Manager, Clinical Documentation Integrity Performance

Summary

Join Aledade as a CDI Manager and lead a team of CDI Coders, ensuring compliance with regulatory standards and optimizing clinical documentation practices. You will oversee CDI coding processes, maintain high-quality documentation standards, and support accurate risk adjustment coding. This remote role involves periodic travel for training and support. The ideal candidate is detail-oriented, service-driven, and a strong communicator proficient in Google Suite. You will manage and monitor coding and billing programs, act as a liaison with internal and external customers, and design and oversee coding-related activities and solutions. You will also manage and lead billing and coding projects, identifying trends and providing feedback to improve practices.

Requirements

• Bachelor's degree in Health Information Management or related healthcare field
• 10 years of experience in lieu of the degree
• Minimum 4-6 years of experience in a health plan or health system setting
• Minimum of 3 years of experience in Risk Adjustment
• Minimum of 3+ years of management experience
• Ability to influence, provide customer service, and work collaboratively with internal and external customers, including physicians
• Ability to establish and maintain effective working relationships across the company
• Complete understanding of acuity levels for specific patient populations and strong clinical knowledge with the ability to interpret clinical documentation
• Critical thinking skills to problem solve and communicate with physicians on clinical issues
• Analytical ability necessary to conduct basic research, analyze and interpret data, evaluate processes and propose solutions
• Extensive knowledge of regulations and guidelines pertaining to documentation and coding
• Ability to prioritize work, meet deadlines, and produce quality results on time with strong attention to detail
• Excellent written and oral communication skills including excellent presentation skills and the ability to communicate effectively with all levels of management and medical providers

Responsibilities

• Plans, organizes, and manages the system-wide CDI Coding performance functions
• Manages the activities of and provides leadership to the CDI Coding team
• People manage a team of 5-10 CDI Coders
• Provide guidance and support and build effective teams (both internally and with vendors) to achieve established goals within established budgets
• Manage and monitor the effectiveness of the coding and billing programs; develop key indicators to effectively monitor performance and identify and implement process improvement strategies necessary to meet annual targets
• Manages coding and quality, productivity, workflow and performance activities
• Acts as a liaison and subject matter expert for internal and external customers in coding, billing, and risk adjustment
• Monitors coding performance to meet regulatory, legal and risk management implications of health information, coding, and documentation compliance guidelines
• Manages adherence to the policies and procedures governing coding and reimbursement in compliance with federal and state laws and regulatory guidelines
• Design, build, scale and oversee activities, programs, interventions and solutions based on market needs
• Actively participates in the evaluation, selection, and maintaining of information systems supporting coding
• Use data to identify practices that could benefit from Aledade services
• Partner with practices to understand billing and coding workflows and identify opportunities for process improvement
• Manage & lead billing and coding related projects, including tracking key metrics across initiatives and driving cross-functional team collaboration
• Identify trends across practices and provide feedback on the best course of action to improve billing and coding practices

Preferred Qualifications

• Master’s degree in health related fields
• One of the following active credentials issued by the American Health Information Management Association (AHIMA) or current Registered Nurse (RN) licensee: RHIA – Registered Health Information AdministratorRHIT – Registered Health Information TechnicianRN – Registered Nurse
• One or more of the following active credentials: Certified Coding Specialist (CCS) - AHIMA Certified Documentation Improvement Practitioner (CDIP) – AHIMA Certified Clinical Documentation and Certification - Outpatient (CCDS-O) - ACDIS Certified Risk Coder (CRC) - AAPC Certified Professional Medical Auditor (CPMA) - AAPC Certified Professional Biller (CPB) - AAPC Rural Health Coding & Billing Specialist (RH-CBS) - ArchPro Coding Community Health Coding & Billing Specialist (CH-CBS) - ArchPro Coding

Benefits

• Flexible work schedules and the ability to work remotely are available for many roles
• Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
• Robust time-off plan (21 days of PTO in your first year)
• Two paid volunteer days and 11 paid holidays
• 12 weeks paid parental leave for all new parents
• Six weeks paid sabbatical after six years of service
• Educational Assistant Program and Clinical Employee Reimbursement Program
• 401(k) with up to 4% match
• Stock options