CDI Manager

Job Description

CDI Manager

Manager I – BPM

Who We Are

Advantasure is a growing company and a member of the UST HealthProof family, Advantasure champions innovative solutions with an eye on the future—providing health plans with the flexibility to adapt to a changing regulatory environment and evolving business needs. Leveraging the industry’s leading experts in government-sponsored health plans, Advantasure offers solutions for administrative cost management, quality patient outcomes and experiences, enrollment growth, risk adjustment and quality and provider engagement initiatives.

We achieve this mission together through teamwork, communication, collaboration, and focus. Our employees are our greatest assets, and we invite you to apply to be a part of our journey toward making a difference in healthcare in the United States. **

You Are**

This role is responsible for management of CDI Review Team who work on review of CDI alerts for providers participating in PEC program for all Advantasure clients. This position provides effective and efficient guidance on maintaining CDI review process within timely review, creation of appropriate queries and communication with PECs and Medical Directors. This role is responsible for strategizing, innovating, analyzing, planning, organizing, budgeting, reporting, identifying equipment needs, and other functions that are required to maintain and operate an efficient and effective department. **

The Opportunity**

• Reviews daily inventory reports to manage workflow for CDI team
• Assigns new implemented practices and maintains assignment list up to date
• Serves as liaison between CDI team and PECs
• Mentors new CDI reviewers
• Review daily and monthly coding reports to manage production goals for team
• Develops and updates all materials and presentations for CDI Reviewers
• Updates and maintains up to date CDI Review Team P&Ps
• Ensure compliance with coding and documentation guidelines for Medicare Risk Adjustment and Advantasure Coding Guidelines
• Organizes topics, agendas and distribution of materials for bi-monthly CDI review team meetings
• Participates in implementation meetings as assigned by supervisor
• Reports trends and opportunities to improve review time and coding for CDI team
• Collaborates with managers, Director of Coding Quality and Training and Production Managers to maintain quality assurance for CDI Review team.
• Responsible for special projects and/or problem resolutions.
• Provides effective and efficient solutions to complex business problems.
• Provides high level oversight and leadership.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. **

What You Need**

• Bachelor’s degree in a related field. Master’s degree preferred. Continuous learning, as defined by the Company’s learning philosophy, is required. AAPC or AHIMA credentials (CPC, COC, CRC, CPMA, or CCS-P) required. AAPC or AHIMA credentials (CPC, COC, CRC, CPMA, or CCS-P) required.
• Master’s degree preferred.
• Three (3) years of experience in medical record coding or related field is required. One (1) year of leadership or lead experience also required.
• Experience and understanding of CMS HCC Risk Adjustment coding and data validation requirements is required.
• Ability to deal with problems involving several concrete variables in standardized situations. Work is performed in a remote setting.
• Ability to work under general direction.
• Ability to work effectively in a team environment.
• Excellent analytical, organizational, planning, verbal, and written communication skills.
• Other related skills and/or abilities may be required to perform this job.
• Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.
• Ability to write routine reports and correspondence.
• Ability to speak effectively before groups of customers or employees of the organization.
• Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.
• Ability to apply concepts of basic algebra and geometry.
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
• Ability to deal with problems involving several concrete variables in standardized situations.
• Must demonstrate leadership ability and team building skills to effectively supervise professional and non-professional staff and interact with all levels of management.
• Ability to work with and empower others on a collaborative basis to ensure success of unit team.
• Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions, and employing active listening techniques.
• Ability to effectively present budgetary and/or cost information and respond to questions as appropriate.
• Ability to establish workflows, manage multiple projects, and meet necessary deadlines

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. As required by local law, UST provides a reasonable range of compensation for roles that may be hired in California, Colorado, New York or Washington as set forth below. **

Role Location: Remote**

Compensation Range: $74,300-$107,500

Our full-time, regular associates are eligible for 401K matching, and vacation accrual and are covered from day 1 for paid sick time, healthcare, dental, vision, life, and disability insurance benefits. **

What We Believe**

We’re proud to embrace the same values that have shaped UST and its subsidiaries since the beginning. Since day one, we’ve been building enduring relationships and a culture of integrity. And today, it's those same values that are inspiring us to encourage innovation from everyone to champion diversity and inclusion and place people at the center of everything we do. **

Humility**

We will listen, learn, be empathetic and help selflessly in our interactions with everyone. **

Humanity**

Through business, we will better the lives of those less fortunate than ourselves. **

Integrity**

We honor our commitments and act with responsibility in all our relationships. **

Equal Employment Opportunity Statement**

UST is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UST reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

#Advantasure

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