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    <title>Apex Health Solutions Jobs</title>
    <link>https://ejob.bz/CompanyPortal.do?companyGK=36560&amp;portalGK=26135</link>
    <description><![CDATA[Job Postings available for application.]]></description>
    <language>en-us</language>
    <pubDate>Fri, 09 Oct 2026 22:15:06 EDT</pubDate>
    <lastBuildDate>Fri, 09 Oct 2026 22:15:06 EDT</lastBuildDate>
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    <item>
      <title><![CDATA[Director, Clinical Documentation Improvement - Houston, TX]]></title>
      <link>https://ejob.bz/jb.do?reqGK=27781203&amp;companyGK=36560&amp;portalGK=26135</link>
      <guid>0099906f-ae98-40dc-afd9-36954a2712ef</guid>
      <description><![CDATA[Job Title: Director, Clinical Documentation Improvement
Supervisor: VP, Market Operations
Required License(s)/ Certification(s): CPC (Certified Professional Coder) or CRC (Certified Risk Adjustment Coder) credential required, or equivalent coding certification. CDEO or RHIA preferred.
FLSA Status: Exempt
 
Summary:  The Director, Clinical Documentation Improvement is responsible for leading Apex Health Solutions&rsquo; risk adjustment and clinical documentation improvement (CDI) strategy across employed and contracted provider engagements. This role owns end-to-end CDI workflow design&mdash;from EMR-embedded and portal-driven programs to payer relationship support and compliance oversight. The Director manages a team of CPC-credentialed coders, drives AI-enabled and potential offshore efficiency strategies, and serves as a strategic partner to clients, payers, and internal Apex Medical and Product leadership. This is a high-impact, client-facing leadership role requiring deep expertise in risk adjustment methodology, coding compliance, and provider education.
 
Essential Duties and Responsibilities include the following. Other duties may be assigned.
 
Risk Adjustment and Clinical Documentation Improvement Workflows
       Design, implement, and oversee both employed and contracted CDI workflows, including EMR-embedded and portal-driven program models.
       Ensure workflow accuracy, compliance, and scalability across diverse client environments and EMR platforms.
Risk Adjustment Strategy Development
       Develop and execute a comprehensive risk adjustment strategy that drives accurate, specific, and compliant clinical documentation across client provider networks.
       Lead workflow development for new client onboardings per year, customizing approaches by EMR platform and client operating model.
       Serve as a client-facing leader, delivering weekly and monthly performance reporting and strategic presentations in partnership with Market Operations leadership.
Team Leadership and Staffing Optimization
       Recruit, lead, and develop a team of CPC-credentialed coders supporting both embedded and contracted CDI workflows.
       Scale and optimize the staffing model to meet client growth, including evaluation of AI-assisted coding tools and offshore hiring strategies to drive efficiency.
       Conduct performance management, annual reviews, and ongoing coaching to develop team capabilities and maintain coding quality standards.
Product Development Partnership
       Serve as a subject matter expert and internal advocate for CDI workflow enhancements, translating operational insights into actionable product requirements.
       Partner with key external consultants to develop the data and AI layers supporting coding workflows, including predictive risk capture and documentation gap identification tools.
       Inform the design and development of audit workflow capabilities to support compliance, accuracy, and revenue integrity.
Provider Education and Audit Workflow
       Develop and maintain a comprehensive provider education library covering risk adjustment best practices, HCC coding, and documentation specificity.
       Partner with Apex Medical leadership to align provider education strategies with clinical quality and risk adjustment objectives.
       Design continuing medical education (CME) offerings that drive provider engagement and support CME credit attainment.
       Develop and oversee the provider audit workflow to identify documentation gaps, track remediation, and measure improvement over time.
Payer Relationship Support
       Support the development and management of upstream payer relationships, including national payers such as UnitedHealthcare, Humana, and others specific to risk adjustment scope.
       Oversee risk adjustment reporting deliverables required by contracted payers, ensuring accuracy, timeliness, and compliance.
       Lead Annual Supplemental Mapping (ASM) process development and support payer-facing risk adjustment submissions and reconciliation activities.
Compliance and Audit Oversight
       Establish and maintain a robust compliance framework for all risk adjustment activities, ensuring alignment with CMS guidelines, RADV audit standards, and payer contract requirements.
       Oversee internal audit processes to monitor coding accuracy, identify risk areas, and implement corrective action plans.
       Stay current on regulatory changes impacting risk adjustment and CDI, and proactively communicate updates to internal and client-facing stakeholders.
 
       Other duties may be assigned.
 
 
Candidate Qualifications 
 
       Deep expertise in risk adjustment methodologies, HCC coding, and CMS risk adjustment models (MA, ACA, PACE).
       Demonstrated experience managing and scaling teams of certified coders (CPC, CRC, or equivalent credentials).
       Strong working knowledge of major EMR platforms and CDI workflow integration (e.g., Epic, Athena, eClinicalWorks).
       Experience developing and delivering provider education programs, including CME-eligible offerings.
       Ability to build and sustain strong client, payer, and cross-functional stakeholder relationships.
       Strong analytical skills with the ability to interpret risk adjustment data and translate insights into actionable strategies.
       Familiarity with AI-assisted coding tools and technology-enabled workflow optimization.
       Advanced written and verbal communication skills, including experience presenting to executive and client audiences.
       Knowledge of compliance frameworks governing risk adjustment, including RADV, CMS audits, and payer audit processes.
 
 
Education/ Experience
       Bachelor&rsquo;s degree in Health Information Management, Healthcare Administration, Nursing, or a related field; Master&rsquo;s degree preferred.
       Minimum of 7 years of experience in risk adjustment, clinical documentation improvement, or health plan coding operations.
       Minimum of 3 years in a people management or team leadership role.
       Experience working in or alongside a physician practice management, managed care, or value-based care organization preferred.
       CPC (Certified Professional Coder) or CRC (Certified Risk Adjustment Coder) credential required, or equivalent coding certification. CDEO or RHIA preferred.
 
 
Skills 
       Strategic Leadership &ndash; Develops and executes multi-faceted strategies that align CDI and risk adjustment operations with organizational growth goals.
       Achievement Focus &ndash; Sets and achieves challenging goals; demonstrates persistence and overcomes obstacles; measures performance against a standard of excellence.
       Communication &ndash; Expresses ideas clearly in both written and verbal form; presents complex data accessibly to diverse audiences.
       Managing People &ndash; Provides clear direction, develops team members, and fosters a high-performance culture.
       Client Orientation &ndash; Builds trusted partnerships with clients and payers; proactively identifies and addresses client needs.
       Problem Solving &ndash; Identifies issues in a timely manner; develops creative solutions; resolves challenges at early stages.
       Planning & Organization &ndash; Prioritizes work effectively; manages multiple client engagements and workstreams simultaneously.
 
 
 
About Apex Health Solutions
Apex Health is a tech-enabled management services organization that enhances the enterprise value of health systems by transforming physician networks into strategic assets. More than a consultant, Apex embeds as a long-term partner to drive sustainable performance across provider enablement, quality, network growth, and value-based care. With proven success at leading health systems, Apex helps clients preserve local control over care delivery and financing, rather than outsourcing it to national insurers.
 
 
The above job description is not intended to be an all-inclusive list of duties and standards of the position.  Incumbents will follow any other instructions, and perform any other related duties, as assigned by their supervisor]]></description>
      <pubDate>Wed, 15 Jul 2026 00:00:00 EDT</pubDate>
    </item>
    <item>
      <title><![CDATA[Practice Performance Manager (Wichita, KS) - Wichita, KS]]></title>
      <link>https://ejob.bz/jb.do?reqGK=27768352&amp;companyGK=36560&amp;portalGK=26135</link>
      <guid>46400587-D4BA-670E-E063-0100007F11C0</guid>
      <description><![CDATA[Summary 


The Practice Performance Manager (PPM) is responsible for all value-based care initiatives, interventions to support the implementation and transition to Value Based Care processes. The PPM is responsible for providing on-site and remote assistance and /or education to clinicians, care teams and their associated practices to drive improvement in clinical quality, risk adjustment and operational efficiency. The PPM is responsible for partnering with practices to ensure VBC goals are met. 


 


This position coaches practice staff to improve patient outcomes by developing skills in process improvement, value-based and teambased care, encouraging patient engagement, and analyzing quality data and measurements. The PPM is committed to leveraging data and analytics for quality improvement, research, and practice transformation. The PPM will provide guidance and expertise in the development, implementation, and optimization of training materials used to facilitate practice transformation. The PPM will work as part of an interdisciplinary team to create and deliver products and services including user education and training materials, project plans, tool kits, and evaluation materials. 


 


Key Responsibilities 




Establish a planned care model with practices in integrating administrative, financial, and clinical systems for better performance and improved outcomes. 






Develop and implement workflow design and redesign, including electronic health record (EHR) optimization, clinical documentation, billing practices, assessments, financial analyses, and financial performance improvement and reporting. 






Works with practice sites on clinical documentation improvement activities, to include chart review, feedback and education. 






Utilize available tools to assist clinicians with capturing and analyzing populationbased data to support practices with datadriven decision making and direct improvement efforts to support practice leadership develop the skills to interpret and act on quality metric data with performance management tactics. 






Build trusting relationships to help drive continuous change with physicians/physician staff to find ways to encourage member clinical participation in wellness and education by providing resources and educational opportunities to provider and staff. 






Engage directly with patients as needed to schedule annual wellness visits, facilitate referrals, and help with patient navigation. 






Develop and implement changes to root causes of financial and quality under performance and communicate strategies to providers and provider groups. 






Understand the role of analytics and the importance of clear, defined, and accurate data for improving healthcare outcomes. 






Execute responsibilities in a manner that promotes collegial, collaborative, and effective communication to successfully reach mutually agreed upon goals with practice sites and colleagues. 






Provide support for other interdisciplinary teams (e.g. s clinical implementation, analysis, research, support services, training, medical record retrieval projects). 




 


Qualifications 




Bachelors Degree in related field or five years related experience 








A license in one of the following is preferred: 






Certified Risk Adjustment Coder (CRC) 






Certified Professional Coder (CPC) 






Certified Professional in Healthcare Quality (CPHQ) 






Licensed Vocational Nurse (LVN) 






Minimum three years of experience with a focus on EMR operations, use, design, and implementation 






Minimum three years of medical practice management, clinical program development, clinical transformation, healthcare quality analytics and/or quality improvement]]></description>
      <pubDate>Fri, 20 Mar 2026 00:00:00 EDT</pubDate>
    </item>
    <item>
      <title><![CDATA[Patient Care Advocate - Houston, TX]]></title>
      <link>https://ejob.bz/jb.do?reqGK=27770120&amp;companyGK=36560&amp;portalGK=26135</link>
      <guid>1cb404ae-e0e3-4406-a997-41c1b090a192</guid>
      <description><![CDATA[SUMMARY:
Works with members and providers to close care gaps, assist with medication refills, identify barriers to care, and improve the overall member and provider experience through outreach with members and providers. Conducts telephonic outreach to members who are identified as needing preventive services in support of quality initiatives and provides education to members regarding the care gaps they have. Assist with scheduling doctor appointments on behalf of the member and assists with wraparound services such as arranging transportation, connecting them with community-based resources and other affinity programs as available. Maintains confidentiality of business and protected health information.
 
Reports to: Manager, Quality & Strategy Engagement
Location: Houston, TX
 
EDUCATION:
&bull; Bachelors or Associates Degree in related field or two (2) years related experience
 
LICENSES/CERTIFICATIONS:
A license in one of the following is preferred:
&bull; Pharmacy Technician (CPhT)
&bull; Licensed Vocational Nurse (LVN)
&bull; Registered Nurse (RN)
&bull; Social Worker (LSW)
 
EXPERIENCE:
&bull; Work experience should be in direct patient care, social work, quality improvement or health coaching
preferable in a managed care environment.
&bull; Knowledge of CMS STAR Ratings Program requirements preferred.
&bull; Knowledge of HEDIS and NCQA requirements preferred.
 
SKILLS:
&bull; Knowledge of healthcare delivery
&bull; Strong oral communication skills
&bull; Ability to work in a fast paced environment with changing priorities
&bull; Ability to work with others in a matrixed environment
&bull; Demonstrated written communication skills
&bull; Demonstrated time management and priority setting skills
&bull; Demonstrated problem solving skills
&bull; Demonstrated organizational skills
 
RESPONSIBILITIES:
&bull; Acts as a liaison and member advocate between the member/family, physician and facilities/agencies.
&bull; Schedules doctor appointments for members with care gaps to access needed preventive care services
&bull; Conducts telephonic outreach to members at risk for medication non-adherence and provides assistance as needed with obtaining medication refills.
&bull; Conducts telephonic outreach to members and providers to support quality improvement & risk adjustment
initiatives
&bull; Arranges transportation for members as needed.
&bull; Arranges follow-up appointments for member as needed.
&bull; Documents all actions taken regarding contact related to member.
&bull; Interacts with other departments including customer service to resolve member issues.
&bull; Refers to case or disease management as appropriate.
&bull; Completes special assignments and projects instrumental to the function of the department.
&bull; Performs other duties as assigned.
 
TECHNICAL SKILLS:
&bull; Working knowledge of Microsoft Office
&bull; Working knowledge of Electronic Health Records (EHR)
 
About Apex Health Solutions
Apex Health is a tech-enabled management services organization transforming how health systems unlock value from their physician networks and succeed in value-based care. More than a consultant, Apex embeds as a long-term partner to drive sustainable performance across provider enablement, quality, network growth, and value-based care. With proven success at leading health systems, Apex helps clients preserve local control over care delivery and financing, rather than outsourcing it to national insurers.]]></description>
      <pubDate>Fri, 13 Mar 2026 00:00:00 EDT</pubDate>
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