Clinical Documentation Manager

Jobgether; États-Unis; À distance; USD 73 000 - 115 000; Plein temps

Avantages offerts par ce poste

Remote work within the United States

Medical/Dental/Vision coverage

Generous PTO

Stipend $100/mo for mobile/internet

Stock options

Bonus eligibility

Parental leave

401(k) plan

Résumé du poste

Partner Company in the United States seeks a Clinical Documentation Manager to serve as a subject matter expert in CDI and Medicare Advantage risk adjustment coding. The role focuses on improving ICD-10-CM coding accuracy, strengthening provider documentation practices, and supporting compliance across a broad healthcare network.

You will develop educational resources, documentation guidance, and scalable improvement programs, collaborating with risk adjustment leadership to drive

Qualifications

• CDI subject matter expert with strong auditing experience.
• Experience with Medicare Advantage risk adjustment coding.
• Ability to review medical records and prepare audit rebuttals.

Responsabilités

• Provide CDI and coding expertise to risk adjustment leadership and workgroups.
• Develop provider documentation resources, templates, and education materials.
• Support provider-facing teams with coding questions and workflow improvements.
• Lead audit preparation and responses with end-to-end chart reviews.
• Implement AI-assisted workflows to improve efficiency and scalability.
• Collaborate to refine risk adjustment insights using multi-source data.
• Conduct quality reviews and trend analyses to drive improvements.

Connaissances

CDI expertise

Risk adjustment knowledge

Auditing

Communication

Independent work

Formation

AAPC/AHIMA/ACDIS credential

Outils

AI tools

Healthcare analytics tools

Description du poste

This position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Clinical Documentation Manager based in the United States.

The Clinical Documentation Manager will serve as a subject matter expert in clinical documentation integrity (CDI) and Medicare Advantage risk adjustment coding.
This role focuses on improving ICD-10-CM coding accuracy, strengthening provider documentation practices, and supporting compliance across a broad healthcare network.
Working closely with risk adjustment leadership and cross-functional teams, you will develop educational resources, documentation guidance, and scalable improvement programs.
You will help provider-facing teams address complex coding questions, optimize clinical workflows, and improve the accuracy of risk adjustment outcomes.
The position also plays a key role in audit readiness, including medical record evaluations, compliance reviews, and evidence-based audit rebuttals.
By leveraging analytics, automation, and emerging AI tools, you will help modernize documentation processes and expand the impact of clinical education.
This is a remote, individual-contributor role offering autonomy, meaningful collaboration, and opportunities to influence enterprise-wide clinical documentation strategy.

Accountabilities

• Provide CDI and Coding Expertise: 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.

• Develop Provider Documentation Resources: Create, standardize, and maintain condition-specific documentation guidelines, electronic health record (EHR) template recommendations, and provider education materials, including webinars.

• Support Provider-Facing Teams: Collaborate with Practice Consultants on provider engagements, operational presentations, escalated coding questions, and workflow improvements that strengthen documentation quality and risk score accuracy.

• Lead Audit Preparation and Responses: Support internal and external risk adjustment audits by conducting end-to-end chart reviews, assessing documentation integrity, and preparing evidence-based rebuttals grounded in applicable coding guidelines.

• Implement Technology and AI Solutions: Identify and introduce AI-assisted workflows, automation, and tracking tools to improve research efficiency, audit readiness, and the scalability of provider education.

• Contribute to Clinical Logic and Program Strategy: Partner with clinical and operational stakeholders to refine and test risk adjustment insights using data from multiple sources, helping integrate relevant information into provider workflows.

• Conduct Quality Reviews and Trend Analysis: Review medical records as needed, analyze documentation trends, measure the effectiveness of educational initiatives, and identify opportunities for continuous quality improvement.

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, ICD-10-CM coding guidelines, AHA Coding Clinic guidance, and CMS regulations.

• A current, active professional credential through AAPC, AHIMA, or ACDIS.

• Demonstrated experience reviewing medical records, evaluating clinical documentation integrity, and preparing audit rebuttals.

• A strong commitment to compliance, ethical coding practices, and adherence to healthcare regulatory requirements.

• Ability to work independently, manage competing deadlines, analyze spreadsheets and dashboards, and adapt to evolving priorities and processes.

• Excellent communication and collaboration skills, including the ability to explain complex coding decisions clearly to colleagues without specialized coding expertise.

• Preferred: A clinical background or healthcare license, such as RN, LPN, NP, PA, or MD.

• Preferred: Experience with generative AI, large language model (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.

Benefits:

• Annual base salary: $73,000-$115,000 USD, depending on qualifications, relevant experience, skills, education, certifications, and work location.

• Employer-sponsored medical, dental, and vision coverage, with low or no employee premiums.

• Generous paid time off.

• 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.

• Parental leave program.

• 401(k) retirement savings program.

• Remote work within the United States.

• Additional benefits as part of the total rewards package.

• Benefits apply to full-time employees; interns and contractors are not eligible for the stated total rewards package.