Lead, CDI Specialist

Health Choice Network; United States; Remote; USD 80,000 - 95,000; Full time

Benefits offered by this job

100% Remote Work

Employer-Paid Medical Insurance

Annual $1,500 HSA Contribution

Generous PTO

403(b) Employer Contribution

Professional Development & Education

Job summary

Health Choice Network, Inc. is seeking a Lead CDI Specialist to provide clinical and operational leadership for our CDI program. This role oversees QA, education, compliance, and continuous optimization while expanding the program.

The Lead CDI will partner with providers and centers to enhance documentation accuracy, risk adjustment capture, and overall performance, driving strategic growth and cross-functional collaboration.

Qualifications

• Current professional certification required (CCS, CPC, CRC, RHIT, RHIA, or equivalent).
• Minimum of five (5) years in CDI, coding audits or related healthcare ops.
• Advanced ICD-10-CM, risk adjustment, HCC model knowledge.
• Experience conducting documentation reviews and QA activities.
• Strong analytical, communication and process-improvement skills.
• Ability to collaborate across cross-functional teams.

Responsibilities

• Lead and maintain the CDI QA program including audits and trend analysis.
• Monitor CMS guidance, coding standards, risk adjustments and payer rules.
• Develop and deliver CDI education and training on regulatory changes.
• Lead provider/health center education with materials and resources.
• Conduct prospective medical record audits to improve documentation.
• Analyze audit findings to drive actionable improvements.
• Drive CDI program optimization across workflows and tools.
• Serve as SME supporting staff, providers, and stakeholders.
• Assist CDI expansion across new centers and contracts.
• Collaborate with clinical, operational, and technical teams.

Skills

CDI experience

QA leadership

Regulatory knowledge

Stakeholder engagement

Education

HIM degree

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Lead, CDI Specialist

VBS Clinical Operations Regular Full-Time US

Salary Range: $80,000.00 To $95,000.00 Annually

What We Are Looking For

We are seeking an experienced Lead Clinical Documentation Improvement (CDI) Specialist to provide clinical and operational leadership that advances the quality, consistency, and effectiveness of our Clinical Documentation Improvement program. This role will oversee quality assurance activities, staff education, regulatory compliance, documentation excellence, and continuous program optimization while supporting ongoing program growth and expansion.

The Lead CDI Specialist will serve as a subject matter expert, partnering with providers, health centers, and internal stakeholders to enhance documentation accuracy, coding specificity, risk adjustment capture, and overall program performance.

Key Responsibilities

• Lead and maintain the CDI Quality Assurance (QA) program, including audits, quality monitoring, staff feedback, trend analysis, and identification of improvement opportunities.
• Monitor CMS guidance, ICD-10-CM coding standards, risk adjustment methodologies, HCC models, and payer requirements, ensuring timely communication of regulatory and industry updates to CDI staff.
• Develop and deliver CDI education and training based on regulatory changes, audit findings, documentation trends, and program needs.
• Lead provider and health center education initiatives, including the development of presentations, training materials, job aids, and documentation resources.
• Conduct prospective medical record audits to identify documentation, coding, clinical specificity, and risk adjustment opportunities.
• Analyze audit findings and trends to develop actionable recommendations and improvement strategies.
• Drive continuous CDI program optimization by evaluating and improving workflows, processes, tools, and operational standards.
• Serve as a CDI subject matter expert, providing guidance and support to CDI staff, providers, and health center stakeholders.
• Support CDI program expansion across new health centers, providers, patient populations, and value-based care contracts.
• Collaborate with clinical, operational, and technical teams to support organizational goals and improve outcomes.

Required Qualifications

• Current professional certification required (CCS, CPC, CRC, RHIT, RHIA, or equivalent).
• Minimum of five (5) years of experience in Clinical Documentation Improvement, coding audits, risk adjustment, quality assurance, or related healthcare operations.
• Advanced knowledge of ICD-10-CM coding standards, risk adjustment methodologies, HCC models, and applicable regulatory requirements.
• Experience conducting documentation reviews, prospective audits, and quality assurance activities.
• Strong analytical, critical thinking, and process improvement skills.
• Excellent written, verbal, presentation, and stakeholder engagement skills.
• Ability to manage multiple priorities and collaborate effectively across cross-functional teams.

Preferred Qualifications

• Associate's or Bachelor's degree in Health Information Management, Nursing, Healthcare Administration, or a related field.
• Experience leading CDI quality assurance programs and educational initiatives.
• Experience supporting value-based care programs and risk adjustment strategies.
• Previous provider education and training experience.
• Experience supporting program growth, implementation, and operational improvement initiatives.

Why You’ll Love Working With Us

100% Remote Work – Work from anywhere in the U.S.
100% Employer-Paid Medical Insurance on one of our health plans
Annual $1,500 HSA Contribution
Generous Paid Time Off (PTO)
403(b) Retirement Plan with Employer Contribution
Professional Development & Education Assistance
Mission-Driven Culture Focused on Community Health

Disclaimer

At this time, Health Choice Network is not able to employ individuals who reside or work in California. Applicants must reside and perform work in an approved state at the time of hire and throughout employment.