risk adjustment specialist

Baptist Health System KY & IN

<div>Summary
Job Description:
Baptist Health Medical Group is looking for an Ambulatory CDI Specialist to join our team! This is a remote work position that requires residency in KY or IN
<div><div><div><div><div><div><div><div><div>The BHMG Ambulatory CDI Specialist I is responsible for the evaluation of documentation utilizing their coding and clinical expertise to ensure specificity of coding and coding accuracy. They identify HCC diagnosis codes, ensure documentation accurately reflects the medical necessity and acuity of the patients. They provide guidance/education to the providers, medical assistants, practice managers and ancillary staff on clinical documentation best practices. Position requires a self-motivated, flexible, confident presenter that is able to travel and work remotely as well as attend internal meetings.
Minimum Education, Training, and Experience Required
<ul><li>2 years&rsquo; professional medical group coding experience
</li><li>Experience with:
<ul><li>ICD-10-CM coding principles and procedures,
</li><li>HCPCS, CPT, CPT II and modifier coding,
</li><li>CMS HCC, HHS HCC, Rx HCC coding and risk adjustment assignment as it relates to provider documentation,
</li><li>Knowledge of Microsoft Office (Outlook, PowerPoint, Excel)
</li></ul></li></ul><ul><li>Preferred Experience
<ul><li>HCC (CMS, HHS, Rx HCC) coding and risk adjustment assignment as it relates to provider documentation,
</li><li>Proficient experience with Epic and/or other major EMR vendor software, and
</li><li>Presenting education to coders, providers and/or other caregivers.
</li><li>Clinical experience a plus
</li></ul></li></ul>Certification/Licenses:
<ul><li>Active Certification Required:
<ul><li>Certified Professional Coder (CPC)
certification or Certified Coding Specialist-Physician based (CCS-P) or equivalent
certification from AAPC, AHIMA or other
acceptable professional organization.
</li></ul></li><li>A minimum of one additional advanced certification, required within one year of hire.
<ul><li>CRC = Certified Risk Adjustment Coder (certification)
</li></ul></li></ul></div></div></div></div></div></div></div></div></div>Work Experience
Education
<h3 class="jobSectionHeader">If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now!
</h3><h3 class="jobSectionHeader">Baptist Health is an Equal Employment Opportunity employer.</h3></div>

BHMG Ambulatory CDI Specialist

Tidelands Health

<div>
 Employee Type:
 
 
 Regular
 
 
 Work Shift:
 
 
 Day - 8 hour shift (United States of America)
 
 
 
 Join Team Tidelands and help people live better lives through better health!
 
 
 
 
 Clinical Documentation Improvement Specialist (RN) (3419)
 
 
 
 Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region's largest health care provider, we are also one of our area's largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day.
 
 
 
 A Brief Overview
 
 
 
 The Clinical Documentation Improvement Specialist (RN) is a hybrid role that combines the expertise of clinical documentation improvement (CDI) and outpatient Hierarchical Condition Category (HCC) coding. This position will report to the Outpatient CDI Program Manager. This position focuses on improving the accuracy, quality, and completeness of clinical documentation in outpatient medical records while ensuring compliance with coding guidelines. The specialist will work collaboratively with providers, coding teams, and other healthcare professionals to facilitate accurate coding, improve risk capture, and optimize reimbursement while reflecting the true severity of illness and care provided.
 
 
 
 Education Qualifications
 
 
 
 <ul>
 <li>
 BSN and a minimum of five years clinical nursing experience Required
 
 
 </li>
 </ul>
 
 Experience Qualifications
 
 
 
 <ul>
 <li>
 At least 3 or more years' experience either in the clinical field (RN), CDI field, or coding field Required
 </li>
 <li>
 Experience in an outpatient or acute care setting Required
 </li>
 <li>
 1 or more years' experience in HCC/Risk Adjustment Preferred
 </li>
 <li>
 Minimum of 3 years of experience in clinical documentation improvement, outpatient Hierarchical Condition Category (HCC), or a combination of both Preferred
 
 
 </li>
 </ul>
 
 Skills And Abilities
 
 
 
 <ul>
 <li>
 Strong clinical experience and critical thinking skills required
 </li>
 <li>
 Extensive knowledge of patient care, and knowledge of clinical measurement, tools, and clinical outcomes
 </li>
 <li>
 Ability to establish cooperative, working relationships with diverse groups and individuals, medical staff and other healthcare disciplines
 </li>
 <li>
 Ability to work independently, be resourceful, and possess strong organizational skills
 </li>
 <li>
 Ability to communicate effectively with physicians and other clinical staff; be courteous and professional
 
 
 </li>
 </ul>
 
 Licenses and Certifications
 
 
 
 <ul>
 <li>
 Registered Nurse - South Carolina Department of Labor, Licensing and Regulation Required
 </li>
 <li>
 Certified Professional Coder - American Academy of Professional Coders within 1 Year Required or
 </li>
 <li>
 Certified Coding Specialist - American Health Information Management Association within 1 Year Required or
 </li>
 <li>
 Certified Clinical Documentation Specialist - Association of Clinical Documentation Integrity Specialist within 1 Year Required
 
 
 </li>
 </ul>
 
 Physical Demand
 
 
 
 Light Physical Demand
 
 
 The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a contract for employment nor a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform tasks other than those specifically presented in this description.
 
 
 Tidelands Health is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
 
 
 Tidelands Health is an equal opportunity employer (EOE). Tidelands Health does not discriminate against employees or applicants for employment on the basis of race, color, creed, religion, age, national origin, disability, marital status, veteran status, gender, genetic information, familial status, or any other legally protected status.
</div>

Outpatient CDI Specialist (RN)

Franklin Templeton

<div><h1 class="jobSectionHeader">Benefit Street Partners: a global leader in alternative credit</h1>
Benefit Street Partners (BSP) is an alternative credit pioneer that seeks to deliver attractive returns through its relationships, specialist expertise and global reach. We focus exclusively on credit, building deep expertise across direct lending, structured credit, liquid credit, special situations, infrastructure debt and real estate. 
As a wholly owned subsidiary of Franklin Templeton, one of the world&rsquo;s largest asset managers, we benefit from institutional scale and resources while retaining full investment and day-to-day operational independence. This enables us to combine specialist focus with global reach, offering solutions-driven strategies to meet long-term client needs.
Visit www.bspcredit.com to learn more about our company.<div>
About the department:<ul><li>
BSP is looking for a full-stack developer who builds with AI tools as their primary workflow. You have a strong engineering foundation&mdash;you understand how software works under the hood&mdash;but your day-to-day is defined by leveraging AI to ship faster, smarter, and with less friction. You&rsquo;ll work across trading, operations, and risk teams to design and deliver production systems from end to end. This role will report to the Head of Development.</li></ul><h1 class="jobSectionHeader">
How you will add value?</h1>
Responsibilities include but are not limited to: You will:<ul><li>
Collaborate with business unit sponsors (trading, operations, and risk) and other stakeholders such as finance, legal, and compliance to gather requirements and document specifications.</li><li>
Design and enhance the internal application platform, supporting traders, portfolio managers, operations, and risk functions.</li><li>
Build and integrate Agentic AI tools for both development productivity and user-focused features to improve efficiency and user experience.</li><li>
Design, build, and support front-end solutions for trading, operations, and modeling, and ensure high availability of custom operational, analysis, and reporting platform with an AI an Agent first approach.</li><li>
Manage time effectively across multiple simultaneous projects, suggest workflow and process improvements, and provide application support as needed.</li><li>
Use AI-assisted development tools as your primary way of building&mdash;from scaffolding features to writing tests to debugging production issues.</li><li>
Report directly to the Head of Development.</li></ul><h1 class="jobSectionHeader">
What will help you be successful in this role?</h1>
Qualifications (Required):
Key Skills:<ul><li>
Net / C# - SignalR / React / MUI / AG Grid / Zustand / React Query / Python / Airflow / Pandas</li><li>
5+ years of software development experience across the full stack.</li><li>
CS or Software Engineering degree from a strong program (or equivalent depth of knowledge).</li><li>
Demonstrated daily use of AI development tools to write, review, and ship code. This isn&rsquo;t a nice-to-have&mdash;it&rsquo;s central to how we work.</li><li>
Strong fundamentals in C#/.NET, React, Python, and SQL. You know how to build things properly, even when AI is doing the heavy lifting.</li><li>
Show thorough understanding of object-oriented analysis and design, database design, data structures, algorithms, and design patterns, including unit testing, performance analysis, and n-tier architecture.</li><li>
Experience with DevOps, CI/CD processes, cloud deployments, and cloud application observability, as well as integrating AI development workflows with legacy systems and infrastructure.</li><li>
Effectively utilize AI tools to enhance productivity and efficiency throughout the development cycle and demonstrate strong knowledge of building and supporting front-end systems using AI/Agentic tools.</li></ul>
Experience (Desired):<ul><li>
Designing and enhancing the internal application platform, supporting Trader&rsquo;s, PM&rsquo;s, Operations and Risk.</li><li>
Designing and improving the DevOps processes and the production environment in AWS</li><li>
Suggest and build out CICD, Deployment process improvements</li></ul>
Job Level - Individual Contributor
Work Shift Timings - 2:00 PM &ndash; 11:00 PM IST</div><h1 class="jobSectionHeader">
Experience our welcoming culture and reach your professional and personal potential!</h1> 
Our culture is shaped by the variety of perspectives and experiences brought by talent from around the world. Regardless of your interests, lifestyle, or background, there&rsquo;s a place for you at Franklin Templeton. We provide employees with the tools, resources, and learning opportunities to help them excel in their career and personal life. 
 
By joining us, you will become part of a culture that focuses on employee well-being and provides multidimensional support for a positive and healthy lifestyle. We understand that benefits are at the core of employee well-being and may vary depending on individual needs. Whether you need support for maintaining your physical and mental health, saving for life&rsquo;s adventures, taking care of your family members, or making a positive impact in your community, we aim to have them covered.
Franklin Templeton is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all applicants and employees, and we evaluate qualified applicants without regard to ancestry, age, color, disability, genetic information, gender, gender identity, or gender expression, marital status, medical condition, military or veteran status, national origin, race, religion, sex, sexual orientation, and any other basis protected by federal, state, or local law, ordinance, or regulation.
If you believe that you need an accommodation or adjustment, due to a medical condition or disability, to search for or apply for one of our positions, please send an email to accommodations@franklintempleton.com. In your email, please include the accommodation or adjustment you are requesting, the job title, and the job number of the position you are applying for. It may take up to three business days to receive a response to your request. Please note that only accommodation requests will receive a response.</div>

Software Engineer (C#/.Net, React, Python, SQL, AI)

North Middlesex Regional School District

POSITION: ADJUSTMENT COUNSELOR/ SOCIAL WORKER REPORTS TO: Building Principal, Director/Asst. Director of Special Education ESSENTIAL FUNCTIONS: Adjustment counselors/ Social Workers assist students with academic learning by providing strategic services that identify and address the social-emotional-environmental issues that interfere with the educational process. Working with parents/guardians, teachers, school principal/principal's designee, and community based resources, the school counselor/ adjustment counselor implements strategies that promote students' positive school adjustment. Adjustment counselors/ Social Workers are members of the Special Education Department.
 
Each adjustment counselor/ social worker is assigned to the school(s) based upon identified needs of the student population. JOB DUTIES: Identifies and assesses academic problems through analysis of factors impinging on student adjustment including factors in the home, school, and community. Determines and implements appropriate school based therapeutic strategies to effect changes in behavioral-social interactions of students and their families. Collection and documentation of student progress through progress monitoring and observation data.
 
Provides individual and group therapeutic counseling to students and, as appropriate, families. Collaborates with school staff and other school system personnel in implementing strategies to promote student learning. Participate as members of the IEP and other school based teams to develop interventions for promoting students' academic success. Serves on both school-based and system-wide committees to address educational, adjustment problems, safety issues, and program development for students.
 
Provides crisis intervention services. Completes psychosocial assessments to assist in the determination of special education services. Provides social work case management for students and families. Provides staff consultation on behavioral/emotional/environmental issues affecting student participation in the learning process.
 
Maintains required clinical records and submits appropriate documents for statistical reports with adherence to program standards in school social work. Serves as District Contact Person for related service IEPs, social/counseling goal. Manages a 504 caseload, including setting up parent meetings, writing 504 plans, and ensuring stakeholders are made aware of new and adjusted 504 plans. Completes risk assessments on referred students.
 
Serves as liaison with community agencies and assists in fostering communication between schools, parents/guardians, and community leaders. Locates and mobilizes community resources to support the educational program. Attends meetings and professional development activities as required. Follows all federal, state and district-wide mandates, laws, and initiatives.

Adjustment Counselor/ Social Worker

Amazon.com

<div><h2 class="jobSectionHeader">DESCRIPTION</h2><div>
At Amazon, we are committed to ensuring our associates have a safe and healthy workplace through continuous improvements and effective accident prevention. As our operations continue to evolve in a demanding work environment, we are seeking a dedicated Workplace Health and Safety (WHS) Specialist to help protect all employees from health and safety risks and damage. The ideal candidate will put safety standards into practice, lead projects to raise safety awareness, and support management's efforts to ensure compliance with all program expectations and applicable regulations. With your proactive approach, you will help drive a safety culture by conducting regular audits, managing safety metrics, and providing guidance on safety-related processes across our 3P operations. You will play a crucial advisory role for associates and managers while helping investigate accidents, near misses and incidents to determine root causes and implement preventive measures. 
 
Key job responsibilities 
<ul><li>Conduct regular site visits across dark stores to evaluate safety conditions in fast-paced, high-throughput environments, providing practical recommendations to reduce risk and improve operational safety.</li><li>Perform risk assessments and safety audits covering in-store operations, rider activities, material handling, and equipment usage, ensuring compliance with local regulatory requirements.
</li><li>Monitor, analyze, and report on safety performance metrics, incident data, and leading indicators, identifying trends and prioritizing risk areas within quick-commerce operations.</li><li>Support the implementation of new safety controls, procedures, and mitigation measures tailored to dark store layouts, rapid picking processes, and rider dispatch activities.</li><li>Ensure compliance with Amazon supply chain, WHS, and third-party safety policies, as well as applicable local and regional regulations across assigned countries.</li><li>Lead and participate in daily/weekly safety briefings, stand-ups, and safety discussions with operations teams and third-party partners to reinforce safety expectations in high-tempo environments</li><li>Support incident, near-miss, and serious injury investigations, ensuring timely reporting, accurate documentation, root cause analysis, and corrective action tracking.</li><li>Support safety training completion for associates, riders, and third-party partners, and verify training effectiveness through observations, audits, and engagement.</li><li>Attend and actively contribute to regional and cross-functional WHS meetings, representing quick-commerce safety risks, trends, and priorities.</li><li>Own and drive country or regional WHS continuous improvement projects related to quick-commerce operations, extending beyond individual scope where required.</li><li>Act as an onboarding buddy for new WHS team members, supporting their integration into dark store and third-party safety operations.</li><li>Serve as a WHS Manager proxy when required, fulfilling assigned standard work and supporting operational continuity.</li></ul></div><h2 class="jobSectionHeader">
BASIC QUALIFICATIONS</h2><ul><li>2+ years of workplace health &amp; safety (WHS) related field experience</li><li>A Health and Safety NVQ Level 3 or NEBOSH National General Certificate (or equivalent)</li><li>Experience in data analysis and reporting</li><li>Experience that includes strong analytical skills, attention to detail, and effective communication abilities, or experience working with customers with a passion for delivering exceptional service</li><li>Work flexible hours as business demands, including overnight, weekends and holidays</li></ul><h2 class="jobSectionHeader">
PREFERRED QUALIFICATIONS</h2><ul><li>Experience building strategic relationships with stakeholders, including communicating and collaborating across teams and functions</li><li>Background in operations, safety or quality management</li><li>Experience working both independently and within a team</li><li>Strong ability to communicate effectively across various stakeholders through presentations and written communications</li><li>Bachelor&rsquo;s degree in occupational health and safety or Engineering/Science bachelor&rsquo;s degree</li></ul> 
Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit https://amazon.jobs/content/en/how-we-hire/accommodations for more information. If the country/region you&rsquo;re applying in isn&rsquo;t listed, please contact your Recruiting Partner.</div>

WHS Specialist, Workplace Health & Safety

Mac Care

Job SummaryWe are seeking a detail-oriented Clinical Data Analyst with strong expertise in healthcare analytics and hands-on experience working with clinical research data. This role will support our Value-Based Care (VBC) and MSSP initiatives, while also contributing to the analysis and interpretation of clinical datasets from research and quality improvement programs.The ideal candidate will transform complex healthcare and clinical research data into actionable insights to improve patient outcomes, ensure regulatory compliance, and drive data-informed decision-making.Key Responsibilities<ul><li>Analyze and manage CCLF, HCC, and quality data for MSSP and Value-Based Care programs.</li><li>Work with clinical research datasets (e.g., study data, patient cohorts, outcomes data) to support research analysis and reporting.</li><li>Develop and maintain interactive dashboards using Power BI to track performance, clinical outcomes, and quality metrics.</li><li>Perform data extraction, transformation, and cleaning using Power Query and SQL.</li><li>Collaborate with clinical, research, and operations teams to identify high-risk populations and monitor quality measures.</li><li>Support CMS reporting, risk adjustment analysis, and quality improvement initiatives.</li><li>Assist in clinical study data validation, reconciliation, and audit readiness.</li><li>Ensure data integrity, accuracy, and compliance with healthcare regulations (HIPAA, CMS guidelines).</li><li>Translate complex datasets into clear insights and recommendations for leadership and stakeholders.</li></ul>Requirements<ul><li>Bachelor&rsquo;s degree in Computer Science, Data Analytics, Public Health, Biostatistics, or a related field.</li><li>2&ndash;4 years of experience in healthcare data analytics, clinical research data analysis, or value-based care programs.</li><li>Hands-on experience working with clinical datasets, research data, or population health data.</li></ul>Technical Skills<ul><li>Power BI (2+ years) &ndash; dashboarding and visualization</li><li>Power Query (2&ndash;3 years) &ndash; data transformation</li><li>SQL &ndash; data extraction and manipulation</li><li>Strong skills in data cleaning, validation, and analysis</li></ul>Domain Knowledge<ul><li>Understanding of CMS programs, MSSP, and HCC risk adjustment</li><li>Familiarity with clinical research processes, datasets, and reporting standards</li><li>Experience with EMR/EHR systems and population health tools</li></ul>Preferred Qualifications<ul><li>Experience supporting clinical trials, registry data, or outcomes-based research</li><li>Knowledge of study design, cohort analysis, and healthcare quality measures (e.g., HEDIS)</li><li>Exposure to statistical tools (R, Python, or similar) is a plus</li></ul>Job Type: Full-timeWork Location: In person

Clinical Data Analyst

Job SummaryWe are seeking a detail-oriented Clinical Data Analyst with strong expertise in healthcare analytics, hands-on experience working with clinical research data, and practical experience using Athena EMR/EHR systems. This role will support our Value-Based Care (VBC) and MSSP initiatives, while also contributing to the analysis and interpretation of clinical datasets from research and quality improvement programs.The ideal candidate will transform complex healthcare and clinical research data into actionable insights to improve patient outcomes, ensure regulatory compliance, and drive data-informed decision-making.Key Responsibilities<ul><li>Analyze and manage CCLF, HCC, and quality data for MSSP and Value-Based Care programs.</li><li>Work with clinical research datasets (e.g., study data, patient cohorts, outcomes data) to support research analysis and reporting.</li><li>Extract, validate, and analyze patient and operational data from Athena EMR and other healthcare systems.</li><li>Develop and maintain interactive dashboards using Power BI to track performance, clinical outcomes, and quality metrics.</li><li>Perform data extraction, transformation, and cleaning using Power Query and SQL.</li><li>Collaborate with clinical, research, and operations teams to identify high-risk populations and monitor quality measures.</li><li>Support CMS reporting, risk adjustment analysis, and quality improvement initiatives.</li><li>Assist in clinical study data validation, reconciliation, and audit readiness.</li><li>Ensure data integrity, accuracy, and compliance with healthcare regulations (HIPAA, CMS guidelines).</li><li>Translate complex datasets into clear insights and recommendations for leadership and stakeholders.</li></ul>Requirements<ul><li>Bachelor&rsquo;s degree in Computer Science, Data Analytics, Public Health, Biostatistics, or a related field.</li><li>2&ndash;4 years of experience in healthcare data analytics, clinical research data analysis, or value-based care programs.</li><li>Hands-on experience working with clinical datasets, research data, or population health data.</li><li>Experience working with Athena EMR/EHR systems for reporting, patient data extraction, workflow analysis, or operational support.</li></ul>Technical Skills<ul><li>Power BI (2+ years) &ndash; dashboarding and visualization</li><li>Power Query (2&ndash;3 years) &ndash; data transformation</li><li>SQL &ndash; data extraction and manipulation</li><li>Experience navigating and reporting from Athena EMR</li><li>Strong skills in data cleaning, validation, and analysis</li></ul>Domain Knowledge<ul><li>Understanding of CMS programs, MSSP, and HCC risk adjustment</li><li>Familiarity with clinical research processes, datasets, and reporting standards</li><li>Experience with EMR/EHR systems, especially Athenahealth / Athena EMR, and population health tools</li></ul>Preferred Qualifications<ul><li>Experience supporting clinical trials, registry data, or outcomes-based research</li><li>Knowledge of study design, cohort analysis, and healthcare quality measures (e.g., HEDIS)</li><li>Exposure to statistical tools such as R or Python is a plus</li></ul>Job Type: Full-timeWork Location: In person

Clinical Data Analyst (Athena Experience Required)

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