Manager, Clinical Documentation Integrity (CDI)
This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Manager, Clinical Documentation Integrity (CDI) based in United States.
The Manager, Clinical Documentation Integrity will lead a high-performing team responsible for accurate, complete, compliant, and defensible clinical documentation. This is a hands-on leadership role combining people management, technical CDI expertise, quality oversight, and operational improvement. You will oversee prospective and concurrent chart review while ensuring the team consistently meets quality, productivity, and turnaround-time expectations. The role also partners closely with physicians and clinical teams to ensure the full clinical picture of senior patients is appropriately captured. You will use data, performance metrics, and workflow insights to strengthen processes, reduce documentation gaps, and improve scalability. This is an opportunity to build a stronger CDI operation while directly supporting clinical integrity, risk adjustment, compliance, and better patient outcomes.
Accountabilities:
- Lead the day-to-day operations of prospective and concurrent CDI review processes, establishing clear expectations and holding the team accountable for quality, productivity, accuracy, and turnaround-time standards.
- Monitor work queues, assignments, coverage, schedules, and workflow on a daily basis, proactively identifying bottlenecks, backlogs, and operational issues before they affect performance.
- Lead team huddles, regular one-on-one meetings, coaching conversations, and performance discussions while creating a supportive environment where expectations and development opportunities are clear.
- Own the onboarding process for new CDI specialists, developing training plans, reference materials, workflows, and job aids while auditing new team members and determining readiness for independent assignments.
- Coach CDI specialists on technical knowledge, documentation quality, productivity, professional development, and performance, providing timely feedback and addressing sustained performance concerns when necessary.
- Track and analyze team performance across accuracy, quality, production, turnaround time, and other CDI metrics, using trends and root-cause analysis to identify opportunities for improvement.
- Partner with CDI oversight leadership on audits, scoring methodologies, follow-up reviews, and quality initiatives to maintain a consistent, fair, and data-driven approach to performance evaluation.
- Improve the CDI operating model by identifying workflow breakdowns, creating and refining SOPs, strengthening documentation standards, and developing coding best practices that improve consistency, speed, quality, and scalability.
- Collaborate with physician leadership, clinical teams, Medical Records, retrieval, billing, claims, and other operational partners to support accurate documentation and remove friction across the provider documentation ecosystem.
- Translate complex coding, documentation, risk-adjustment, and compliance requirements into practical guidance that can be understood and applied by CDI specialists, physicians, and non-technical stakeholders.
- Ensure CDI activities align with ICD-10-CM guidelines, CMS-HCC risk-adjustment requirements, payer policies, and applicable regulatory standards, while supporting audit readiness for RADV and other payer or regulatory reviews.
- At least 5 years of experience in clinical documentation integrity, risk adjustment, or HCC coding, including experience supporting Medicare Advantage populations and working with physicians or clinical teams on documentation quality.
- Demonstrated experience leading, supervising, or coaching CDI, coding, or risk-adjustment professionals, with the ability to establish performance expectations, monitor results, and develop team members effectively.
- Deep knowledge of ICD-10-CM and CMS-HCC risk-adjustment methodology, including familiarity with both V24 and V28 models and their practical application in clinical documentation and coding.
- An active professional credential such as CRC, CPC, CCS, RHIT, or RHIA is required, with CRC strongly preferred and CDIP or CCDS considered an additional advantage.
- An Associate's or Bachelor's degree in Health Information Management, nursing, or a related field is preferred, although equivalent relevant professional experience may be considered.
- Experience working with EHRs and CDI, coding, or risk-adjustment platforms, combined with the ability to navigate complex clinical documentation and coding workflows.
- Strong analytical and problem-solving skills, with the ability to use performance data and operational metrics to identify issues, determine root causes, and implement practical improvements.
- Strong project management and stakeholder-management capabilities, with the ability to balance multiple priorities while maintaining high standards for quality, compliance, and operational performance.
- Excellent communication and collaboration skills, including the ability to explain complex coding and documentation requirements clearly to technical and non-technical stakeholders.
- Strong judgment, discretion, accountability, resilience, and teamwork, particularly when handling sensitive performance matters, compliance risks, quality concerns, and competing operational priorities.
- A continuous-improvement mindset and willingness to take ownership of problems, build effective solutions, and create structured processes that can scale as the organization grows.
- Base compensation of $115,000 annually, based on experience and qualifications.
- Generous annual performance bonus, with additional commission eligibility where applicable.
- Health, dental, and vision insurance to support comprehensive employee wellbeing.
- Paid time off to support sustainable work-life balance.
- 401(k) plan with company matching.
- Fully remote position within the United States, with a preference for candidates located in Eastern or Central time zones.
- Standard Monday–Friday schedule with office hours from 8:00 a.m. to 5:00 p.m.
- Opportunity to lead and develop a specialized CDI function with meaningful influence over quality, compliance, risk adjustment, and operational performance.
- Direct impact on healthcare delivery by helping ensure that clinical documentation accurately reflects patient conditions and supports better outcomes for senior populations.
- Opportunity to build scalable training, workflow, quality, and performance systems while growing within an expanding healthcare environment.
- Collaborative, mission-driven culture that values Heart, Excellence, Accountability, Resilience, and Teamwork, alongside a strong commitment to inclusion and equal employment opportunity.
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