Registered Nurse - Population Health Specialist

About the Role and Organization

Banner Health is transforming healthcare delivery to address current and future challenges in the U.S. This position for a Registered Nurse with expertise in population health strategies focuses on improving quality, value-based measures, and risk adjustment. The RN will collaborate closely with physicians and Advanced Practice Providers (APPs) while working alongside executive leadership in a team-based, integrated model.

The role centers on operations and workflows across multiple locations in the west valley region of Arizona, fostering partnerships with service line colleagues and maintaining high visibility with senior leaders. Banner Medical Group delivers primary and specialty care through various settings, employing over 1,000 physicians and 3,500 employees, emphasizing high-quality patient care consistent with its nonprofit mission.

Responsibilities

• Serve as a subject matter expert on Risk Adjustment Factor (RAF) tools, overseeing the design, testing, implementation, and ongoing functionality of web-based RAF resources.
• Develop and execute education and training programs for physicians and practices about documentation, coding, Hierarchical Condition Categories (HCCs), and HEDIS quality ratings linked to risk adjustment.
• Build and maintain collaborative relationships with physicians, vendors, and healthcare team members to ensure timely and accurate clinical data exchange for utilization and regulatory compliance.
• Evaluate HCC recapture accuracy and timing to maximize financial benefits for Banner Health through optimal identification of diagnoses.
• Guide Risk Adjustment tool usage, including providing direct physician and practice support and resolving escalated issues with attention to resource management and customer satisfaction.
• Analyze varied data sources to identify trends and educational needs; collaborate with workforce and quality teams to develop improvement plans and educational content.
• Lead or participate in Risk Adjustment projects addressing program enhancements and system limitations, including practice management and CMS submission processes.
• Monitor data submission for CMS attestation, review clinical risk adjustment reports, and ensure data compliance and accuracy.
• Regularly interact with personnel across organizational levels and external vendors to support Risk Adjustment objectives.

Qualifications

• Valid Registered Nurse (RN) license for the state of practice.
• Three to five years of relevant healthcare experience, particularly related to provider relations and population health strategies.
• Strong communication skills to develop relationships and educate providers in group and individual settings.
• Effective teamwork, critical thinking, and project management abilities.
• Proficiency in common software including word processing, spreadsheets, claims adjudication, and provider management systems.
• Additional related education or experience is preferred.

Compensation

The expected pay range for this position is $35.43 to $59.05 per hour. Actual salary will reflect experience, education, certifications, skills, and geographic factors, aligned with Banner Health’s commitment to equitable compensation.

Additional Information

Banner Health is an equal opportunity employer supporting disabled individuals and veterans. The organization maintains a drug-free workplace and observes strict privacy policies.