves more than 200,000 dialysis patients in 10 countries outside the U.S. and has over 55,000 teammates in the U.S. Since 2011, DaVita teammates have donated $11 million to local nonprofits and have volunteered over 180,000 hours since 2006. DaVita has been on Fortune’s list of the world’s most admired companies for 15 years in a row.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Denver, CO, US

Year founded

1994

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