CDI Risk Adjustment Nurse

As a CDI Risk Adjustment Nurse, you will provide clinical documentation and risk adjustment review for Tendo's QDI Services customers, working in real time with physicians and advanced practice providers to ensure documentation accurately reflects patient acuity and quality of care. Success in this role depends on deep clinical expertise in acute-care documentation, risk adjustment methodology, and the ability to translate complex clinical detail into clear, compliant provider queries.

You will manage a daily assigned review queue, identify clinically supported documentation opportunities, and communicate directly with physicians and APPs on documentation and quality risk adjustment gaps. You will work closely with the Director of QDI Services and fellow reviewers on quality calibration, and support provider education initiatives across Tendo's customer portfolio.

Your work will directly shape the accuracy, quality, and financial integrity of our customers' clinical documentation.

Responsibilities

• Conduct QDI review of assigned inpatient cases, identifying clinically supported documentation opportunities in real time.
• Develop and follow up on compliant, physician-facing documentation queries.
• Communicate directly with physicians and APPs regarding documentation and quality risk adjustment opportunities.
• Manage and prioritize an assigned daily review queue to meet turnaround expectations.
• Participate in provider education activities related to clinical documentation, risk adjustment, and quality outcomes.
• Contribute to reviewer calibration and quality assurance activities.
• Support customer-specific workflows and initiatives as new health system partners onboard.

Requirements

• 6+ years of CDI/QDI experience.
• 6+ years of acute-care nursing experience.
• Active RN license, in good standing.
• CCDS certification.
• Epic experience.
• Working knowledge of HCCs, Elixhauser comorbidities, and quality risk adjustment methodology.
• Direct experience communicating and educating physicians and APPs on documentation opportunities.
• Must be able to work independently and manage a queue with minimal oversight.
• Excellent written and verbal communication skills.