Project Director - Documentation Integrity

United States • ,

8d • Remote

About The Position

The Project Director - Documentation Integrity supports Utilization Management (UM) leaders and department operations at assigned Acadia facilities, helping ensure medical necessity, regulatory compliance, and financial performance. The role applies behavioral health treatment and medical necessity expertise, payer audit readiness, and documentation excellence to optimize reimbursement in collaboration with facility leaders and corporate partners. It provides expert guidance on clinical documentation integrity, clinical protocols, payer reimbursement, and payer audit compliance.

The position provides on-site leadership at assigned facilities and involves up to 100% nationwide travel, including long-term assignments and extended stays away from home that may last weeks to months. Evening and weekend work may be required based on need. The role also supports education and training, chart and facility audits, process improvement, action planning, and effective utilization of documentation and reimbursement processes.

Requirements

• RN, LPC, LCSW, or LMFT license/designation/certification is required.
• Strong knowledge of payer clinical guidelines and audit processes, experience writing appeal letters, and strong working knowledge of documentation standards for payer reimbursement.
• Significant behavioral healthcare experience in a variety of settings and service lines.
• Effective and accurate oral and written communication skills.
• Ability to influence facility leaders, teams, and corporate partners to adopt operational changes by clearly articulating their long-term benefits.
• Knowledge of office administration procedures and ability to operate most standard office equipment.
• Ability to work professionally with sensitive and proprietary data while maintaining confidentiality.
• Excellent interpersonal skills and ability to interact professionally with people at all levels, internally and externally.
• Self-motivated, organized, and attentive to detail.
• Ability to manage multiple tasks and projects simultaneously within inflexible time frames and adapt to frequent priority changes.
• Ability to travel up to 100% nationwide and undertake extended stays away from home; evening and weekend work may be required based on need.

Nice To Haves

• Bachelor’s degree in a clinical field or a nursing degree preferred.
• At least 5 years of supervisory experience in Intake and Utilization Management/Review or Case Management preferred.
• Knowledge of insurance billing requirements preferred.

Responsibilities

• Provide on-site leadership to assess and analyze Intake and Utilization processes, challenges, and outcomes, including compliance with regulatory requirements.
• Audit patient charts at assigned facilities for accuracy, completeness, regulatory compliance, and adherence to practice guidelines; identify discrepancies or missing information and work with facility care teams on corrective action.
• Conduct facility audits of clinical and financial information related to denial management, including length of stay, medical necessity documentation, precertification, concurrent authorizations, Medicare certification and recertification, Medicare internal audits, and EMTALA compliance.
• Ensure records and documentation practices comply with HIPAA and other applicable healthcare laws and standards; participate in internal audits and implement corrective actions.
• Conduct quality checks on medical records and scanned documents, and report issues in real time to care providers and facility clinical leaders.
• Generate and maintain reports on chart audits, compliance issues, and related data; provide recommendations to improve record-keeping and documentation practices.
• Provide education and training to physicians and clinical staff on documentation and current regulations.
• Support development and ongoing implementation of action plans to resolve problematic issues or address compliance vulnerabilities.
• Assist with developing and maintaining facility process-improvement practices, including data analysis and prioritization of efforts.
• Collaborate with clinical services to ensure documentation supports authorization and use of each patient's individualized benefits.
• Provide consultation and guidance on written level-of-care guidelines for various payers.
• Advise on the appeals process and assist facility UM staff in preparing effective appeal letters.
• Ensure proper use of Medhost, the Medhost dashboard, and SharePoint.
• Maintain current knowledge of applicable behavioral healthcare regulations and regulatory updates.
• Comply with organizational policies, procedures, performance-improvement initiatives, and confidentiality requirements.
• Communicate clearly and effectively with people receiving services, family members, guests, and healthcare team members.
• Build and maintain constructive working relationships and promote mutual trust, respect, and cooperation among team members.
• Maintain regular and predictable attendance.
• Perform other duties as assigned.

Benefits

• Competitive base salary commensurate with experience
• Bonus eligible
• Comprehensive medical, dental, and vision insurance
• 401(k) plan with company match
• Paid time off (PTO) and recognized holidays
• Company-paid basic life and AD&D insurance
• Employee Assistance Program (EAP) and mental wellness resources
• Professional growth and advancement opportunities within Acadia’s nationwide network

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Education Level: No Education Listed