CDI Enablement Manager

About the role

We are seeking a CDI Enablement Manager that is clinically-informed, coder-certified, and responsible for driving documentation quality and provider education at the practice level. This role sits at the intersection of clinical knowledge, risk adjustment expertise, and coding accuracy, serving as a trusted resource for providers, a frontline education delivery channel for the CDI team, and a concurrent reviewer of clinical documentation.

Responsibilities

• Deliver targeted, intervention-based education with prioritization driven by practice performance data
• Facilitate one-on-one provider education sessions, including DSP documentation coaching, ICD-10-CM specificity guidance, and clinical scenario-based learning
• Participate in Pod meetings, RMO sessions, and practice-facing touchpoints to deliver vignette-style CDI education and reinforce documentation best practices
• Design and maintain practice-specific education plans based on coding data, RAF trend analysis, and recapture opportunity outputs
• Support provider understanding of point-of-care tools, suspect delivery outputs, and documentation expectations tied to CDI (Clinical Documentation Integrity) program goals
• Respond to education needs and engagement escalations for practices with persistent documentation gaps
• Monitor performance against practice-specific education plans, and propose and act upon improvement plans
• Lead provider-facing webinars and educational sessions
• Build and maintain the CDI clinical content library, including condition-specific advisories, documentation tip sheets, and slide-ready education modules, for use by RMO and CDI staff
• Collaborate with the VP, CDI & Coding Operations and QA Lead to ensure all clinical content reflects current coding guidelines and risk adjustment requirements
• Create provider-facing survey content, webinars, and self-service education resources within the CDI SharePoint knowledge hub
• Conduct concurrent documentation reviews, evaluating clinical support for active diagnoses and identifying documentation gaps prior to or following encounters
• Review coding outputs against clinical documentation to assess accuracy, specificity, and completeness; flag discrepancies for QA escalation or provider follow-up
• Apply MEAT criteria in documentation review; identify conditions requiring addendum, query, or provider education
• Contribute to the development of concurrent review workflows and eligibility criteria in coordination with the CDI Operations Lead and VP
• Partner with RMOs, market medical directors, and practice-facing staff to align education delivery with population health and performance priorities
• Coordinate with the CDI Operations Lead for EMR access needs, and workflow logistics for education and review activities
• Track and report on education delivery, concurrent review activity, and provider engagement outcomes against established benchmarks
• Escalate compliance concerns, coding accuracy issues, and documentation risks to the VP, CDI & Coding Operations in a timely manner

Requirements

• Bachelor’s degree in Health Information Management, Nursing, Healthcare Administration, or a related clinical or health sciences field preferred
• Experience: 5+ years of experience in clinical documentation integrity, coding operations, risk adjustment, or a related field
• Demonstrated experience delivering provider education or clinical training in an ambulatory or value-based care setting
• Prior experience conducting concurrent or retrospective documentation review
• Licenses & Certifications: Active CRC (Certified Risk Coder) certification required in addition to a CPC (Certified Professional Coder) or CCS (Certified Coding Specialist). Active CDI certification required, the CDEO (Certified Documentation Expert Outpatient), CDIP (Certified Documentation Improvement Practitioner), or CCDS-O (Certified Clinical Documentation Specialist – Outpatient) or equivalent credential issued by AAPC or AHIMA. Certification must be current and in good standing at time of hire; maintenance of certification is required as a condition of employment

Skills & Competencies

• Strong working knowledge of risk adjustment coding, methodology (v24/v28), and CMS documentation standards
• Demonstrated ability to apply DSP/MEAT and clinical criteria in documentation review and provider education contexts
• Proven ability to communicate complex clinical and coding concepts to non-coding clinical audiences (providers, care teams)
• Strong client-facing skills with the ability to educate stakeholders, identify improvement opportunities, and deliver actionable feedback and recommendations
• Excellent verbal and written communication skills, including ability to navigate difficult conversations and respond to both positive and negative customer feedback with professionalism and accountability
• Strong organizational skills with the ability to manage a portfolio of practices and prioritize independently
• Experience working in Medicare Advantage, ACO REACH, or MSSP risk adjustment environments