Manager, Clinical Documentation Integrity
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Job Description
CDI Manager leading documentation integrity, risk adjustment, and HCC coding operations. Improving compliance, physician support, team performance, and care outcomes for seniors.
Responsibilities:
- Lead day-to-day operations of prospective and concurrent CDI review processes
- Set and enforce quality, productivity, and turnaround-time standards
- Monitor work queues and workflow, identifying bottlenecks
- Lead team huddles, 1:1s, coaching conversations, and performance discussions
- Manage schedules, coverage, timecards, and time-off requests
- Serve as the escalation point for coding questions and challenges
- Own onboarding, training plans, resources, workflows, and readiness assessments for new CDI specialists
- Coach team members on technical knowledge, quality, productivity, and professional growth
- Track accuracy, quality, production, turnaround time, and other CDI metrics
- Identify trends, root causes, and improvement opportunities
- Partner on audits, scoring methodology, follow-up reviews, and quality improvement
- Build and improve SOPs, workflows, job aids, documentation standards, coding best practices, and internal guidance
- Partner with physician leadership, clinical teams, Medical Records, retrieval, billing, claims, and operational teams
- Translate complex coding and documentation requirements into practical guidance
- Ensure alignment with ICD-10-CM guidelines, CMS-HCC risk-adjustment requirements, payer policies, and applicable regulations
- Support audit readiness, including RADV and other regulatory or payer reviews
Requirements:
- 5+ years of experience in clinical documentation integrity, risk adjustment, or HCC coding, including experience supporting Medicare Advantage populations
- Experience leading, coaching, or supervising others and holding a team accountable to clear performance standards
- Deep knowledge of ICD-10-CM and CMS-HCC risk-adjustment methodology, including V24 and V28
- Strong experience working alongside physicians and clinical teams on documentation quality
- Active coding credential such as CRC, CPC, CCS, RHIT, or RHIA
- Associate's or Bachelor's degree in Health Information Management, nursing, or a related field, or equivalent relevant experience
- Experience working with EHRs and CDI, coding, or risk-adjustment platforms
- Strong judgment when navigating complex compliance, quality, and performance issues
- CRC certification, with CDIP or CCDS considered a plus
- Experience building training programs, provider education, SOPs, or workflows
- Ability to coach technical teams without micromanaging
- Comfort using data and performance metrics to identify problems and drive improvement
- Ability to explain complex coding and documentation requirements clearly to coders, physicians, and non-technical stakeholders
- Ability to take ownership and solve problems
- Ability to thrive in a structured, deadline-driven environment where details matter
- Collaborative, supportive leadership style
- Judgment and discretion to handle sensitive performance and compliance matters
Benefits:
- Generous annual performance bonus (add commission if applicable)
- Health, dental, and vision insurance
- Paid time off
- 401(k) with company match
- Opportunities to grow skills and take on new challenges
- Reasonable accommodations during the recruitment process
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