Supervisor, Senior Documentation Quality Program Manager Arizona Residency Required

Department Name:

Risk Adjustment

Work Shift:

Day

Job Category:

Revenue Cycle

Estimated Pay Range:

$33.69 - $56.15 / hour, based on location, education, & experience.

In accordance with State Pay Transparency Rules.

Great options and opportunities. We’re certified as a Great Place To Work® and are looking for professionals to help us make Banner Health the best place to work and receive care. Apply today!

Banner Plans & Networks (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is to reduce healthcare costs while keeping our members in optimal health. BPN is known for its innovative, collaborative, and team-oriented approach to healthcare. We offer diverse career opportunities, from entry-level to leadership positions, and extend our innovation to employment settings by including remote and hybrid opportunities.

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 re