Position Summary:
- The Manager of the Clinical Documentation & Quality Program will lead a team of Medical Assistants responsible for risk adjustment (HCC) and Quality Payment Program (QPP) closure activities on behalf of partnered Payors.
- This role is responsible for overseeing chart reviews, pre-visit documentation, and patient outreach to ensure accurate documentation needed to satisfy gap opportunities.
- The Manager will be the liaison between internal teams, providers, and payers, while managing team performance.
Essential Functions:
- Manage, coach and develop a team of Medical Assistants performing HCC and QPP activities.
- Set productivity and quality standards and measure performance against Key Performance Indicators (KPIs).
- Align documentation with provider-specified EHR workflows and resolve workflow barriers.
- Provide oversight and feedback for telephone interactions between the team and patients for collecting documentation and scheduling visits.
- Oversee opportunity database and reports on team productivity and outcomes.
- Ensure compliance with HIPAA, CMS guidelines and applicable state and federal regulations.
Position Type and Expected Hours of Work:
This is a full-time position. Hours of business are Monday - Friday 8:00 am – 4:30 pm EST
Required Education and Experience:
- RN, LPN/LVN or MA, or equivalent required and of good standing.
- Additional Certifications/Licenses preferred:- Certified Coders (CCS, CCA, CPC), Health Information professionals (RHIT, RHIA), or Risk Adjusters (CRC).
- Relevant Experience may include Risk adjustment and HCC coding experience; HEDIS, STARS, QPP or similar quality program experience.
- Applicants must have EHR experience; experience in multiple EHR systems or Enterprise systems preferred.
- Experience managing or leading larger operations teams preferred.