Clinical Document Integrity Specialist 1, Managed Care Network Development Med Mgmt-Boca Raton, FT, 8:30A-5P

Baptist Health; Boca Raton (FL); On-site; USD 74,000 - 96,000; Full time

Job summary

Baptist Health in Boca Raton is hiring a Clinical Document Integrity Specialist 2 to improve the quality and completeness of clinical documentation and ensure accurate reimbursement for DRG-based payors.

The role requires clinical experience, leadership, and familiarity with Milliman and Interqual. You will educate care teams, participate in CDMP processes, and support managed care network development on a full-time basis.

Qualifications

• Medical degree required: Doctor of Medicine or DO.
• RN with MBA preferred; international graduates of medical school.
• At least four years of clinical inpatient experience (adult/pediatrics/OB/critical care).
• CDIS certification preferred; Milliman and Interqual experience helpful.
• Leadership and knowledge of coding, MS-DRG, APR-DRG, utilization management, discharge planning, and managed care.
• Experience with healthcare web-based applications (Milliman, InterQual).
• Basic computer skills; Windows-based software.
• Foreign Medical Graduate required for hires after 06/04/2023; incumbents may be CPC or RN.

Responsibilities

• Improve the quality and completeness of clinical documentation.
• Facilitate modifications to documentation to ensure appropriate DRG reimbursement.
• Ensure accuracy of clinical information used for outcomes measurement.
• Educate all patient care team members on an ongoing basis.
• Actively participate in team meetings and CDMP education.

Skills

Leadership experience

Communication with physicians

Utilization management

Case management

Discharge planning

Managed care experience

Clinical documentation improvement

Windows-based software

Education

Doctor of Medicine / DO

RN with MBA

Foreign Medical Graduate

Tools

Milliman

Interqual

Job description

Clinical Document Integrity Specialist 2, Managed Care Network Development Med Mgmt, FT, 8:30A-5P - 159321

Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors.

What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients' shoes ourselves and that shared experience fuels out commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact – because when it comes to caring for people, we're all in.

At Baptist Health, we’re committed to supporting our employees at every stage of their journey, both personally and professionally. Our approach is rooted in a “grow our own” philosophy, designed to help our team members build meaningful, long-term careers with us, supported by benefits that make a real difference, including:

• Career growth and development opportunities, with clear pathways and ongoing support
• Comprehensive health and wellness resources that go beyond traditional benefits
• A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs
• Tuition reimbursement to support continued learning and advancement
• And so much more
  

Together, these benefits and others reflect our commitment to caring for our people, so they can build fulfilling careers with us while making a meaningful impact every day.

Description

Responsible for improving the overall quality and completeness of clinical documentation. Facilitates modifications to clinical documentation through extensive interaction with physicians, nursing staff, other patient caregivers, and medical records coding staff to ensure that appropriate reimbursement is received for the level of service rendered to all patients with a DRG based payor. Ensures the accuracy and completeness of clinical information used for measuring and reporting physician and medical center outcomes. Educates all members of the patient care team on an ongoing basis. Active participation in team meetings and education of staff in the CDMP process is a key role. Estimated salary range for this position is $74100.20 - $96330.26 / year depending on experience.

Qualifications

Degrees:

• Doctor of Medicine / DO.

Additional Qualifications:

• International graduates of medical school, or RN with MBA preferred.
• Four years of recent clinical experience adult, pediatrics, obstetrics hospital inpatient medical, surgical and critical care setting.
• Four years of recent clinical documentation improvement experience in adult/pediatric hospital in-patient medical/surgical and critical care setting.
• CDIS certification preferred.
• Experience in Milliman and Interqual preferred.
• Leadership experience, knowledge of legal aspects of coding, Medicare MS-DRG, Medicaid APR-DRG assignments, utilization management, case management, discharge planning, and or managed care experience preferred.

• Experience using healthcare web based applications, Milliman, Interqual, etc.

  , preferred.

• Basic computer skills (familiarity with windows based software programs).
• Incumbents hired prior to 6/4/2023 may be a Certified Coding Specialist or a Registered Nurse to continue in a Clinical Document Spec role.
• Anyone hired after 06/4/2023 must be a Foreign Medical Graduate.

Minimum Required Experience: 4 Years

Job

Corporate

Primary Location

Boca Raton

Organization

Corporate

Schedule

Full-time

Job Posting

May 27, 2026, 12:00:00 AM

Unposting Date

Ongoing

Equal Opportunity

EOE, including disability/vets