Manager, Clinical Documentation Integrity

đź•’ vor 19 Tagen

🇺🇸 Vereinigte Staaten – Remote

đź’µ $115.000 / Jahr

⏰ Vollzeit

🟡 Mittelstufe

đźź  Senior

🏥📝 Medizinischer Autor

đź‘» Geisterscore 0%

infoinfo

🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of TGH Senior Center Powered by Greenbrook Medical

TGH Senior Center Powered by Greenbrook Medical

2 - 10 Mitarbeiter

GegrĂĽndet 2024

🏥 Gesundheitswesen

⚕️ Krankenversicherung

👥 B2C

Healthcare • Healthcare Insurance • B2C

Das TGH Senior Center, angetrieben von Greenbrook Medical, ist eine auf Erwachsene ab 65 Jahren spezialisierte Primärversorgungsgruppe, die in Partnerschaft mit dem Tampa General Hospital und mit der Unterstützung von Greenbrook Medical gegründet wurde. Die Praxis bietet seniorenorientierte, beziehungsbasierte Primärversorgung mit längeren Besuchen, verkürzten Wartezeiten und einem rund um die Uhr verfügbaren Betreuungsteam. Zu den vor Ort angebotenen Dienstleistungen gehören Labordienste, EKG- und Kreislauftests, Lungenfunktionstests (PFT), Gelenkinjektionen und Hautbiopsien. Häufig behandelte Erkrankungen sind unter anderem Arthritis, Diabetes, Bluthochdruck, hoher Cholesterinspiegel, Herzkrankheiten und COPD. Zu den Standorten gehören Brandon, Riverview und Spring Hill, und das Zentrum akzeptiert Medicare-Pläne einschließlich UnitedHealthcare MA.

Beschreibung

• Lead day-to-day operations of prospective and concurrent CDI review processes • Set and enforce quality, productivity, and turnaround-time standards • Monitor work queues and workflow, identifying bottlenecks • Lead team huddles, 1:1s, coaching conversations, and performance discussions • Manage schedules, coverage, timecards, and time-off requests • Serve as the escalation point for coding questions and challenges • Own onboarding, training plans, resources, workflows, and readiness assessments for new CDI specialists • Coach team members on technical knowledge, quality, productivity, and professional growth • Track accuracy, quality, production, turnaround time, and other CDI metrics • Identify trends, root causes, and improvement opportunities • Partner on audits, scoring methodology, follow-up reviews, and quality improvement • Build and improve SOPs, workflows, job aids, documentation standards, coding best practices, and internal guidance • Partner with physician leadership, clinical teams, Medical Records, retrieval, billing, claims, and operational teams • Translate complex coding and documentation requirements into practical guidance • Ensure alignment with ICD-10-CM guidelines, CMS-HCC risk-adjustment requirements, payer policies, and applicable regulations • Support audit readiness, including RADV and other regulatory or payer reviews

🎯 Anforderungen

• 5+ years of experience in clinical documentation integrity, risk adjustment, or HCC coding, including experience supporting Medicare Advantage populations • Experience leading, coaching, or supervising others and holding a team accountable to clear performance standards • Deep knowledge of ICD-10-CM and CMS-HCC risk-adjustment methodology, including V24 and V28 • Strong experience working alongside physicians and clinical teams on documentation quality • Active coding credential such as CRC, CPC, CCS, RHIT, or RHIA • Associate's or Bachelor's degree in Health Information Management, nursing, or a related field, or equivalent relevant experience • Experience working with EHRs and CDI, coding, or risk-adjustment platforms • Strong judgment when navigating complex compliance, quality, and performance issues • CRC certification, with CDIP or CCDS considered a plus • Experience building training programs, provider education, SOPs, or workflows • Ability to coach technical teams without micromanaging • Comfort using data and performance metrics to identify problems and drive improvement • Ability to explain complex coding and documentation requirements clearly to coders, physicians, and non-technical stakeholders • Ability to take ownership and solve problems • Ability to thrive in a structured, deadline-driven environment where details matter • Collaborative, supportive leadership style • Judgment and discretion to handle sensitive performance and compliance matters

🏖️ Vorteile

• Generous annual performance bonus (add commission if applicable) • Health, dental, and vision insurance • Paid time off • 401(k) with company match • Opportunities to grow skills and take on new challenges • Reasonable accommodations during the recruitment process

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