Clinical Quality & Coding Performance Manager

Elevance Health; Atlanta (GA); Hybrid; USD 95,000 - 145,000; Full time

Benefits offered by this job

Hybrid work model

Medical, dental, vision benefits

401(k) + match

Stock purchase plan

Paid holidays & PTO

Job summary

Elevance Health is seeking a Manager of Clinical Performance & Quality Coding to lead the quality documentation for provider visits and ensure accurate ICD-10 coding. You will develop training on advanced coding, align clinical goals with workflows, and implement KPIs to meet quarterly targets.

The role includes supervising staff, conducting chart audits, and driving HEDIS opportunities while working in a hybrid model with in-office requirements to enable collaboration and impact.

Qualifications

• Requires NP or PA license in your resident state.
• Masters in Nursing (or PA equivalent) and 3+ years of clinical coding experience.
• Experience with CMS Risk Models and HCC coding.

Responsibilities

• Lead quality documentation for provider visits to ensure accurate ICD-10 coding.
• Develop and deliver clinical training on advanced coding and documentation.
• Liaise with clinical leadership to align goals and workflows for value capture.
• Create performance management plans, KPIs, and tracking for coding timeliness and accuracy.
• Lead clinical quality reviews and chart audits with remediation procedures.
• Develop workflows for closing HEDIS opportunities to improve plan performance.
• Participate in peer review of documentation and patient profiles in EMR.
• Hire, train, coach, and evaluate direct reports.

Skills

Nurse Practitioner

Physician Assistant

Management experience

CMS Risk Adjustment

Risk Models

HEDIS

CRC certification

Clinical documentation

Training

Leadership

Education

Master’s in Nursing

Nurse Practitioner license

Physician Assistant license

PA degree

Tools

EMR systems

CMS software

Job description

Elevance Health is seeking a Manager of Clinical Performance & Quality Coding to lead the quality documentation for provider visits and ensure accurate ICD-10 coding. You will develop training on advanced coding, align clinical goals with workflows, and implement KPIs to meet quarterly targets.

The role includes supervising staff, conducting chart audits, and driving HEDIS opportunities while working in a hybrid model with in-office requirements to enable collaboration and impact.