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Vytalize Health · 3 days ago

Vice President- Clinical Documentation Integrity, and Coding Operations

United States

Full-time

Onsite

Director/Executive

10+ years exp

Vytalize Health is a rapidly growing organization focused on value-based healthcare, and they are seeking a Vice President of Clinical Documentation Integrity and Coding Operations. This role involves leading enterprise-wide CDI and risk adjustment strategy, optimizing workflows, and ensuring compliance while driving performance across ACO and private payer programs.

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Growth Opportunities

Responsibilities

Lead clinical documentation and integrity operations and central programs to support all practices with Vytalize Health

Collaborate with the business product team, clinical and non-clinical team members to implement programs across practices and at scale

Own end-to-end performance outcomes of CDI program; identify key leading and lagging performance metrics to monitor progress and impact of CDI programs and operations

Track and trend risk adjustment data, and translate into actionable insights to support medical management, quality initiatives and operational improvements

Develop comprehensive practice and provider educational programs and engagement plans that can be scaled and customized

Measure and monitor impact of coding education programs

Partner with practices and Vytalize team members to improve day-to-day practice workflows, billing and revenue cycle processes, and optimize the use of EMR and/or other electronic tools to support CDI initiatives

Drive innovation and efficiency in risk capture methodologies and coding operations

Coach and mentor managers to develop a culture of continuous feedback, recognition, and improvement, driving accountability and standard work

Promote a culture of accountability, innovation, compliance and collaboration

Oversee multiple vendor partnerships and monitor production and impact

Serve as subject matter expert on all aspects of risk adjustment policy changes and risk scoring methodologies

Stay informed of and communicate changes to regulatory coding guidance

Maintain knowledge of industry trends and perspectives on coding guidance

Ensure the accuracy and completeness of data submissions and risk scores for ACO and private payer value based care contracts

Support troubleshooting and resolution through multi-department and external vendor collaboration

Qualification

Risk adjustment operationsClinical Documentation IntegrityCoding standardsData analysisCertified Professional CoderHealthcare managementPerformance metric trackingCoachingCommunicationStrategic thinkingMentoringRelationship building

Required

Bachelor's degree in Healthcare Administration, Business, or a related field required; advanced degree preferred

Minimum of 10 years of experience in risk adjustment operations, coding, or healthcare management

Proven track record of leading CDI and coding initiatives with measurable improvement/business impact

Experience leading large-scale, multi-unit programs in a healthcare setting

Extensive experience in collaborating with executive leadership and cross-functional teams

Expert level knowledge of CMS-HCC models, coding standards, claims data lifecycle and submission systems

Strong executive presence, influencing skills and ability to drive change across matrixed organization

Experience building and expanding CDI coding team with experience coaching and mentoring managers and coders

In-depth knowledge of risk adjustment processes, coding guidelines, and regulatory requirements

Proficiency in data analysis and performance metric tracking and reporting out on performance

Excellent communication and interpersonal skills for engaging with stakeholders at all levels

Strategic thinker with excellent analytical, critical thinking, problem solving, and relationship building skills who can manage complex, multi-faceted programs

Skill with managing onshore and offshore vendors, and partnership optimization

Ability to travel as needed to support national operations and vendor partnerships