Manager, Clinical Documentation Integrity Performance

The CDI Manager will lead a team of CDI Coders, ensuring compliance with regulatory standards and optimizing clinical documentation practices. This role requires a strong commitment to regulatory compliance, accuracy in coding, and collaboration with stakeholders at various levels of healthcare operations.The manager will be responsible for overseeing CDI coding processes, ensuring alignment with national, market, practice, and individual provider-level requirements. They will work closely with CDI coders to maintain high-quality documentation standards, support accurate risk adjustment coding, and facilitate workflow efficiencies.
This position offers a remote work environment, with opportunities for periodic travel to practices for on-site training, auditing, and support. The ideal candidate is detail-oriented, service-driven, and an effective communicator, with proficiency in Google Suite tools or a willingness to quickly master them

Primary Duties:

• Plans, organizes, and manages the system wide CDI Coding performance functions. Manages the activities of and provides leadership to the CDI Coding team. People manage a team of 5-10 CDI Coders.  Provide guidance and support and build effective teams (both internally and with vendors) to achieve established goals within established budgets.


• Manage and monitor the effectiveness of the coding and billing programs; develop key indicators to effectively monitor performance and identify and implement process improvement strategies necessary to meet annual targets.  Manages coding and quality, productivity, workflow and performance activities. 


• Acts as a liaison and subject matter expert for internal and external customers in coding, billing, and risk adjustment. Monitors coding performance to meet regulatory, legal and risk management implications of health information, coding, and documentation compliance guidelines. Manages adherence to the policies and procedures governing coding and reimbursement in compliance with federal and state laws and regulatory guidelines. 


• Design, build, scale and oversee activities, programs, interventions and solutions based on market needs.  Actively participates in the evaluation, selection, and maintaining of information systems supporting coding. Use data to identify practices that could benefit from Aledade services.  Partner with practices to understand billing and coding workflows and identify opportunities for process improvement.


• Manage & lead billing and coding related projects, including tracking key metrics across initiatives and driving cross-functional team collaboration. Identify trends across practices and provide feedback on the best course of action to improve billing and coding practices.

Minimum Qualifications:

• Bachelor's degree in Health Information Management or related healthcare field.  10 years of experience in lieu of the degree.  
• Minimum 4-6 years of experience in a health plan or health system setting
• Minimum of 3 years of experience in Risk Adjustment
• Minimum of 3+ years of management experience
• Ability to influence, provide customer service, and work collaboratively with internal and external customers, including physicians
• Ability to establish and maintain effective working relationships across the company
• Complete understanding of acuity levels for specific patient populations and strong clinical knowledge with the ability to interpret clinical documentation
• Critical thinking skills to problem solve and communicate with physicians on clinical issues
• Analytical ability necessary to conduct basic research, analyze and interpret data, evaluate processes and propose solutions. 
• Extensive knowledge of regulations and guidelines pertaining to documentation and coding. 
• Ability to prioritize work, meet deadlines, and produce quality results on time with strong attention to detail. 
• Excellent written and oral communication skills including excellent presentation skills and the ability to communicate effectively with all levels of management and medical providers. 

Preferred Key Skills and Abilities:

• Master’s degree in health related fields. 
• One of the following active credentials issued by the American Health Information Management Association (AHIMA) or current Registered Nurse (RN) licensee:
• RHIA – Registered Health Information Administrator
• RHIT – Registered Health Information Technician
• RN – Registered Nurse
• One or more of the following active credentials:
• Certified Coding Specialist (CCS) - AHIMA
• Certified Documentation Improvement Practitioner (CDIP) – AHIMA
• Certified Clinical Documentation and Certification - Outpatient (CCDS-O) - ACDI