Documentation & Risk Adjustment Manager

Job Summary

The Documentation & Coding Manager provides leadership and operational accountability for WellBe’s documentation and coding program. This role leads the coding team and oversees program performance, documentation and coding controls, pre-encounter review operations, query auditing, vendor performance, and implementation of strategic initiatives.

The Manager establishes clear productivity and quality standards, develops team capabilities, and drives sustainable workflow improvements that strengthen documentation accuracy, coding compliance, provider experience, and risk adjustment performance.

Essential Duties and Responsibilities

• Lead, coach, and manage the coding team, including goal setting, performance monitoring, professional development, and workforce planning.

• Establish, communicate, and monitor productivity, quality, timeliness, and accountability standards for documentation and coding operations.

• Use performance data to identify trends, address operational gaps, and lead corrective action and performance improvement plans.

• Oversee pre-encounter review workflows and other documentation initiatives to improve provider readiness and reduce administrative burden.

• Implement and sustain documentation and coding controls, including quality assurance processes, query reviews, audit protocols, and escalation pathways.

• Monitor coding and billing vendor performance against contractual, service-level, quality, productivity, compliance, and financial expectations.

• Partner with clinical, operations, compliance, finance, analytics, technology, and vendor stakeholders to execute program objectives and resolve barriers.

• Develop and maintain policies, procedures, workflows, training materials, dashboards, and standard operating practices.

• Ensure documentation, coding, and query practices align with applicable regulatory requirements, payer guidance, and internal policies.

• Prepare and present program performance, risks, recommendations, and implementation updates to department and organizational leadership.

• Support annual planning, resource allocation, vendor strategy, and continuous improvement initiatives for documentation and risk adjustment operations.

• Perform other duties as assigned.

Required Qualifications

Education
Bachelor’s degree in health information management, nursing, healthcare administration, business, or a related field, or an equivalent combination of education and relevant experience.

Experience
Three to five years of progressive experience in healthcare documentation, coding, or risk adjustment, including at least one year of people leadership or equivalent program leadership. Experience managing vendors and implementing operational controls is preferred.

Skills
Demonstrated knowledge of clinical documentation, coding quality, risk adjustment concepts, compliant provider query practices, and healthcare operations. Strong people leadership, coaching, vendor management, project implementation, data analysis, problem-solving, and executive communication skills. Ability to translate performance data into practical action plans and manage multiple priorities in a remote, cross-functional environment. Proficiency with Microsoft Office and healthcare reporting or workflow systems.

Physical and Mental Requirements

• Ability to stand or sit for extended periods.

• Visual acuity and fine motor skills.

• Ability to travel locally or nationally as needed.

Work Environment

This role is performed in a remote, professional work environment and requires regular use of standard office technology, virtual collaboration tools, and healthcare information systems.

Remote: Travel may be required up to 15% locally or nationally.

Sponsorship Statement

WellBe does not offer employment-based visa sponsorship for this position. Applicants must be legally authorized to work in the United States without the need for employer sponsorship now or in the future.

Pay Transparency Statement

Compensation for this position will be disclosed in accordance with applicable state and local pay transparency laws.

Safety-Sensitive Statement

This position has been designated as safety-sensitive. As such, the employee must be able to perform job duties in a manner that ensures the safety of themselves, coworkers, patients, and the public. The role requires full cognitive and physical functioning at all times.

Employees in safety-sensitive positions are subject to drug and alcohol testing, including for substances that may impair judgment or motor function, in accordance with applicable federal and state laws and company policy. Due to the safety-sensitive nature of this role and in alignment with federal law and workplace safety standards, the use of marijuana—including medical or recreational use—is prohibited. WellBe Senior Medical will comply with applicable state laws regarding medical marijuana and reasonable accommodations, where such laws do not conflict with safety requirements or federal regulations.

Drug Screening Requirement

As a condition of employment, WellBe Senior Medical requires all candidates to successfully complete a pre-employment drug screening. Ongoing employment may also be contingent upon compliance with the company’s Drug-Free Workplace Policy, which includes random, post-accident, and reasonable suspicion drug testing. The company reserves the right to test for substances that may impair an employee’s ability to safely and effectively perform their job duties.

Background Check Statement

Employment is contingent upon successful completion of a background check, as permitted by law. As a healthcare organization, WellBe conducts monthly FACIS (Fraud and Abuse Control Information System) checks on all employees. Continued employment is contingent upon satisfactory results of these checks, in accordance with applicable laws and regulations.

Equal Employment Opportunity (EEO) Statement

WellBe 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, protected veteran status, or any other legally protected status.

Americans with Disabilities Act (ADA)

WellBe Senior Medical is committed to complying with the Americans with Disabilities Act (ADA) and applicable state and local laws. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job.

If you require an accommodation during the application, interview, or employment process, please contact Human Resources at HRPeopleLine@wellbe.com.

At-Will Employment Statement

Employment with WellBe is at-will unless otherwise specified by contract. This job description does not constitute an employment contract.

Disclaimer

This job description is intended to describe the general nature and level of work performed. It is not intended to be an exhaustive list of all responsibilities, duties, and skills required. Management reserves the right to modify, add, or remove duties as necessary.