Clinical Risk Adjustment Coordinator

Bluebird Kids Health is a dynamic organization that provides underserved communities with new access to value-based pediatric primary care. We are on a mission to provide exceptional care, so every child can thrive. We offer comprehensive, evidence-based primary and urgent care services to children and their families, with around-the-clock support. Our care model includes robust care coordination, chronic disease management, and other population health supports. Our success is measured by exceptional health outcomes, lower medical costs, outstanding child and family experience, and a rewarding environment for our clinicians and staff.

We are seeking a Clinical Risk Adjustment Coordinator to support our Continuity of Care (CoC) program. This role is primarily responsible for retrospective clinical chart review and accurate documentation to ensure compliance with program requirements. The coordinator will review pediatric patient charts and appointment agendas, identify care gaps, complete reports, and support providers in documenting and addressing pre-existing or suspected conditions. Provide insight into common care gaps and opportunities for process improvement, trends in care gaps and documentation to support care provided. The ideal candidate will be detail-oriented, highly organized, and comfortable working in a fully remote environment while handling protected health information (PHI) in compliance with HIPAA standards. Familiarity with pediatrics, value-based care (VBC), and EHR systems such as Athenahealth is strongly preferred.

Temporary, per diem role with a minimum requirement of 10 hours per week, if requested by Bluebird Kids Health. Conduct retrospective chart reviews for assigned patients in Athenahealth, verifying identifiers, and reviewing clinical documentation. Review and update Continuity of Care (CoC) Appointment Agendas in health plan provider portals. Accurately document condition status using standardized categories. Identify incomplete documentation and escalate to providers for review using established workflows. Upload CoC Appointment Agenda PDFs to patient EHRs and annotate appropriately for upcoming or past encounters. Maintain case status tracking in the CoC Appointment Agenda Tracker to ensure accuracy and timeliness. Handle PHI securely - never storing patient data locally and ensuring compliance with HIPAA requirements at all times. Meet productivity expectations of reviewing an average of 3-6 patient cases per hour, depending on complexity. Collaborate with nursing and provider teams to support accurate and timely risk adjustment reporting. Identify and document trends and deficiencies in clinical documentation to improve accuracy Track risk adjustment data to identify trends, gaps, and opportunities for process improvement.