RN Population Health

Department AZ Pop Health - Clinic. Shift: Day. Category: Nursing. Job Overview We are looking for a Registered Nurse with experience in population health strategies, including quality, value‑based measures, and risk adjustment. The RN will work alongside Medical Group Executive leadership and develop collaborative relationships with physicians, APPs, and Banner employees in a true integrated team model. Responsibilities focus on workflows and operations across multiple geographic areas in the West Valley, collaborating with service line partners and reporting to senior executives. Position Summary This position provides clinical and operational coordination of all Risk Adjustment efforts in support of organizational strategic initiatives related to the Risk Adjustment program goals. It also serves as an informative source on Medicare Advantage funding models (Risk adjustment, HCCs, HEDIS quality rates, etc.) and collaborates with key stakeholders to implement activities across Banner Medical Group and identify opportunities for optimization of RAF scores and capture of HCCs. Core Functions Serve as subject‑matter expert for Risk Adjustment Factor (RAF) tools; coordinate design, testing, implementation, and post‑implementation monitoring of web‑based RAF tools and reports. Develop and implement Risk Adjustment education and training for network physicians and practices, covering documentation and coding requirements, HCCs, and HEDIS quality ratings. Establish and promote collaborative relationships with physicians, third‑party vendors, and other healthcare team members; collect and communicate timely clinical information for utilization and regulatory requirements. Assess accuracy and comprehensiveness of HCC recapture to ensure timely and appropriate diagnosis identification, optimizing financial benefit. Partner with Risk Adjustment resources to guide utilization of tools; provide formal training and support to physicians and practices. Serve as primary contact for external physicians and practices on escalated RAF tool issues; identify trends, resolve issues, and recommend business process improvements. Access and interpret data from multiple sources to analyze trends and educational opportunities; meet with workforce teams to review findings and develop improvement plans. Participate or lead Risk Adjustment projects to improve program offerings or address system limitations (e.g., practice management systems, clearinghouse routing, vendor routing, CMS submissions). Monitor data submission to CMS for Risk Adjustment attestation; analyze reports for data accuracy and compliance; prepare, analyze, and present reports as needed. Interface regularly with all levels at assigned facilities/entities and coordinate with internal resources and external vendors. Minimum Qualifications 3–5 years of related healthcare experience; strong knowledge of healthcare provider relations. Valid state RN license. Effective relationship development and communication skills in individual and group settings. Teamwork, attentive listening, and polished presentation skills. Critical thinking and project management capabilities. Proficiency in personal software applications: word processing, spreadsheets, claims adjudication, and provider systems. Preferred Qualifications Additional related education and/or experience. Estimated Pay Range $35.43 – $59.05 per hour. EEO Statement Banner Health is an equal‑employment opportunity employer and supports employees of all backgrounds, including persons with disabilities and veterans. Banner Health also supports a drug‑free work environment. #J-18808-Ljbffr Banner Medical Group