Director of Quality, Coding & CDI (Risk Adjustment)

Femtech Insider Ltd.; United States; Hybrid; USD 150,000 - 210,000; Full time

Job summary

Herself Health is seeking a Director, Quality, Clinical Coding and Documentation to lead the end-to-end quality, risk adjustment and CDI programs for women 65+ in a value-based care model. You will guide HEDIS and Star Ratings initiatives, ensure accurate documentation, and drive NCQA submissions across multiple clinics.

The role includes clinician education, workflow integration, audit readiness, vendor oversight, and collaboration with payers and leadership.

Qualifications

• Bachelor’s degree in health information management or related field with coding certification.
• Active coding credentials (CPC, CRC, CCS, CCS-P, RHIA or RHIT).
• 7+ years in medical coding, risk adjustment, or clinical documentation integrity.
• Strong knowledge of CMS-HCC model and NCQA/STARs requirements.

Responsibilities

• Own quality, risk adjustment, and CDI programs end to end across clinics.
• Lead HEDIS/STARs performance, NCQA submissions, and data validation.
• Design clinician education and workflow changes to improve documentation accuracy.
• Partner with clinics and payers to ensure compliant, audit-ready coding.

Skills

Leadership

Quality management

Coding proficiency

HEDIS knowledge

NCQA expertise

Data analytics

Team building

Education

Bachelor’s degree in health information management or related field

CPC/CRC/CCS/CCS-P/RHIA/RHIT (CRC preferred)

7+ years in coding, risk adjustment, or CDI

CMS-HCC knowledge

Tools

EHR templates

Coding audit tools

Quality dashboards

Job description

Herself Health is seeking a Director, Quality, Clinical Coding and Documentation to lead the end-to-end quality, risk adjustment and CDI programs for women 65+ in a value-based care model. You will guide HEDIS and Star Ratings initiatives, ensure accurate documentation, and drive NCQA submissions across multiple clinics.

The role includes clinician education, workflow integration, audit readiness, vendor oversight, and collaboration with payers and leadership.