About this role
Use your expertise in value-based care, HCC coding, and documentation integrity to improve population health outcomes.
Pennant Services is seeking an experienced Population Health Coding & Documentation Integrity Auditor to join our Population Health team.
This role is ideal for a professional with deep expertise in ACO operations, value-based care, risk adjustment, CMS-HCC methodology, ICD-10-CM coding, and clinical documentation integrity who enjoys translating complex clinical information into accurate, compliant documentation and coding practices. This is not a traditional coding role focused solely on claim submission. Instead, you will serve as a strategic partner to providers and operational leaders, ensuring that documentation accurately reflects patient complexity, supports value-based care initiatives, and strengthens population health performance. The successful candidate will be responsible for reviewing medical records, conducting documentation and coding audits, identifying risk adjustment opportunities, educating providers, and helping improve the quality and accuracy of clinical documentation across Pennant's value-based care programs.
What You'll Do
• Conduct prospective and retrospective documentation and coding reviews for Medicare and value-based care populations. • Perform detailed chart audits to evaluate documentation accuracy, coding compliance, and risk-adjustment capture. • Identify missed, unsupported, under-documented, or inaccurately reported diagnoses. • Validate ICD-10-CM diagnosis coding and clinical support for reported conditions. • Review documentation for compliance with CMS-HCC and other risk-adjustment methodologies. • Identify opportunities to improve documentation specificity, clinical accuracy, and risk capture. • Analyze coding and documentation trends across providers, practices, and patient populations. • Partner with physicians, nurse practitioners, physician assistants, coders, and population health leaders to improve documentation quality. • Develop and deliver provider education focused on HCC documentation, risk adjustment, coding compliance, and value-based care performance. • Research CMS regulations, coding guidance, and risk adjustment requirements to support operational excellence. • Create audit reports, educational materials, provider scorecards, and documentation improvement resources. • Support ACO, MSSP, Medicare Advantage, and other value-based care initiatives. • Collaborate with operational and clinical leadership to improve documentation workflows and population health outcomes.
What We're Looking For We are seeking a highly analytical professional with significant experience in documentation integrity, coding audits, risk adjustment, and value-based care.
Required
• Minimum 3 years of experience in risk adjustment, coding compliance, clinical documentation integrity, population health, value-based care, or a related healthcare field. • Expertise in MSSP, HCC capture, provider auditing, RAF optimization, documentation integrity, and value-based reimbursement. • Strong knowledge of: • ICD-10-CM coding • CMS-HCC risk adjustment methodology • Clinical documentation integrity principles • Medical terminology, anatomy, physiology, and chronic disease management
• Experience conducting chart audits and medical record reviews. • Experience identifying documentation opportunities and coding accuracy concerns. • Demonstrated expertise in Medicare risk adjustment and HCC documentation requirements. • Strong understanding of ACOs, value-based reimbursement models, and population health strategies. • Ability to analyze clinical documentation and coding patterns across provider populations. • Excellent communication and provider education skills. • Strong analytical, organizational, and critical-thinking ability. • Ability to work independently while collaborating across multidisciplinary teams.
We'd Especially Like to Meet You If You Have
• Clinical Documentation Integrity/Improvement (CDI) experience • Population health or value-based care experience • Medicare Advantage or risk-adjustment experience • Experience with CMS-HCC documentation and coding • Coding or clinical documentation auditing experience • Provider education experience • Experience with prospective and retrospective chart review • Experience caring for medically complex or chronically ill populations • A BSN • CPC, CRC, CDIP, CCDS, or another relevant documentation/coding credential Preferred
• Experience supporting: • Medicare Shared Savings Program (MSSP) • ACO REACH or successor value-based care models • Medicare Advantage risk adjustment programs • Population health management initiatives
• Experience performing coding audits and compliance reviews. • Experience developing provider feedback and educational programs. • Experience with prospective and retrospective HCC review programs. • Familiarity with eClinicalWorks, HomeCare HomeBase, PCC, or other EHR platforms. • Knowledge of CMS documentation requirements and Medicare regulations. Preferred Certifications One or more of the following:
• Certified Risk Adjustment Coder (CRC) • Certified Professional Coder (CPC) • Certified Professional Medical Auditor (CPMA) • Certified Documentation Expert Outpatient (CDEO) • Certified Documentation Integrity Practitioner (CDIP) • Certified Clinical Documentation Specialist (CCDS) • RHIA or RHIT • CCS or CCS-P Clinical licensure (RN, LPN, PA, NP, etc.) is welcomed but not required.
The Kind of Person Who Will Thrive in This Role:
• Value-based care focused. You understand how accurate documentation impacts quality performance, risk adjustment, compliance, and patient outcomes. • An HCC expert. You know how to identify documentation opportunities, validate coding accuracy, and ensure diagnoses are clinically supported and compliant. • Analytical. You enjoy reviewing records, identifying patterns, and translating findings into meaningful action. • Provider-centric. You can educate physicians and advanced practice providers in a collaborative, practical way that improves documentation without creating unnecessary burden. • Compliance-minded. You understand the difference between appropriate risk capture and unsupported coding. • Data-driven. You use audit findings and population trends to drive improvement and measure success. • Continuous-improvement oriented. You look beyond individual charts to improve processes, provider performance, and organizational results.
Work LocationThis is a full-time, 40-hour-per-week position with a flexible remote work arrangement.
• Preference will be given to candidates based in or near Draper, Utah, and/or those residing within the Mountain Time Zone. Candidates located in other regions will be considered if they are able and willing to travel periodically to the Draper office and other Pennant locations as needed for meetings, provider education, audits, training, collaboration, and other business activities. • While this role may be performed remotely, regular availability during Mountain Time Zone business hours is strongly preferred to support effective collaboration with providers, operational leaders, and Pennant team members. • Periodic travel, including travel to the Draper, Utah office and affiliated operations, should be expected based on business needs.
Why This Role Matters
• Great population health starts with understanding the patient accurately. • The documentation in the medical record informs how an organization understands disease burden, identifies care opportunities, measures outcomes, manages populations, and succeeds in value-based care. • In this position, your expertise in documentation integrity, coding, risk adjustment, and value-based care will help ensure that patient complexity is accurately captured and represented. • You'll help bridge the gap between clinical care, documentation, coding, and population health strategy by providing providers with practical guidance that improves documentation quality, strengthens compliance, and enhances Pennant's ability to serve its patient populations effectively.
The hourly range for this position is $38.00-$53.00 per hour. Actual hourly rate is dependent upon experience, qualifications, credentials, and demonstrated expertise in risk adjustment, value-based care, coding, and documentation integrity.
Why Join Us? Something else that sets us apart from other companies is the quality of our most valuable resources – our people! We are dedicated to living out our culture as defined by our core values, “CAPLICO”:
• Customer Second – We prioritize and support our team so they can deliver exceptional care.
• Accountability – Own your work and outcomes.
• Passion for Learning – Grow continuously with curiosity and culture.
• Love One Another – Build authentic, respectful, and trusting relationships.
• Intelligent Risk Taking – Innovate and challenge the status quo.
• Celebrate – Recognize the small wins, they add up!
• Ownership – Be the CEO of your role.
Additional Benefits:
• True Work-Life balance – We believe in taking care of yourself before you take care of others!
• Full benefits package (medical, dental, vision, 401(k) with match)
• Paid time off, holiday pay, and professional development
• Your voice matters! - Work with other passionate and high-achieving leaders who care deeply about patient outcomes and team success.
About Pennant Services We support over 250 home health, hospice, senior living, and home care operations across 19 states. Our Service Center model empowers local leadership while providing centralized clinical, legal, HR, IT, and compliance support to help ensure high-quality care.
www.pennantgroup.com
The employer for this position is stated in the job posting. The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at http://www.pennantgroup.com.