At St. Luke’s Health Plan, we’re transforming the healthcare experience by bringing providers and insurance together on the same team. As Idaho’s provider-sponsored health plan, our mission is to connect people with affordable, high-quality, and hassle-free healthcare. Join us and be part of a team committed to improving outcomes, strengthening provider partnerships, and advancing value-based care.
We are seeking a Clinical Risk Adjustment Specialist (LPN) to support provider education, documentation integrity, and coding accuracy across our network. This role is ideal for an experienced LPN who enjoys working collaboratively with providers and using their clinical expertise to improve quality outcomes and compliance initiatives.
Remote opportunity for candidates located in Idaho or Oregon.
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Monday–Friday
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7:00 a.m.–3:30 p.m.
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No weekends
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Fully remote work environment
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Collaborative and mission-driven team
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Opportunity to partner directly with providers and care teams
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Focus on quality improvement, documentation integrity, and value-based care
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Meaningful work that impacts patient outcomes and provider performance
Under general supervision, the Clinical Risk Adjustment Specialist (LPN) will:
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Support network providers and care teams with risk adjustment, billing, and coding accuracy
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Partner with health plans and internal stakeholders to support billing, coding, and documentation audits
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Provide consultative support to improve clinical documentation and coding practices
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Deliver provider education, coaching, and feedback related to coding and risk adjustment methodologies
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Review medical records to ensure accurate capture of patient complexity, severity of illness, and burden of disease
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Collaborate directly with providers to improve compliance, quality metrics, and performance outcomes
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Serve as a subject matter expert for risk adjustment, documentation integrity, and quality initiatives
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Current Licensed Practical Nurse (LPN) license
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Minimum of 2 years of relevant experience
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Strong understanding of clinical documentation practices
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Experience collaborating with providers or interdisciplinary clinical teams
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Knowledge of medical billing, coding, and/or risk adjustment principles
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Coding certification required or must be obtained within six (6) months of hire
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Coding or quality certification such as CPC, CCS, CRC, AAPC, or ACDIS
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Experience supporting audits, quality programs, or value-based care initiatives
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Previous experience working with health plans or provider networks
