Clinical Documentation Manager
New
J
JobgetherHealthcare risk adjustment
Remote work within the United States.Full-TimeManager
SalaryAnnual base salary: $73,000–$115,000 USD, depending on qualifications, relevant experience, skills, education, certifications, and work location. Monthly mobile phone or internet stipend of $100. Stock options available to all employees. Bonus eligibility for most roles, excluding Director-level positions and above.
Apply NowOpens the employer's application page
Job Details
- Experience
- At least 3 years of outpatient Clinical Documentation Integrity (CDI) experience or 5 years of Medicare Advantage risk adjustment coding or auditing experience.
- Required Skills
- Generative AI
Requirements
- At least 3 years of outpatient Clinical Documentation Integrity (CDI) experience or 5 years of Medicare Advantage risk adjustment coding or auditing experience.
- Strong expertise in Medicare Advantage risk adjustment, including CMS-HCC.
- Expertise in ICD-10-CM coding guidelines, AHA Coding Clinic guidance, and CMS regulations.
- Hold a current, active professional credential through AAPC, AHIMA, or ACDIS.
- Demonstrated experience reviewing medical records and evaluating clinical documentation integrity.
- Demonstrated experience preparing audit rebuttals.
- Commitment to compliance, ethical coding practices, and healthcare regulatory requirements.
- Ability to work independently, manage competing deadlines, analyze spreadsheets and dashboards, and adapt to evolving priorities and processes.
- Preferred: clinical background or healthcare license, such as RN, LPN, NP, PA, or MD.
- Preferred: experience with generative AI, LLM workflows, healthcare data analytics, or modern technical tools in CDI or risk adjustment.
- Preferred: experience contributing to cross-functional workgroups, strategic projects, or continuous improvement initiatives.
Responsibilities
- Serve as a subject matter expert and strategic partner to risk adjustment leadership, contributing to coding workgroups and promoting alignment with ICD-10-CM, AHA Coding Clinic, CMS, and AHIMA guidance.
- Create, standardize, and maintain condition-specific documentation guidelines, EHR template recommendations, and provider education materials, including webinars.
- Collaborate with Practice Consultants on provider engagements, operational presentations, escalated coding questions, and workflow improvements.
- Conduct end-to-end chart reviews, assess documentation integrity, and prepare evidence-based rebuttals for internal and external risk adjustment audits.
- Identify and introduce AI-assisted workflows, automation, and tracking tools to improve research efficiency, audit readiness, and provider education.
- Partner with clinical and operational stakeholders to refine and test risk adjustment insights using data from multiple sources and integrate relevant information into provider workflows.
- Review medical records, analyze documentation trends, measure educational initiative effectiveness, and identify opportunities for continuous quality improvement.
View Full Description & ApplyYou'll be redirected to the employer's site
