Clinical Documentation Program Manager (Remote)

REMOTE, U.S. /RISK AND QUALITY – RISK ADJUSTMENT /FULL TIME/ REMOTE

Interwell Health is a kidney care management company that partners with physicians on its mission to reimagine healthcare—with the expertise, scale, compassion, and vision to set the standard for the industry and help patients live their best lives. We are on a mission to help people and we know the work we do changes their lives. If there is a better way, we will create it. So, if our mission speaks to you, join us! 

We are seeking an experienced Clinical Documentation Program Manager that will help establish, develop, and maintain key operational initiatives to drive Clinical Documentation Program activities. The incumbent will be responsible for the execution of Value Based campaigns, managing deadlines, working with providers and practices in execution of program activities. You will be responsible for facilitating and driving the definition and prioritization of complex risk adjustment improvement strategies.

What you’ll do:

• Establishes, develops, and implements Risk Adjustment activities across different Markets to ensure successful execution of Risk Adjustment programs while maintaining programs compliantly.
• Creates & executes out of box thinking/creative way to execution of RA programs. 
• Ensures all activities are fully executed through end-to-end process from provider to Centers for Medicare and Medicaid Services (CMS), State and federal regulatory requirements. 
• Ensures early detection of major risks and interdependencies for program initiatives across the entire network. 
• Combines an in-depth knowledge of Risk Adjustment business, products, and services with a solid understanding of industry trends to develop differentiated solutions to maximize and grow partner relationships.
• Works with stakeholders across the system to ensure effective coordination.
• Provides updates to Risk Adjustment Stakeholders on program operational activities – creates dashboards and operational metrics to demonstrate program success.
• Manages activity of cross-functional teams to help support reporting capabilities.

What you’ll need:

• Bachelor’s degree in related field of study preferred. Advanced Degree preferred or an equivalent combination of education and experience. 
• 5+ years of experience with Risk Adjustment/HCC Payment Methodology 
• 5+ years of experience working for a Health Plan/payor including 3+ years of experience in project management
• Solid knowledge and understanding of Payor, ACO, Medicare/Medicaid, End to End cycle for Risk Adjustment.
• Must be a strategic thinker, open minded, with a high level of intellectual curiosity and openness to change as well as excellent verbal and written skills.
• Proven ability to perform complex business analysis and decision-making, outstanding presentation and communication skills with the ability to effectively analyze and synthesize large amounts of complex data in relevant insights.

Our mission is to reinvent healthcare to help patients live their best lives, and we proudly live our mission-driven values: 

- We care deeply about the people we serve. 

- We are better when we work together. 

- Humility is a source of our strength.  

- We bring joy to our work. 

We are committed to diversity, equity, and inclusion throughout our recruiting practices. Everyone is welcome and included. We value our differences and learn from each other. Our team members come in all shapes, colors, and sizes. No matter how you identify your lifestyle, creed, or fandom, we value everyone's unique journey. 

Oh, and one more thing … a recent study shows that men apply for a job or promotion when they meet only 60% of the qualifications, but women and other marginalized groups apply only if they meet 100% of them. So, if you think you’d be a great fit, but don’t necessarily meet every single requirement on one of our job openings, please still apply. We’d love to consider your application!   

Come join us and help our patients live their best lives. Learn more at www.interwellhealth.com.

It has come to our attention that some individuals or organizations are reaching out to job seekers and posing as potential employers presenting enticing employment offers. We want to emphasize that these offers are not associated with our company and may be fraudulent in nature. Please note that our organization will not extend a job offer without prior communication with our recruiting team, hiring managers and a formal interview process.