Position Summary
The APRN – Provider Education Specialist is responsible for delivering education, coaching, and performance support to Advanced Practice Providers (APRNs/PAs) and Physicians to enhance clinical documentation accuracy, risk adjustment capture, and quality outcomes in a value-based care environment. This role serves as a clinical subject matter expert in HCC documentation, CMS risk adjustment guidelines, and quality measures, translating regulatory and clinical requirements into practical, provider-focused education.
The Provider Education Specialist partners closely with Clinical Affairs, Quality, Coding, and Operations teams to support provider performance, compliance, and improved patient outcomes across the organization.
Key Responsibilities
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Develop and deliver onboarding and ongoing education for APRNs, PAs, and Physicians related to risk adjustment, quality measures, and documentation standards.
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Provide training on HCC capture, diagnosis specificity, chronic condition documentation, and annual reassessment requirements.
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Translate CMS, ICD-10, and organizational requirements into clear, clinically relevant guidance for providers.
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Educate providers on compliant documentation practices aligned with Medicare Advantage and CMS standards.
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Reinforce best practices to support accurate risk representation and continuity of care.
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Collaborate with Coding and Clinical Documentation Improvement (CDI) teams to address audit findings, documentation gaps, and trends.
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Train providers on quality metrics, preventive care standards, and chronic disease management expectations.
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Support initiatives focused on care gap closure, quality score improvement, and patient outcomes.
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Provide targeted coaching based on performance dashboards, audits, and quality reports.
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Build strong, collaborative relationships with providers across disciplines.
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Conduct one-on-one and group coaching sessions to reinforce expectations and drive performance improvement.
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Serve as a trusted clinical education resource for documentation, risk adjustment, and quality-related questions.
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Review provider performance data, audit results, and quality reports to identify education opportunities.
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Partner with leadership to develop targeted education plans and improvement strategies.
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Track training effectiveness and recommend enhancements to education content and delivery.
Required Qualifications
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Active, unrestricted APRN license
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Minimum 3 years of clinical practice experience
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Demonstrated knowledge of:
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Risk adjustment and HCC documentation
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Medicare Advantage and value-based care models
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Clinical documentation improvement (CDI)
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Strong communication, facilitation, and coaching skills
Preferred Qualifications
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Experience training or mentoring providers
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Background in Quality, Risk Adjustment, Population Health, or CDI
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Familiarity with CMS guidelines, RADV audits, and quality programs
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Experience working in a multi-site or medical group environment
Core Competencies
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Provider education and adult learning principles
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Clinical documentation expertise
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Risk adjustment and quality knowledge
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Influence without authority
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Data-driven coaching and problem solving
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Relationship building and provider engagement
