Supervisor, Senior Documentation Quality Program Manager Arizona Residency Required

As the Senior Supervisor, Documentation Quality Program Manager, you will play a key leadership role in ensuring excellence in documentation and compliance within our risk adjustment program. You will serve as a subject matter expert in risk adjustment, collaborating effectively across internal teams and with external partners. You will be highly knowledgeable in CMS and OIG audits (e.g., RADV). You will call upon your strengths in being detail oriented and being a strong communicator daily. In this role, you will supervise and mentor a team of QA professionals. This is a great opportunity to foster a supportive, high-performing team environment.

Your work schedule will be primarily Monday-Friday working in the Arizona time zone. Your work location will be primarily remote with some in office meetings required at the Banner Corporate Centers. Arizona Residency is required for this role.

Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BHN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs.

POSITION SUMMARY
This position provides cross functional support and leadership of efforts to improve the quality and compliance of documentation, as per accrediting and regulatory standards. This includes collaborating with key stakeholders to oversee the activities across the organization, e.g. acute care, ambulatory, as it pertains to documentation integrity and reliability.

CORE FUNCTIONS
1. Oversees and/or directs the development and implementation of policies, programs and standards for the organization's documentation integrity, including performance of documentation reviews to proactively identify areas of opportunity for documentation improvement.

2. Establishes and oversees the development and implementation of programs/projects, including establishing short and long-term goals and objectives, and determines the optimal progression to obtain these goals. Reviews analyses and reports of various activities to determine enterprise progress toward stated goals and objectives.

3. Develops and maintains documentation to support consistent and accurate documentation processes. Maintains a current professional and technical knowledge relating to regulatory requirements and directives for documentation integrity to ensure policies and procedures meet compliance requirements.

4. Acts as a liaison to various departments, including EMR teams, clinical education, clinical consensus groups (CCG), medical and clinical informatics, clinical documentation improvement (CDI), information technology (IT), etc. This would include oversight of 3M 360 Encompass tool, including maintenance of document catalog through collaboration with appropriate teams.

5. Maintain and share knowledge of documentation requirements as it relates to HIMS operations and coding.

6. Participate in and lead enterprise teams including Enterprise Information Management Team (EIMT), documentation excellence, etc.

7. This position is responsible for large scale, multi-facility, high risk projects across multiple departments system-wide and requires interaction at all levels of staff and management. Requires work in context of multiple commitments, priorities and conflicts. The incumbent functions in a fast-paced healthcare environment with a wide variety of healthcare programs, activities, and settings. This position is accountable for all resources within the areas of operational responsibility to ensure standards are exceeded for customer service, financial management and regulatory compliance. Internal customers include employees at all levels within the organization, including system leadership. External customers include vendors, providers and government entities.

MINIMUM QUALIFICATIONS

Must possess a strong knowledge of business and/or healthcare as normally obtained through the completion of a bachelor's degree in business, healthcare administration or related field.

In the acute care environment, requires a Registered Health Information Administrator (RHIA), Registered Health Information Technologist (RHIT) or Certified Coding Specialist (CCS) in an active status with American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). In the ambulatory setting, requires Certified Professional Coder (CPC) certification or Certified Coding Specialist-Physician (CCS-P), with RHIA, RHIT or CCS certification preferred.

Must possess progressively responsible experience working with medical documentation and the principles governing healthcare reimbursement, including ICD/CPT coding. Must possess five or more years of healthcare experience to understand, lead and oversee documentation and coding programs/projects. Requires proven record of successfully leading and directing a large-scale projects and programs, along with personal presentation and negotiation skills to build consensus and implement advanced business solutions. Requires thorough familiarity with workflow and process improvement applicable to a healthcare setting. Must possess strong oral, written and interpersonal communication skills to effectively interact with all levels in the organization. Ability to function effectively in a team oriented, fast-paced environment that requires application of critical thinking skills. Position requires proficiency in personal software applications, including word processing, generating spreadsheets, and creating graphics/presentations.

PREFERRED QUALIFICATIONS

Additional related education and/or experience preferred.

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