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United States
Remote only
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.
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.
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.
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.