Sr. Director Coding and Documentation

Cano Health•Miami, FL

About The Position

The Senior Director of Coding and Documentation is a member of the Coding and Documentation leadership team and reports to the CFAO. The role provides strategic oversight of the company's coding, documentation, audit, and education departments, supporting both owned clinics and affiliate business. The Senior Director leads and directs the team and collaborates with senior leadership to align coding and documentation functions with compliance and clinical requirements, as well as Cano Health's mission, vision, values, and policies. The position provides expertise in Medicare Advantage coding, documentation, risk adjustment, and related regulations. It leads department managers and team leads, monitors coding quality and productivity, ensures timely audits and follow-up education or corrective actions, and collaborates with clinical, operations, revenue cycle, vendor, and health plan partners. The role also supports strategic initiatives, budgeting and forecasting, performance measurement, and efforts to improve the accuracy and completeness of CMS revenue. The position works under usual office conditions, using a computer and telephone for extended periods. It may require extended and flexible hours and weekend work as needed, as well as 25–50% travel involving driving to medical centers in company regions and expanding markets.

Requirements

10+ years of experience in Medicare Advantage coding and documentation.
7+ years of leadership experience.
Experience in primary care.
Leadership skills to effectively direct work and support other department professionals.
Ability to communicate professionally with all levels of leadership.
Excellent written and oral communication skills, including technical writing 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 as they pertain to the role.
Ability to assess work and patient needs related to department practices, procedures, and computer systems, and to use materials to address those needs.
Knowledge of the medical field and practices.
Skill in operating technology and other IT systems.
Bachelor's degree.

Nice To Haves

CPC, CRC, and/or CPMA certifications.

Responsibilities

Model Cano Health's core values and leadership essentials while building an effective team that delivers quality results.
Provide experience-based guidance to managers and staff on coding guidelines, educational programs for coders and clinicians, and Medicare Advantage guidelines and processes.
Drive strategic initiatives using analytical tools for owned-clinic and affiliate businesses.
Monitor coders' work quality and productivity.
Ensure physician and coder documentation audits are completed timely and effectively, and provide corrective actions or education as needed.
Collaborate with clinical and operations leadership on annual education programs, disease prevalence programs, and preventative screening protocols.
Support execution of the strategy for compliant Medicare Advantage risk adjustment 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 and forecasting, goals, and initiatives.
Maintain key performance indicators and reports 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 serve as a subject matter expert with 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.