Manager, Clinical Documentation Integrity (CDI)

About the role

The Manager, Clinical Documentation Integrity (CDI) is a hands-on leadership role responsible for overseeing a high-performing team that ensures accurate, complete, compliant, and defensible clinical documentation. This role involves leading day-to-day operations, monitoring team performance, coaching team members, and collaborating with various stakeholders to support clinical integrity, risk adjustment, compliance, and better patient outcomes.

Responsibilities

• 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.
• Maintain and optimize 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.
• 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.
• 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.

Schedule

Standard Monday–Friday schedule with office hours from 8:00 a.m. to 5:00 p.m.

Pay

Base compensation of $115,000 annually, based on experience and qualifications.