Clinical Documentation ACO Program Manager id-11108
Full job description
The Clinical Documentation ACO, Program Manager is responsible for continuous improvement of clinical documentation, in alignment with regulatory requirements to support the quadruple aim via TeamHealth’s Accountable Care Organization (ACO), TeamACO. This position collaborates closely with post-acute care clinicians, coding staff, and administrative teams to review, evaluate, and enhance the clarity, specificity, and accuracy of clinical documentation in the medical record.
Principal Duties and Responsibilities:
- Clinician Education: Provides targeted education to providers on clinical quality measure workflows and accurate ICD-10 code selection, improving coding practices and compliance. Delivers individualized feedback to clinicians, focusing on improving documentation specificity and completeness in alignment with regulatory guidelines.
- Medical Record Reviews: Conducts thorough retrospective reviews of patient records to identify gaps, offering educational opportunities to enhance documentation accuracy.
- ICD-10 and Risk Adjustment Knowledge: Maintains up-to-date knowledge of ICD-10 and risk adjustment methodologies through ongoing education and adherence to official guidelines and regulatory updates.
- ACO Quality Measures: Stays informed on ACO clinical quality measures and documentation requirements, educating clinicians on the impact of documentation on performance.
- Tool Development: Advises on the creation of macros, templates, and databases to support accurate and efficient clinical documentation.
- Trend Identification: Analyzes trends in documentation, presenting improvement opportunities and solutions to clinicians, leadership, and ACO administration.
- Ethical Conduct: Adheres to TeamHealth and ACDIS ethical standards.
- Safety Compliance: Performs all duties safely and reports hazards or unsafe practices in a timely manner.
- Additional Responsibilities: Completes other duties as required to support the organization’s clinical documentation improvement efforts.
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- This role is ideal for a detail-oriented professional with a strong background in quality improvement, coding and documentation, healthcare analytics, and clinician engagement.
- Action-oriented with an understanding for process. “Can do” attitude. Hands on.
- Demonstrates that he/she has the analytical problem-solving skills necessary to help a healthcare system accomplish its mission.
Job Requirements:
- Coding Certification: Certified Clinical Documentation Specialist (CCDS), Certified Clinical Documentation Specialist Outpatient (CCDS-O) Certification or Certified Risk Adjustment Coder (CRC) preferred; Willingness to receive coding training and sit for certification.
- Bachelor’s degree in healthcare related field, Health Information Technology, or related field required; Master’s degree preferred
- Experience in inpatient or ambulatory clinical quality, documentation review, coding and/or auditing preferred
- Post-Acute Care experience preferred
- Knowledge of Uniform Hospital Discharge Data Set, ICD and CPT Coding Guidelines and Principles
- Advanced knowledge of anatomy and physiology and medical terminology
- Working knowledge of pathophysiology and basic pharmacology
- Ability to demonstrate proficiency in using general office equipment, computer systems, and software applications as necessary to perform work functions.
- Ability to review medical records and make accurate decisions
- Ability to act independently within established guidelines
- Ability to maintain confidential information and materials
- Ability to exercise judgment, tact, and diplomacy
- Strong communication (written and verbal) and interpersonal skills (teamwork required)
- This role may have the potential to have supervisory responsibilities
PHYSICAL / ENVIRONMENTAL DEMANDS:
- Job performed in a remote working environment;
- Occasional lifting/carrying (10 pounds or less);
- Prolonged sitting; with prolonged work in a computer/PC;
- Requires infrequent overnight travel;
- Ability to work well in fast-paced environment.
The information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification.
It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position
