Documentation Integrity Specialist IV, Clinical Licensure-Risk Adjustment

Sustainable World, Inc.; Sacramento (CA); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Sustainable World, Inc. seeks a CDI Risk Adjustment Specialist in Sacramento to improve documentation quality and drive alignment with coding and regulatory standards.

You will identify opportunities for clarification and collaborate with providers, coding, compliance, and operations to strengthen audit preparedness and program effectiveness. The role requires experience in inpatient settings and a relevant nursing, medical, or health information management background, with a focus on continuous

Qualifications

• Minimum two (2) years of experience in an inpatient acute care or clinical setting.
• Bachelor's degree in Nursing, Medicine, Health Administration, Health Information Management, or related field AND minimum four (4) years experience in nursing, CDI, inpatient coding, quality review, case management, or a directly related field OR Minimum seven (7) years of experience in nursing, medicine, CDI, inpatient coding, quality review, case management, or a directly related field.
• Physician Assistant License (California) required at hire OR Doctor of Medicine License (California) required at hire OR Nurse Practitioner Certificate (California) required at hire OR Registered Nurse License (California) required at hire

Responsibilities

• Support CDI Risk Adjustment programs through documentation quality and opportunities for clarification.
• Collaborate with providers, coding, compliance, and operational teams to support audit preparedness.
• Promote alignment with coding, regulatory, and organizational standards.
• Drive continuous quality improvement initiatives.

Skills

Documentation integrity

Stakeholder collaboration

Audit readiness

Quality improvement

Clinical coding knowledge

Education

Bachelor's degree in Nursing, Medicine, Health Administration, Health Information Management, or related field

Job description

Support Clinical Documentation Integrity Risk Adjustment programs through documentation quality, identify opportunities for clarification and improvement, and promote alignment with coding, regulatory, and organizational standards. Collaborate with providers, coding, compliance, and operational teams to support audit preparedness, strengthen documentation integrity, improve program effectiveness, and drive continuous quality improvement initiatives.

Minimum two (2) years of experience in an inpatient acute care or clinical setting.
Bachelors degree in Nursing, Medicine, Health Administration, Health Information Management, or related field AND minimum four (4) years experience in nursing, medicine, CDI, inpatient coding, quality review, case management, or a directly related field OR Minimum seven (7) years of experience in nursing, medicine, CDI, inpatient coding, quality review, case management, or a directly related field.
Physician Assistant License (California) required at hire OR Doctor of Medicine License (California) required at hire OR Nurse Practitioner Certificate (California) required at hire OR Registered Nurse License (California) required at hire