Clinical Documentation Manager

Job description

**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.