Director of Coding Operations and CDI

CommuniCare Health Services; Blue Ash (OH); Remote; USD 100,000 - 125,000; Full time

Job summary

Join a forward-thinking healthcare organization as a CDI/Auditor Leader, where you'll lead a talented remote team in enhancing clinical documentation integrity and risk adjustment audits. This full-time position offers the opportunity to make a significant impact in a rapidly expanding medical practice dedicated to personalized care. Collaborate across departments to drive performance and compliance while developing innovative strategies for provider education. If you're a seasoned expert with a passion for excellence and a commitment to continuous improvement, this role is tailor-made for you.

Qualifications

• 10+ years in risk adjustment and auditing with proven success.
• 5+ years of leadership experience in clinical or coding teams.

Responsibilities

• Lead a remote team of auditors in delivering accurate risk adjustment audits.
• Develop strategies for provider education and engagement.

Skills

Risk Adjustment

Clinical Documentation Improvement (CDI)

Auditing

Leadership

Communication Skills

Strategic Thinking

Organizational Skills

Education

CPC Certification

CRC Certification

CPMA Certification

Job description

Director Medical Coding and Clinical Documentation Improvement CDI/Auditor

Position: CDI/Auditor Leader
Location: Remote (U.S. based only)
Job Type: Full-Time, Benefits-Eligible

Are you a world-class leader with deep expertise in Risk Adjustment, CDI, and Auditing?
We're seeking a seasoned and strategic CDI/Auditor Leader to join our growing team and elevate our audit and provider education programs to the next level. This is a full-time, non-contract position with comprehensive benefits. The position is remote but must be in Eastern time zone.

About Us

Personalized Health Partners (PHP) is an innovative medical practice dedicated to delivering personalized care that aligns with each patient's goals and enhances quality of life. Through our comprehensive provider solutions and convenient telehealth services, we offer a modern approach to healthcare that is responsive, accessible, and deeply individualized.

As part of the CommuniCare Health Services family—an organization with over 40 years of trusted healthcare experience—PHP is rapidly expanding across six states, bringing high-quality, patient-centered care to more communities every day. Our growth reflects our commitment to excellence, innovation, and the well-being of those we serve.

What You’ll Do

• Lead and mentor a high-performing remote team of auditors and CDI professionals in the delivery of compliant, accurate, and timely risk adjustment audits.
• Oversee workflows, quality assurance, and process improvement initiatives to ensure excellence in clinical documentation integrity.
• Partner cross-functionally with internal departments to drive performance and compliance.
• Develop and implement strategies for provider education and engagement, including individual coaching and group sessions.
• Serve as a subject matter expert on HCC risk adjustment (v28), CMS guidelines, and audit best practices.

What We’re Looking For

• 10+ years of experience in risk adjustment and auditing with a proven track record of success.
• 5+ years of leadership experience managing and developing clinical and/or coding teams.
• 3+ years of experience in provider education, with the ability to translate complex coding guidelines into actionable insights.
• Recent hands-on experience with v28 HCC coding and guidelines is required.
• Strong understanding of long-term care settings is preferred.
• CPC Certifications a must have
• CRC, and CPMA are strongly preferred
• Exceptional communication, strategic thinking, and organizational skills.
• Committed to high standards, team development, and continuous improvement.