Provider Educator

Provider Educator – Job Description 

About Herself Health: 

Herself Health is an Advanced Primary Care practice for women 65+ enrolled in Medicare and Medicare Advantage plans. Our mission is to redesign healthcare for women 65 and up. We personalize care by connecting life goals with health goals to help our patients get more out of life. The company was founded in 2022 by the successful venture-backed team at Juxtapose, based in NYC, and a board with a well-established record of building best-in-class healthcare companies. Our focus on patient experience, staff training in women’s health, and value-based care differentiate us and allow us to provide best-in-class primary care to our patients. Our goal is to ensure that every patient feels seen, heard, understood and respected as they navigate their unique care journeys. Our first clinical market is Minneapolis/Saint Paul, MN, with our first clinic in the Highland Park community of Saint Paul.  

• Female focused – Female focused, age-conscious services designed to lead patients to their best lives.
• Whole person approach – Care that considers every part of health: physical, emotional, spiritual, sexual, and social. 
• Genuine relationships – Real talk and meaningful support from doctors that take the time to get to know the patient.
• Unique to her goals – Customized care methods that help patients reach unique life goals, realistically. 

About you: 

As we grow our early team, we are seeking strategic thought leaders who have a passion for building and innovating. We foster a culture of collaboration, excellence, and the willingness to roll up our sleeves and learn as we grow. We have a customer first mindset, and we are looking for team members who share that. Our ideal candidates have strategic prowess and the ability to use data to build best practices and implement great ideas in collaboration with our team and our community.   

About the Provider Educator Role:  

The Provider Educator will facilitate and provide detailed analysis, reporting, training, education, and support for providers and care teams across medical offices to promote accurate clinical documentation and risk adjustment opportunities identified during chart reviews or analytics. They will also prepare medical records for providers before each visit. 

The Provider Educator will directly support the Herself-Health Clinical Team. They will be expected to perform within the following scope, as well as other assigned duties and activities that aid and leverage our Team function. Responsibilities include and are not limited to:

• Responsible for successful education across internal and Providers around condition identification, documentation and coding 
• Responsible for chart prep and review before each patient visit 
• Ensure assigned Providers are trained and educated on CMS compliance and guidelines  
• Build, establish and maintain collaborative relationships with assigned Providers 
• Remain up-to-date, educated and competent in applicable Health Plan, Medicare, AMA, ICD-10 and documentation changes
• Conduct chart audits to establish patterns of opportunity for improved documentation
• Identify potential chronic conditions
• Identify missing treatment plans
• Ensure accurate identification and documentation of current active diagnosis only
• Educate providers in-person or remotely on the purpose of Risk Adjustment, Hierarchical Condition Categories (HCC), CMS Documentation Guidelines, Condition Identification, Appropriate Documentation with MEAT
• Flexible to accommodate Provider schedules when facilitating education and training needs
• Provide onboarding and training for all new Primary Care Providers and Nurse Practitioners across internal and affiliate medical offices
• Establish meetings after onboarding to educate, guide and provide feedback to Providers regarding their conditional identification, documentation and coding
• Analyze key coding performance indicators to determine providers in need of initial or additional training, continually
• Evaluate Providers on consistent identification of chronic conditions
• Responsible for developing HCC specific provider improvement plans based on analysis and internal review outcomes
• Develop and implement Quality Improvement Plans (QIP) as needed based on the chart reviews conducted to identify specific areas of training needs
• Update and maintain individual Provider profiles to identify strengths, areas of improvement and conditional identification, documentation and coding patterns
• Assist in creation and development of new playbooks, policies and procedures (p&p) or the revision of existing P&Ps around Provider education
• Expected to attend and participate in weekly team meetings with team
• Expected travel as needed to any designated region to assist in leveraging initiatives
• Expected attendance, participation and facilitation (as needed) of “Bootcamp” and “Mini-Bootcamp” training forums (anticipated weeknight or weekend)
• Assist in creating content
• Facilitate and lead (as applicable) clinical conversations
• Prepared to speak and present (as applicable)
• Other designated administrative, clinical support and tasks as assigned to leverage goals 

Must-have Qualifications and Skills: 

• Foreign Medical Graduate MD or RN License (Full or Limited License) 
• CPC or CRC certification (Or ability to get certified within 6 months) 
• 2 years of experience in a Risk Adjustment / Documentation preferred 

Nice-to-have Qualifications and Skills: 

• Proven ability to work with Google Suite software or equivalent (MS Excel and MS Powerpoint) 
• Demonstrate high level communication skills and successful delivery of clinical information (ie: common chronic conditions) 
• Ability to work independently with minimal supervision 
• Excellent organizational, time-management, and multi-tasking skills with strong attention to detail 
• Demonstrated resourcefulness, initiative, and results-oriented capabilities
• Ability to work in a shifting and fast-paced environment
• Ability and flexibility to work a traveling schedule as needed
• Must be able to work professionally with confidential information
• Excellent written and verbal communication skills
• Ability to work cross-functionally with multiple teams
• Ability to shift focus, multi-task, and prioritize in a rapidly changing environment
• Strong reasoning and critical thinking required
• Must be results oriented with a focus on quality execution and delivery