Kaitlin Sebourn, MHA, RHIA, CDIP, CRC

Director of Engineering

Columbus, Ohio, United States9 yrs 5 mos experience

Most Likely To SwitchHighly Stable

Key Highlights

Expert in Medicare Advantage and population health initiatives.
Proven track record in risk adjustment and clinical documentation.
Leadership in managing complex healthcare projects.

Stackforce AI infers this person is a Healthcare professional specializing in value-based care and risk adjustment.

Contact

Skills

Core Skills

Medicare AdvantagePopulation HealthRisk AdjustmentClinical Documentation

Other Skills

CPTChart AuditsClinical Documentation ImprovementClinical Documentation Improvement EducationCodingCoding Team ManagementEHR FunctionalitiesElectronic Medical Record (EMR)HCPCS Level I & IIHealth Information ManagementHealthcareHealthcare ManagementHealthcare ReimbursementICD-10ICD-10 CM

About

Experienced senior value-based care professional with a demonstrated history of working in the managed care space. Skilled in Medicare Advantage Organizations, risk-bearing entities, CMMI models, special needs populations, population health initiatives, risk adjustment, coding, clinical documentation integrity, provider education, compliance, and finance.

Experience

Davita kidney care

2 roles

Director, Clinical Programs

Promoted

Oct 2024 – Present · 1 yr 5 mos

Senior Manager, Clinical Programs

Nov 2021 – Oct 2024 · 2 yrs 11 mos

As a part of the Integrated Kidney Care team, we’re building population health programs for our C-SNP and Comprehensive Kidney Care Contracting patients diagnosed with CKD and ESKD. In my role, I lead Medicare Risk Adjustment initiatives, our coding team, encounter data submission efforts and guide our Clinical Documentation Improvement team. I also serve as the lead for reporting and analytics surrounding the Continuous Health Evaluations of our patients. Finally, I provide the Integrated Kidney Care team with project management services to support innovative initiatives.

Medicare Risk AdjustmentCodingClinical Documentation ImprovementReporting and AnalyticsProject ManagementMedicare Advantage+1

Agilon health

Manager, Risk Adjustment

May 2019 – Nov 2021 · 2 yrs 6 mos

Manager of Risk Adjustment in Columbus, Ohio within the partnership between agilon health and Central Ohio Primary Care. I partnered with more than 56 adult medicine practices & more than 250 providers to deliver agilon’s advanced population health model to our Medicare Advantage & Medicare Fee For Service patient population. I also managed a coding team & physician reviewer team to assist our provider partners in accurately describing the burden of illness of these patients to our partnered health plans.

Risk AdjustmentPopulation Health ModelCoding Team ManagementProvider EducationPopulation Health

Mount carmel health system

2 roles

Project Manager

Promoted

Apr 2019 – May 2019 · 1 mo

Mount Carmel Health Partners was granted $10M from Trinity Health's Innovation Council to further the reaches of quality healthcare. Risk Adjustment was a large part of this initiative and my role was to manage the transition of nearly 50 independent practices from the original delivery system to the re-imagined delivery system.

Risk Adjustment ManagementTransition ManagementRisk Adjustment

Risk Adjustment Coding Auditor

Nov 2018 – May 2019 · 6 mos

I worked closely with 15 practices and 49 providers to provide Clinical Documentation Improvement Education. I regularly performed audits of charts to target common documentation and coding errors that can affect revenue. I also provided support to practices that participate in third-party vendor programs like Optum HQPAF and Advantasure (Tessellate) for their Medicare Advantage patients.

Clinical Documentation Improvement EducationChart AuditsSupport for Third-party Vendor ProgramsClinical Documentation

Cincinnati children's hospital medical center

Administrative Health Information Management Intern

Mar 2018 – Apr 2018 · 1 mo · Cincinnati, Ohio

This internship placed me with the Senior Director of the Health Information Management Department of CCHMC. This experience allowed me to engage in interdepartmental meetings for implementing new software or EHR functionalities, partake in director's level meetings across the organization, explore the ramifications of policy and workflow changes, and meet department heads to explore the possibilities of what it means to be an HIM professional.

Health Information ManagementEHR Functionalities

The ohio state university wexner medical center

2 roles

Student Intern

Jan 2017 – Mar 2018 · 1 yr 2 mos · Columbus, Ohio Metropolitan Area

I used ICD-10 CM, ICD-10 PCS, and HCPCS Level I & II codes to engage with and assist both inpatient and outpatient coding specialists at the OSU Wexner Medical Center. I was responsible for coding monthly "bill drops" for outpatient facilities as well as developing ways to improve coding specialists' productivity.

ICD-10 CMICD-10 PCSHCPCS Level I & II

Student Intern

Feb 2016 – Jan 2017 · 11 mos · Columbus, Ohio Metropolitan Area

I was a student employee of the Medical Information Management Department at the OSU Wexner Medical Center. I worked with Satellite Operations of the Ross Heart Hospital. I was responsible for file services which includes working with document imaging software as well as Epic.