Sr. Director Coding and Documentation

Cano Health•Miami, FL

22h

About The Position

The Senior Director of Coding and Documentation is a key member of Cano Health’s Coding and Documentation leadership team and reports to the CFAO. The role provides strategic oversight of coding, documentation, audit, and education departments supporting both the owned-clinic and affiliate businesses. The Senior Director leads and directs the team and collaborates with senior leadership to align coding and documentation functions with compliance and clinical requirements and Cano Health’s mission, vision, values, and policies. The role oversees department managers and team leads responsible for Pre-Review Coding, Coding Education, Coding Audit, and MSO Coding. It provides guidance on coding standards, educational programs, and Medicare Advantage guidelines and processes; leads risk adjustment operations and strategy; monitors quality and productivity; and supports budgeting, forecasting, performance reporting, and revenue accuracy initiatives. The position works with clinical and operations leaders, contracted health plans, the Revenue Cycle Management team, an outsourced vendor, and an EMR vendor. It is performed under usual office conditions, involves extended computer and phone use, and requires travel of 25–50% to medical centers across company regions and expanding markets.

Requirements

10 or more years of experience in Medicare Advantage coding and documentation.
7 or more years of leadership experience.
Experience in primary care.
CPC, CRC, and/or CPMA certifications.
Bachelor’s degree.
Leadership skills to direct work and support other department professionals.
Ability to communicate professionally with all levels of leadership.
Excellent written and oral communication and technical writing skills for developing, implementing, and maintaining documentation and presenting to leadership.
Ability to communicate and maintain the integrity of sensitive, detailed information.
Understanding of system applications, including Microsoft Office, medical terminology, and medical procedures and services relevant to the role.
Ability to assess work and patient needs related to department practices, procedures, and computer systems, and to develop materials to address those needs.
Knowledge of the medical field and its practices.
Skill in operating technology and other IT systems.
Ability to work extended and flexible hours and weekends as needed.
Ability to perform essential functions including typing, standing, sitting, stooping, and occasionally climbing.
Ability to work at a personal computer and use the phone for extended periods.

Responsibilities

Model Cano Health’s core values and leadership essentials while leading and building an effective team.
Provide guidance to managers and staff on coding guidelines, coder and clinician education programs, and Medicare Advantage guidelines and processes.
Drive strategic initiatives using analytical tools for the owned-clinic and affiliate businesses.
Monitor coder work quality and productivity.
Ensure physician and coder documentation audits are completed on time and effectively, and provide corrective actions or education as needed.
Collaborate with clinical and operations leadership on annual education programs, disease prevalence programs, and preventive screening protocols.
Support execution of compliant Medicare Advantage risk-adjustment strategy using CMS and HCC models.
Manage delivery of the risk-adjustment business process and serve as a subject matter expert on risk-adjustment processes and related regulations.
Support department budgeting, forecasting, goals, and initiatives.
Maintain key performance indicators and reporting to support performance and responsiveness to internal and external stakeholders.
Support strategies to improve the accuracy and completeness of CMS revenue through prospective assessments and retrospective chart reviews.
Collaborate with contracted health plans on documentation and audit requests as needed.
Work with the Revenue Cycle Management team and outsourced vendor to address identified coding issues.
Own the internally developed pre-review coding workflow tool and provide subject matter expertise to the EMR vendor on coding workflows as needed.
Oversee and lead department managers and team leads for Pre-Review Coding, Coding Education, Coding Audit, and MSO Coding.