It's rewarding to be on a team of people that truly believe in making an impact!
We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.
Job Summary
As a key member of the Coding and Documentation leadership team, this position will report to the CFAO, and assume a strategic role in the oversight of the company's coding, documentation and audit/education departments to support both the owned clinic and affiliate business. The Senior Director provides leadership and direction to the team, as well as collaborates with senior leadership to ensure that all coding and documentation functions are aligned with compliance and clinical requirements and are in accordance with the mission, vision, values and policies of Cano Health
Essential Duties & Responsibilities
· Models Cano Health's core values and leadership essentials to lead and build a highly effective team, with associates who will provide quality results.
· Provides experience-based guidance to managers and staff regarding coding guidelines, educational programs for both coders and clinicians and understands Medicare Advantage guidelines and processes
· Drives strategic initiatives using analytical tools for both the owned-clinic and affiliate businesses.
· Closely monitors coders work quality and productivity.
· Ensures physician and coder documentation audits are completed timely and effectively and that corrective actions/education is provided, as needed.
· Work collaborately with clinical and operations leadership to drive annual education programs, disease prevalance programs and preventative screening protocals.
· Supports execution of the strategy for compliant Medicare Advantage risk adjustment utilizing CMS and HCC models.
· Manages delivery of the risk adjustment business process and serves as a subject matter expert for risk adjustment processes and related regulations.
· Supports department budgeting and forecasting, goals, and initiatives.
· Maintains key performance indicators (KPIs) and reports to ensure optimal performance and responsiveness to internal and external stakeholders.
· Supports strategy to improve accuracy and completeness of revenue from CMS through prospective assessments and retrospective chart reviews.
· Work collaboratively with contracted health plans on documentation and audit requests, as needed.
· Work with Revenue Cycle Management team and outsourced vendor to address any coding issues identified.
· Business owner of the internally developed pre-review coding workflow tool and subject matter expert, as needed, with EMR vendor related to coding workflows.
Supervisory Responsibilities
· Oversee and lead department managers/team leads (Pre-Review Coding, Coding Education, Coding Audit & MSO Coding).
Education & Experience
10+ years of experience in Medicare Advantage coding/documentation
7+ years of leadership experience
Experience in primary care
CPC, CRC, and/or CPMA certifications
Education Requirements
Required/Preferred
Education Level
Discipline
Required
Bachelor's Degree
Knowledge, Skills & Proficiencies
Leadership skills to effectively direct work and support to other department professionals
Ability to communicate professionally with all levels of leadership
Excellent written and oral communication skills, technical writing skills for development, implementation and maintenance of documentation and presenting to leadership
Communicate and maintain the integrity of sensitive, detailed information
Understanding of system applications including but not limited to: Microsoft Office, medical terminology and medical procedures and services as pertaining to the role
Ability to assess work and patient needs related to department practices, procedures, computer systems with materials to target these needs
Knowledge of the medical field and…