Clinical Documentation Manager
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
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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.
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Develop Provider Documentation Resources: Create, standardize, and maintain condition-specific documentation guidelines, electronic health record (EHR) template recommendations, and provider education materials, including webinars.
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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.
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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.
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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.
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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.
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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.
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At least 3 years of outpatient Clinical Documentation Integrity (CDI) experience or 5 years of Medicare Advantage risk adjustment coding or auditing experience.
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Strong expertise in Medicare Advantage risk adjustment, including CMS-HCC, ICD-10-CM coding guidelines, AHA Coding Clinic guidance, and CMS regulations.
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A current, active professional credential through AAPC, AHIMA, or ACDIS.
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Demonstrated experience reviewing medical records, evaluating clinical documentation integrity, and preparing audit rebuttals.
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A strong commitment to compliance, ethical coding practices, and adherence to healthcare regulatory requirements.
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Ability to work independently, manage competing deadlines, analyze spreadsheets and dashboards, and adapt to evolving priorities and processes.
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Excellent communication and collaboration skills, including the ability to explain complex coding decisions clearly to colleagues without specialized coding expertise.
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Preferred: A clinical background or healthcare license, such as RN, LPN, NP, PA, or MD.
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Preferred: Experience with generative AI, large language model (LLM) workflows, healthcare data analytics, or modern technical tools in CDI or risk adjustment.
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Preferred: Experience contributing to cross-functional workgroups, strategic projects, or continuous improvement initiatives.
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Annual base salary: $73,000–$115,000 USD, depending on qualifications, relevant experience, skills, education, certifications, and work location.
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Employer-sponsored medical, dental, and vision coverage, with low or no employee premiums.
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Generous paid time off.
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Monthly mobile phone or internet stipend of $100.
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Stock options available to all employees.
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Bonus eligibility for most roles, excluding Director-level positions and above.
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Parental leave program.
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401(k) retirement savings program.
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Remote work within the United States.
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Additional benefits as part of the total rewards package.
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Benefits apply to full-time employees; interns and contractors are not eligible for the stated total rewards package.
Requirements:
Benefits:
Skills
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