Coding and Performance Manager, Devoted Medical Group

Waltham, MA /
Devoted Medical Group /
A bit about us: 

We’re on a mission to change healthcare — how it’s paid for, delivered, experienced. We want to put people center stage, not process or profit. We are guided by a deep belief that every person on Medicare should be treated like we would treat a member of our own family: with loving care and a profound commitment to their health and well-being. 

That’s why we’re gathering a whole bunch of smart, big-hearted people to create a new kind of healthcare company — one that combines compassion, health insurance, clinical care, and technology seamlessly. 

We want to throw the long ball with people we love for a cause we believe in. Life is short. Join us.

Devoted Medical Group, a division of Devoted Health, employs physicians and nurse practitioners who are specially trained and equipped to care for our members via house calls and telehealth -- especially those who are home-bound and unable to get to the doctors office.  The ability to project clinical care into members’ homes is an incredibly powerful differentiator for Devoted Health, one that advances our ability to deliver the right care in the right place (increasingly, the home) at the right time, in all kinds of ways. 

The role of the Coding and Performance Manager for Devoted Medical Group (DMG) is a key part of Devoted’s Quality and Compliance Strategy.  This position will help to ensure the compliance and accuracy of all diagnostic information and coding (ICD-10 CM) submitted by Devoted Medical Group. This individual will lead the team preparing charts before visits and performing post-work coding review once a visit is completed.  The Coding and Performance Manager will ensure their team performs these duties in accordance with ICD-10 CM coding guidelines, internal coding protocols, and CMS guidance.  

This role will oversee provider education, guidance and training related to diagnostic documentation and coding.  Additionally, this role will scope and deliver on any required training and state-level reporting for the medical group in order to function compliantly. As an affiliate of Devoted Health, we are part of their overarching Compliance Program, but this individual will close the gap between what the health plan already covers and medical group requirements.  This role requires limited domestic travel to meet with and educate providers and support staff in Devoted Medical Group’s office locations. 

Responsibilities include (but not limited to):

    • Create and maintain the DMG coding Standards, QA, and Audit Guidelines in partnership with Health Plan and engaged Vendors.  
    • Manage DMG’s CDI and Coding workflow, leveraging the technology platforms available and evaluating new ones as necessary to efficiently deliver the most comprehensive, accurate results possible.  
    • Ensure timely chart prep and post-visit review, QA and audit completion, and continuous improvement of Medical Group Performance. 
    • Oversee DMG’s participation in and response to Health Plan and/or CMS Audits.  
    • Remain current and act as an internal expert on ICD-10-CM coding guidelines,  AHA Coding Clinic Guidance and CMS Risk Adjustment guidance.
    • Complete Provider education and training regarding Risk Adjustment overall and based on trends and areas of opportunity regarding compliant coding practices. 
    • Establish ongoing performance monitoring and reporting to help ensure accurate CMS payment and improve quality of care.
    • Perform analysis of practice coding patterns to tailor provider education and training to ensure accurate reporting of diagnoses and improve the quality of care.
    • Be prepared to be a player-coach, serving as DMG’s coding expert for your team as well as external and senior stakeholders.  
    • Ensure DMG remains compliant with medical practice guidelines and regulations.
    • Understand and deliver on any required training and state-level reporting for the medical group in order to function compliantly.
    • Hire and lead a high-performing team of engaged and accurate Clinical Documentation Improvement specialists and Coders. 

Desired skills and experience:

    • 5+ years managing a Coding, CDI, and Practice Performance-Focused Team
    • 3-5 years in Medicare Risk Adjustment 
    • Current with CMS guidelines as it relates to Risk Adjustment
    • Familiar with CMS compliance requirements Medicare Risk Adjustment
    • CPC or CRC certification through AAPC or CDI or CCS certification through AHIMA
    • Experience with practice compliance requirements and reporting (i.e. federal, state, and local laws/regulations from the practice side)

Attributes to success:

    • Ability to thrive in a start-up, fast-paced environment 
    • Desire to utilize and influence new and ever-changing technology to drive practice performance 
    • Strong analytical and problem solving skills
    • Strong oral and written communication skills
    • Strong organization and time management skills
    • Ability to work independently 
    • Ability to manage to metrics  
    • Willingness to jump in and do whatever is necessary to make your team a successful, engaged, well-oiled machine
    • A deep desire to make US healthcare better
If you love running towards complex challenges and transforming them into solutions, if you want to make a potentially huge impact on many lives, and if you are looking for a disruptive startup with an inspiring and talented team, Devoted Health may be the place for you! 

Devoted is an equal opportunity employer.  We are committed to a safe and supportive work environment in which all employees have the opportunity to participate and contribute to the success of the business. We value diversity and collaboration. Individuals are respected for their skills, experience, and unique perspectives. This commitment is embodied in Devoted’s Code of Conduct, our company values and the way we do business.

As an Equal Opportunity Employer, the Company does not discriminate on the basis of race, color, religion, sex, pregnancy status, marital status, national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. Our management team is dedicated to this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.