Manager, Clinical Documentation Integrity (CDI)

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.

Requirements

• 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.

Benefits

• 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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