Remote Director of Quality, Coding & CDI

Herself; Northern (KY); Hybrid; USD 140,000 - 210,000; Full time

Job summary

Herself Health is seeking a Director of Quality, Clinical Coding and Documentation to own the organization’s quality performance and coding integrity. The role combines quality and CDI leadership, advancing HEDIS and CMS Star Ratings while ensuring accurate documentation and coding across clinics, with hybrid work in the Twin Cities metro and occasional travel.

You will guide NCQA submissions, chart-based data, risk adjustment strategy, and clinician education, partnering with payer and finance

Qualifications

• Bachelor’s degree or equivalent experience in health information management, nursing, healthcare administration, or related field.
• Active coding certification (CPC/CRC/CCS/CCS-P/RHIA/RHIT) with CRC preferred.
• Seven+ years of progressive experience in medical coding, risk adjustment, or clinical documentation integrity, including 3+ years in leadership or program ownership.

Responsibilities

• Own the quality program and drive HEDIS and Medicare Advantage Star Ratings performance across all clinics and payer contracts.
• Lead end-to-end gap closure, including outreach design, scheduling strategy, and closed-loop tracking.
• Direct the coding and documentation strategy for risk adjustment, including pre-visit and post-visit coding workflows.
• Ensure compliance and audit readiness for RADV, external audits, and CMS guidance.
• Build and mentor a combined quality, coding, and CDI team capable of scaling across markets.

Skills

Quality program leadership

HEDIS & Star Ratings

Risk adjustment

Clinical Documentation Integrity

Coding accuracy

CMS-HCC knowledge

Audit defense

Payer collaboration

Leadership

Clinician education

Education

Bachelor’s degree in health information management, nursing, healthcare administration, or related field

Active coding certification - CPC, CRC, CCS, CCS-P, RHIA, or RHIT

CRC strongly preferred

Tools

EHR systems

Payer audit tooling

Job description

Herself Health is seeking a Director of Quality, Clinical Coding and Documentation to own the organization’s quality performance and coding integrity. The role combines quality and CDI leadership, advancing HEDIS and CMS Star Ratings while ensuring accurate documentation and coding across clinics, with hybrid work in the Twin Cities metro and occasional travel.

You will guide NCQA submissions, chart-based data, risk adjustment strategy, and clinician education, partnering with payer and finance