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Job Description
A bit about this role:
As a Clinical Documentation Manager, you will serve as a subject matter expert within our Provider support team and the broader Risk Adjustment department, driving clinical documentation integrity and ICD-10-CM coding accuracy across the enterprise. You will be part of the Clinical Documentation Integrity hub, which owns provider education materials, documentation guidance, and answers to questions escalated from the field. Practice Consultants are your peers who also report to the Director, Risk Adjustment Provider Program. While they own provider relationships in their markets, you will support them through programs that improve risk score accuracy via practice workflow improvements and clinical documentation education. This work is largely enabling our provider network support team rather than managing a dedicated portfolio of practices.
This role also acts as a thought partner to leadership, supporting coding guidelines development, serving as a risk adjustment coding expert on internal and external audits, designing and iterating on reporting, and using technology to scale our impact. During peak audit seasons, a high percentage of your time is spent supporting our response to external audits. This is an individual contributor role with no direct reports, meaning you will work independently, manage your own priorities, and step in directly where needed.
Your Responsibilities and Impact will include:
Lead CDI & Coding Thought Partnership: Serve as the CDI subject matter expert and strategic partner to Risk Adjustment leadership and cross-functional teams, contributing to the Coding Steering Workgroup and ensuring enterprise alignment with ICD-10-CM guidelines, AHA Coding Clinic, CMS guidance, and AHIMA guidance.
Own Provider Documentation & Education Assets: Design, standardize, and maintain condition-specific clinical documentation guidance, EHR template recommendations, and network-wide webinars that drive coding accuracy and provider compliance.
Enable Field Teams & Provider Relationships: Partner closely with Practice Consultants on provider engagements, Joint Operations Committee (JOC) presentation content, and escalated coding inquiries to improve practice workflows and risk score accuracy.
Drive Audit Readiness & Response: Support external and internal risk adjustment audit responses; execute end-to-end chart evaluations and author guideline-backed audit rebuttals.
Integrate Advanced Technology & AI Solutions: Pioneer and implement emerging technologies—including AI-assisted workflows and automated tracking mechanisms—to scale CDI research, audit readiness, and provider education impact.
Develop Clinical Logic & Program Strategy: Collaborate with clinical and operational leaders in workgroups to refine and test risk adjustment insights logic using multi-source clinical data to support embedding high quality information in provider workflows.
Conduct Quality Reviews & Trend Analysis: Perform medical record reviews as needed and leverage data-driven trend analyses to identify documentation integrity findings, measure educational outcomes, and support ongoing quality assurance.
Required skills and experience :
3+ years of experience in Outpatient Clinical Documentation Integrity (CDI) or 5+ years in Medicare Advantage Risk Adjustment coding/auditing.
Deep subject matter expertise in Medicare Advantage Risk Adjustment (CMS-HCC), ICD-10-CM coding guidelines, AHA Coding Clinic guidance, and CMS regulations.
Current, active professional credential through AAPC, AHIMA, or ACDIS.
Experience conducting medical record chart reviews, evaluating documentation integrity, and executing audit rebuttals.
Demonstrated commitment to compliance, ethical coding rigor, and adhering to both the letter and spirit of healthcare regulatory standards.
Autonomous self-starter with the ability to analyze spreadsheets and dashboards, prioritize competing internal deadlines, and adapt smoothly to evolving workflows.
Strong collaborative communication skills to distill complex coding decisions into clear, accessible guidance for non-coding colleagues.
Desired skills and experience:
Prior clinical background or healthcare licensure (e.g., RN, LPN, NP, PA, or MD).
Experience utilizing modern technical tools, generative AI/LLM workflows, or healthcare data analytics within a clinical documentation or risk adjustment context.
Experience contributing to workgroups, cross-functional projects, or continuous process improvement initiatives.
Salary Range: $73,000 - $115,000 / year
The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Our Total Rewards package includes:
Employer sponsored health, dental and vision plan with low or no premium
Generous paid time off
$100 monthly mobile or internet stipend
Stock options for all employees
Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
Parental leave program
401K program
And more....
Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.
Founded in 2017, Devoted Health is on a mission to dramatically improve the health and well-being of older Americans by caring for everyone like they are family, and that includes our employees. Our robust and seamlessly integrated care platform merges advanced data and AI access with world-class clinical and service experiences to create a member experience that is unlike the industry norm. To continue building upon our mission, we want to bring together those who share our values, embrace change and advancement, and are enthusiastic about where we're going — all the while bringing their own unique qualities, experiences, and expertise, in hopes of further changing the healthcare experience.
Devoted is an equal opportunity employer. We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.
As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.
