Clinical Documentation Manager

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.

• 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.