Senior Director of Clinical Documentation Integrity Strategy

HealthPartners; BLOOMINGTON (MN); In loco; USD 190.000 - 230.000; Tempo pieno

Descrizione del lavoro

HealthPartners is seeking a Senior Director of Clinical Documentation Integrity Strategy to lead enterprise-wide CDI, coding quality, and data integrity initiatives. This executive will align documentation with reimbursement, quality measures, and population health across care settings.

The role partners with physician and operational leadership to drive strategic transformation using analytics, AI, and automation to support future regulatory and reimbursement changes.

Competenze

• Bachelor's degree in Healthcare Administration, Health Information Management, Nursing, Business Administration, Finance, Public Health, or related field.
• Ten or more years of progressively responsible healthcare leadership experience.
• Five or more years of leadership experience managing leaders and complex organizational functions.
• Significant experience leading clinical documentation integrity, diagnosis accuracy, coding, revenue cycle, quality improvement, health information management, or related healthcare operations.
• Experience leading enterprise initiatives in large, highly matrixed healthcare organizations.
• Experience operating within both fee-for-service and value-based reimbursement models.

Mansioni

• Establish and lead the enterprise strategy for clinical documentation integrity, diagnosis accuracy, coding quality, and clinical data integrity across all care settings.
• Provide executive leadership and governance that aligns documentation, reimbursement, quality, population health, compliance, and value-based care objectives.
• Serve as the senior advisor to executive leadership on documentation integrity, diagnosis accuracy, regulatory trends, and reimbursement implications.
• Provide enterprise oversight for inpatient and ambulatory documentation integrity, diagnosis accuracy, provider documentation excellence, and related operational programs.
• Drive operational effectiveness through standardized governance, optimized workflows, workforce planning, and performance management.
• Ensure organizational compliance, accuracy, efficiency, and sustainable operational outcomes.
• Lead enterprise strategies that improve diagnosis accuracy, risk adjustment performance, and the integrity of clinical data used for reimbursement, quality measurement, and population health management.
• Partner across care delivery, health plan, finance, quality, contracting, and population health functions to optimize performance under fee-for-service and value-based payment models.
• Establish performance measures and reporting strategies that monitor documentation quality, coding integrity, diagnosis accuracy, financial outcomes, quality performance, and clinician engagement.
• Utilize analytics and actionable insights to support strategic decision-making and continuous improvement.
• Communicate performance trends, risks, and recommendations to executive leadership.
• Lead the evaluation and implementation of technologies that advance documentation integrity, coding quality, and diagnosis accuracy.
• Develop organizational capabilities related to artificial intelligence, automation, advanced analytics, and emerging healthcare technologies.
• Position the organization to successfully navigate evolving regulatory, reimbursement, and healthcare delivery requirements.

Conoscenze

CDI knowledge

CMS-HCC experience

Population risk methods

Executive leadership

Strategic planning

Communication

Formazione

Bachelor's degree

Master's degree preferred

Descrizione del lavoro

HealthPartners is hiring a Senior Director of Clinical Documentation Integrity Strategy. They serve as the enterprise leader responsible for the strategic vision, operational performance, governance, and future direction of clinical documentation integrity, diagnosis accuracy, provider documentation excellence, coding quality, and clinical data integrity across HealthPartners.

This position provides executive leadership for inpatient and ambulatory documentation programs, diagnosis accuracy strategies, coding integrity initiatives, and clinical documentation technologies that support revenue integrity, quality measurement, value-based care performance, regulatory compliance, and population health outcomes. As a key leader within an integrated care delivery and health plan organization, the Senior Director aligns documentation, coding, reimbursement, quality, and risk adjustment strategies to ensure the complete and accurate representation of patient health status across all care settings.

The Senior Director partners extensively with physician leadership, operational leaders, health plan leaders, finance, quality, population health, contracting, information technology, and analytics teams to optimize enterprise performance across fee-for-service, shared savings, global risk, Medicare Advantage, Medicaid, ACA Exchange, and emerging payment models. This leader drives innovation through advanced analytics, artificial intelligence, automation, and technology-enabled transformation to position HealthPartners for future regulatory, reimbursement, and healthcare delivery changes.

MINIMUM QUALIFICATIONS:

• Education, Experience or Equivalent Combination:
  • Bachelor's degree in Healthcare Administration, Health Information Management, Nursing, Business Administration, Finance, Public Health, or a related field.
  • Ten (10) or more years of progressively responsible healthcare leadership experience.
  • Five (5) or more years of leadership experience managing leaders and complex organizational functions.
  • Significant experience leading clinical documentation integrity, diagnosis accuracy, coding, revenue cycle, quality improvement, health information management, or related healthcare operations.
  • Experience leading enterprise initiatives in large, highly matrixed healthcare organizations.
  • Experience operating within both fee-for-service and value-based reimbursement models.
• Licensure/ Registration/ Certification:
  • Applicable healthcare, coding, CDI, risk adjustment, nursing, or health information credentials as relevant to education and experience.
• Knowledge, Skills, and Abilities:
  • Expert knowledge of clinical documentation integrity, coding methodologies, diagnosis accuracy, risk adjustment, and revenue cycle operations.
  • Strong understanding of CMS-HCC, HHS-HCC, CDPS, ACG, and other population risk methodologies.
  • Comprehensive knowledge of healthcare reimbursement models, quality measurement programs, population health strategies, and regulatory requirements.
  • Demonstrated executive leadership, strategic planning, organizational transformation, and change management capabilities.
  • Exceptional communication, collaboration, influence, and relationship management skills.
  • Ability to translate complex financial, analytical, operational, and regulatory concepts into actionable business strategies.
  • Demonstrated success leading multidisciplinary teams and enterprise-wide initiatives.

PREFERRED QUALIFICATIONS:

• Education, Experience or Equivalent Combination:
  • Master's degree in Business Administration, Healthcare Administration, Public Health, Health Informatics, Nursing, or related field.
  • Experience within an integrated healthcare delivery system and health plan organization.
  • Experience supporting Medicare Advantage, Medicaid, ACA Exchange, commercial risk adjustment, and value-based care programs.
  • Experience leading technology modernization, artificial intelligence, automation, and analytics transformation initiatives.
  • Experience supporting both hospital and ambulatory operations.
• Licensure/ Registration/ Certification:
  • One or more of the following: CCDS, CDIP, RHIA, RHIT, CCS, CCS-P. CPC, CRC, RN
• Knowledge, Skills, and Abilities:
  • Advanced understanding of healthcare quality programs, alternative payment models, and value-based care arrangements.
  • Knowledge of emerging clinical documentation technologies, artificial intelligence, natural language processing, and computer-assisted coding solutions.

ESSENTIAL DUTIES:

1. (30%) Enterprise Strategy and Governance

• Establish and lead the enterprise strategy for clinical documentation integrity, diagnosis accuracy, coding quality, and clinical data integrity across all care settings.
• Provide executive leadership and governance that aligns documentation, reimbursement, quality, population health, compliance, and value-based care objectives.
• Serve as the senior advisor to executive leadership on documentation integrity, diagnosis accuracy, regulatory trends, and reimbursement implications.

1. (25%) Operational Leadership and Performance

• Provide enterprise oversight for inpatient and ambulatory documentation integrity, diagnosis accuracy, provider documentation excellence, and related operational programs.
• Drive operational effectiveness through standardized governance, optimized workflows, workforce planning, and performance management.
• Ensure organizational compliance, accuracy, efficiency, and sustainable operational outcomes.

1. (20%) Value-Based Care and Clinical Data Integrity

• Lead enterprise strategies that improve diagnosis accuracy, risk adjustment performance, and the integrity of clinical data used for reimbursement, quality measurement, and population health management.
• Partner across care delivery, health plan, finance, quality, contracting, and population health functions to optimize performance under fee-for-service and value-based payment models.

1. (15%) Analytics, Quality, and Organizational Performance

• Establish performance measures and reporting strategies that monitor documentation quality, coding integrity, diagnosis accuracy, financial outcomes, quality performance, and clinician engagement.
• Utilize analytics and actionable insights to support strategic decision-making and continuous improvement.
• Communicate performance trends, risks, and recommendations to executive leadership.

1. (10%) Innovation and Transformation

• Lead the evaluation and implementation of technologies that advance documentation integrity, coding quality, and diagnosis accuracy.
• Develop organizational capabilities related to artificial intelligence, automation, advanced analytics, and emerging healthcare technologies.
• Position the organization to successfully navigate evolving regulatory, reimbursement, and healthcare delivery requirements.