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Nurse Risk Adjustment Jobs in Colorado (NOW HIRING)

Phpmcs

Physician - Primary Care - Denver

Denver, CO · On-site

$190 - $220/hr

... risk adjustment coding education, population health management, data and analytics, specialist ... The team is made up of Providers and support staff, as well as a social worker and an RN/patient ...

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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

Physician Family Practice-Without OB - Competitive Salary

Alpine Physician Partners

Denver, CO

Other

Re-posted 18 days ago

Job description

Job Description:

Job Description

Colorado Physician Partners, PLLC is looking for a Primary Care Physician to join our clinic in Denver, Colorado, one of 12 clinics in an independent private practice in the Denver area.

Our practice is a member of the independent practice association (IPA), PHPprime. PHPprime provides wrap-around services to help make our practice successful, including care coordination, practice transformation coaching, risk adjustment coding education, population health management, data and analytics, specialist network management and large group contracting.

About our clinics:

  • Independent, outpatient private practices within the Denver area

  • The team is made up of Providers and support staff, as well as a social worker and an RN/patient educator, who are care coordinators. Most of our practices also have mental health support

  • This practice is an active participant in the largest IPA in Colorado and physicians have clinical faculty appointments with the University of Colorado. CU Medical students and Regis APP students keep physicians’ teaching skills sharp.

  • We are known as the “go-to” group in the area for complex patients needing the very best medical care. The physicians’ clinical excellence has earned maximum scores/bonuses with CPC+ and the practices look forward to continued high performance.

  • Practice are located off a major commuting/shopping artery in excellent payer-mix zip codes

If interested in relocating to the Denver area, please apply! We would love to have you
Qualified Candidates:

  • Board eligible/board certified in either Internal Medicine or Family Medicine

  • Supervisory skills and interest in working with advanced practice providers

  • Geriatric fellowship training or medicine subspecialty interests are welcome

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About Us: Colorado Physician Partners (CP2) is an exceptional group of independent primary care practices in Colorado focused on offering comprehensive individual and family care to the community. Our providers work collaboratively to share best practices and create innovative solutions for improved quality of care. Join our team and grow your career with the highest performing practice group in the Colorado market!

Salary Range:

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