When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.This role supports a clinically integrated network of providers and care teams committed to delivering high-quality, value-based care. The CDI Risk Adjustment Nurse plays a critical role in improving risk adjustment accuracy, documentation integrity, and gap closure performance across the network. This position leverages clinical expertise to conduct chart review and abstraction, identify coding opportunities, validate diagnoses, and support provider workflows, with a strong emphasis on chronic condition capture and pre-visit planning integration. Working under the direction of the CDI Manager and Performance leadership, this role collaborates across coding, quality, and provider teams to ensure accurate representation of patient complexity and to drive performance in value-based contracts.Job Description:Essential Duties & Responsibilities including but not limited to:Under the supervision of the CDI Manager, the CDI Risk Adjustment Nurse will: 1. Chart Review, Abstraction & Risk Gap Identification · Perform prospective, concurrent, and retrospective chart reviews to identify documentation and coding opportunities for risk adjustment · Abstract clinical data to support HCC/risk score accuracy and gap closure initiatives · Identify missed or undocumented chronic conditions, ensuring alignment with clinical evidence and documentation standards · Apply MEAT criteria Monitor, Evaluate, Assess, Treat to validate coding appropriateness · Identify trends and recurring documentation opportunities through chart review activities and communicate findings to CDI leadership to support provider education and performance improvement initiatives. 2. Coding Opportunity Identification & Pre-Visit Workflow Support · Identify coding opportunities as directed by the CDI Manager and Performance Director, with a focus on chronic disease burden · Pa
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