Miami, FL · On-site
Familiarity with CMS guidelines, RADV audits, and quality programs preferred * Experience working within a multi-site healthcare organization or medical group preferred Join Our Team Join a team ...
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Miami, FL · On-site
Familiarity with CMS guidelines, RADV audits, and quality programs preferred * Experience working within a multi-site healthcare organization or medical group preferred Join Our Team Join a team ...
... audit readiness directly drive financial and compliance outcomes. You will sell to the leaders who ... models, RADV, quality programs, value-based care, and the competitive landscape) to engage ...
... audit readiness directly drive financial and compliance outcomes. You will sell to the leaders who ... models, RADV, quality programs, value-based care, and the competitive landscape) to engage ...
Tallahassee, FL · On-site
$41.85/hr
... RADV) Audits. Works closely with physicians, team members, Quality, Compliance, partners at Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding.
Tallahassee, FL · On-site
$41.85/hr
... RADV) Audits. Works closely with physicians, team members, Quality, Compliance, partners at Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding.
Miami, FL · Remote
$82K - $108K/yr
Certified professional coder (CPC) * 3+ year(s) retrospective risk adjustment coding experience. * 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV ...
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Miami, FL · Remote
$82K - $108K/yr
Certified professional coder (CPC) * 3+ year(s) retrospective risk adjustment coding experience. * 1+ year(s) experience Quality Auditing and/or Risk Adjustment Data Validation Audit (RADV ...
| Aspect | Radv Audit | Radv Analyst |
|---|---|---|
| Certifications | CPA, CIA, CISA | CPA, CIA, CISA |
| Work Environment | Audit firms, corporate audit departments | Financial institutions, consulting firms |
| Primary Focus | Evaluating internal controls, compliance, and financial accuracy | Analyzing risk, data, and financial reports to support audits |
Radv Auditors primarily focus on evaluating internal controls and ensuring compliance through audits, while Radv Analysts analyze data and risks to support audit processes. Both roles require similar certifications and often work in related environments, but their core responsibilities differ in scope and focus.
For Radv Audit jobs in Florida, the most frequently searched job titles are:
The top searched job categories for Radv Audit jobs in Florida are:
Cities in Florida with the most Radv Audit job openings:
Full-time
Medical, Dental, Vision, Life, Retirement, PTO
Re-posted 24 days ago
Community Medical Group is seeking an experienced, collaborative, and results-oriented APRN - Provider Education Specialist to join our clinical leadership team.
As an APRN Provider Education Specialist, you will serve as a key resource for providers across the organization, delivering education, coaching, and performance support focused on clinical documentation improvement, risk adjustment accuracy, and quality outcomes. This role partners closely with Clinical Affairs, Quality, Coding, and Operations teams to help ensure providers are equipped with the knowledge and tools necessary to succeed in a value-based care environment while improving patient outcomes and regulatory compliance.
BenefitsEligible employees receive a comprehensive benefits package that includes:
• 17 days of paid time off
• 11 paid holidays and one floating holiday
• Medical, dental, and vision coverage through UnitedHealthcare
• 401(k) retirement plan with company match
• Company-paid life insurance
• Opportunities for professional growth
• Develop and deliver onboarding and continuing education programs for APRNs, Physician Assistants, and Physicians
• Provide education on HCC capture, risk adjustment, diagnosis specificity, chronic condition documentation, and annual reassessment requirements
• Translate CMS, ICD-10, and organizational requirements into practical, provider-focused guidance
• Educate providers on compliant documentation practices aligned with Medicare Advantage and CMS standards
• Reinforce best practices that support accurate risk representation, quality performance, and continuity of care
• Collaborate with Coding and Clinical Documentation Improvement teams to address documentation gaps, audit findings, and performance trends
• Train providers on quality measures, preventive care standards, and chronic disease management initiatives
• Support organizational efforts related to care gap closure, quality score improvement, and patient outcomes
• Provide individualized coaching based on provider performance dashboards, audits, and quality reports
• Build strong relationships with providers and clinical leaders across the organization
• Conduct group and one-on-one education sessions to drive performance improvement and documentation excellence
• Serve as a trusted resource for provider questions related to documentation, quality, and risk adjustment
• Analyze provider performance data and identify opportunities for targeted education and coaching
• Partner with leadership to develop improvement strategies and educational action plans
• Monitor training effectiveness and recommend enhancements to educational materials and delivery methods
• Perform additional duties as assigned
• Active and unrestricted APRN license required
• Minimum of three (3) years of clinical practice experience required
• Demonstrated expertise in risk adjustment, HCC documentation, and Medicare Advantage programs
• Strong understanding of value-based care models and Clinical Documentation Improvement (CDI) principles
• Experience interpreting and applying CMS guidelines and documentation standards
• Exceptional communication, presentation, facilitation, and coaching skills
• Strong analytical and problem-solving abilities
• Ability to influence and educate providers in a collaborative and supportive manner
• Strong organizational skills and attention to detail
• Ability to analyze performance data and develop actionable improvement plans
• Experience training, mentoring, or coaching providers preferred
• Background in Quality, Population Health, Risk Adjustment, or CDI preferred
• Familiarity with CMS guidelines, RADV audits, and quality programs preferred
• Experience working within a multi-site healthcare organization or medical group preferred
Join a team committed to advancing quality healthcare through clinical excellence, innovation, and provider engagement. At Community Medical Group, you'll have the opportunity to help shape provider performance, strengthen documentation quality, improve patient outcomes, and support the continued success of our value-based care initiatives.
