编码质量保证(QA)经理,远程
Coding Quality Assurance (QA) Manager, Remote
作为编码质量保证(QA)经理,您将领导一支高绩效的QA专家团队,在临床精准与运营卓越的交汇点上工作。您将推动编码准确性,制定稳健的标准操作流程(SOP),并通过评估我们内部CDI团队和外部合作伙伴的文档,确保全面的审计准备就绪。如果您在风险调整和层级状况类别(HCC)方面拥有深厚的专业知识,并且热衷于培养人才和提升合规标准,这个职位将为您提供直接平台来塑造我们的质量运营并产生可衡量的影响。
候选人应能够在美国任何地方远程办公,覆盖所有美国时区。
我们是谁:
Aledade PBC是一家公共利益公司,旨在赋能医疗保健领域最具变革性的部分——独立初级护理。我们成立于2014年,至今已成为全国最大的独立初级护理网络,帮助诊所、健康中心和医疗机构为患者提供更好的护理,并在基于价值的护理中蓬勃发展。此外,通过在各种健康计划中创建基于价值的合同,我们旨在改变传统的按服务收费模式。我们的工作加强了护理的连续性,对齐了激励机制,确保初级护理医生因他们最擅长的工作——保持患者健康而获得报酬。如果您希望参与创建一个对患者、对诊所、对社会都好的医疗体系,并且渴望加入一个协作、包容、以远程为主的文化,那么您来对地方了。
对你而言意味着什么?
在Aledade PBC,您将融入一种富有创造力的文化,这种文化由对复杂问题的尊重、开放心态和学习欲望驱动。您将与来自不同背景、兴趣、经历、信仰和成就的团队成员合作,他们都在公共健康领域有着共同的热情,并致力于实现Aledade的使命。
除了支持工作与生活平衡和享受的时间外,我们还提供以下全面的福利包,以促进团队成员的整体福祉:
许多职位均可灵活安排工作时间并远程办公
员工、家属和伴侣的健康、牙科和视力保险费用最高支付80%
强大的
查看英文原文
As a Coding Quality Assurance (QA) Manager, you will lead a high-performing team of QA Specialists at the intersection of clinical precision and operational excellence. You'll drive coding accuracy, build robust Standard Operating Procedures (SOPs), and ensure full audit readiness by evaluating documentation from both our internal CDI team and external partners. If you bring deep expertise in Risk Adjustment and Hierarchical Condition Categories (HCC) alongside a passion for mentoring talent and elevating compliance standards, this role offers a direct platform to shape our quality operations and make a measurable impact.
Candidates should be comfortable working remotely from anywhere within the US, across all US time zones.
Who We Are:
Aledade PBC, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
What Does This Mean for You?
At Aledade PBC, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much more!
At Aledade PBC, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
Primary Duties
- Team Leadership & Oversight: Lead, mentor, and manage a team of QA Specialists. Establish team goals, monitor productivity, conduct regular performance reviews, and foster a culture of continuous learning.
- Quality Audits: Oversee and perform comprehensive quality assurance reviews for coding completed by internal CDI staff and external vendor partners, ensuring compliance with official ICD-10-CM guidelines and risk adjustment models.
- SOP & Guideline Development: Design, implement, and maintain standard operating procedures, audit workflows, scoring methodologies, and coding quality guidelines across the organization.
- Payer Audit Support: Act as a key subject matter expert (SME) during external payer audits (e.g., RADV, Medicare, Commercial). Assist with chart selection, review, dispute documentation, and appeal responses.
- Vendor Management: Evaluate third-party coding vendor accuracy rates against established SLAs. Deliver constructive feedback, identify trend errors, and drive corrective action plans when necessary.
- Education & Feedback Loops: Translate QA audit findings into actionable insights. Provide structured feedback and target educational resources to internal CDI specialists and vendors to prevent recurring errors.
- Other duties as assigned
Minimum Qualifications:
- Bachelor’s Degree in health care management, nursing or related field or an Associate Degree with relevant experience in CDI, coding, coding management, or HCC Risk Adjustment required.
- Minimum of 4 years of HCC coding experience with 2 years specifically focused on coding quality assurance, auditing, or compliance monitoring.
- Active professional credentials from AAPC and/or AHIMA required (such as CRC, CCS, CPC, or CPMA).
- Deep mastery of ICD-10-CM coding, CMS Risk Adjustment guidelines, RADV audit rules, and clinical documentation requirements.
Preferred KSA's:
- CRC (Certified Risk Adjustment Coder)
- Experience working within Value-Based Care (VBC) models, ACOs, or Advantage plans.
- Prior experience managing small teams or leading vendor oversight programs.
- Exceptional leadership, communication, and organizational skills.
- Proficiency with EHR systems and encoder software