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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.

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