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AVP Clinical Documentation Integrity



Los Angeles, CA, USA
Posted on Thursday, November 2, 2023

The Associate Vice President, Clinical Documentation Integrity partners closely with our clinicians and leaders across WelbeHealth to ensure we have accurate diagnoses of our participants’ disease burden. The AVP will build and lead the clinical documentation function at WelbeHealth– a critical element to the delivery of excellent participant care and WelbeHealth’s mission expansion as an at-risk provider for vulnerable seniors. This high visibility role will be very cross-functional, partnering with clinical teams, operations, analytics, compliance, and other functions to drive alignment and performance across the organization. The AVP, Clinical Documentation Integrity will report to our Head of Performance Excellence, which rolls up into the Office of the Chief Medical Officer. The AVP, Clinical Documentation Integrity, is a member of the WelbeHealth leadership team and facilitates collaborative relationships across WelbeHealth and with external stakeholders to promote WelbeHealth values, team culture and mission.

Duties and Responsibilities
• Build and lead the clinical documentation function for Welbe, interfacing frequently with executives across the organization.
• Partner closely with our clinical and operations leaders to incorporate clinical documentation performance into our daily, weekly, monthly operational cadence.
• Design and implement standard process, workflows and tools to help our providers appropriately document the disease burden of participants.
• Be the organizational subject matter expert (SME) for all things related to clinical documentation, including any changes to coding models and compliance guidelines at the national and regional levels.
• Develop and implement an education strategy to ensure all providers and teammates have sufficient training related to documentation best practices.
• Ensure we have the right audit safeguards in place to meet all clinical and compliance requirements.
• Manage all external vendors that support our clinical documentation program.
• Oversee the development of key analytics and data to support Risk Adjustment financial forecasts, analyses and reporting to engage key stakeholders and communicate program results to the organization.
• Manage direct reports including hiring, training, supervising, and mentoring.

Qualifications and Requirements:
• Bachelor’s Degree in relevant field, professional experience may be substituted.
• Master’s Degree preferred (MBA, Health Policy, Health Administration)

Skills and Experience:
• Minimum of 10 years’ of experience in the healthcare industry with a focus on managed care and/or population health for seniors.
• Minimum of two years’ working in clinical documentation integrity.
• Experience in healthcare operations leadership and / or management consulting.
• Experience supporting complex enterprise-level initiatives that impact clinical operations.
• Experience working with clinical leaders, including coaching physicians and their teams to provide exemplary care.
• Strong understanding of managed care model and what initiatives impact quality and total cost of care.
• Passionate about improving the quality and cost of healthcare in the U.S.
• Outstanding stakeholder management, critical/analytical thinking, and senior executive communication/presentation skills.
• Strong analytic foundation with ability to synthesize conclusions and direction from incomplete data using qualitative and quantitative methods –strong spreadsheet and slide presentation skills.
• Demonstrated ability to build and mentor teams and develop top talent.
• Two years’ supervisory experience with demonstrated ability to mentor and develop team members.

COVID-19 Vaccination Policy

At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.

Our Commitment to Diversity, Equity and Inclusion

At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.

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