Clinical Performance & Quality Coding Manager (NP/PA)

The Elevance Health Companies, Inc.

Atlanta (GA)

Hybrid

USD 110,000 - 160,000

Full time

8 days ago

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Job summary

Elevance Health is seeking a Manager of Clinical Performance & Quality Coding (Nurse Practitioner or PA). The role requires in-office presence 3 days per week within commutable distance of eligible Elevance Health offices.

The position emphasizes leading documentation quality, CMS Risk Adjustment, and training to improve HEDIS outcomes. A valid NP/PA license and a master’s degree are required, with 3+ years in Medicare coding. Hybrid work and strong leadership are key.

Qualifications

Requires active NP or PA license in your state.
Master's in Nursing (or PA equivalent) and 3+ years in Medicare HCC coding.
Experience with CMS Risk Models.

Responsibilities

Lead quality documentation and value capture for provider visit encounters; ensure accurate ICD-10 codes.
Serve as primary resource on CMS Risk Adjustment and quality documentation.
Develop and deliver clinical training on advanced coding and documentation with coder feedback.
Liaise with clinical leadership to align goals and workflows for value capture and high-quality chart notes.
Develop and manage clinical QA reviews to ensure peer review and chart audits with remediation procedures.
Develop operational workflows for closing HEDIS opportunities to improve health plan outcomes.
Participate in peer review of medical documentation and patient profile information in EMR.
Hire, train, coach, and evaluate performance of direct reports.