Director Medical Coding and Clinical Documentation Improvement CDI/Auditor
Location: Remote (U.Job Type: Full-Time, Benefits-Eligible
Are you a world-class leader with deep expertise in Risk Adjustment, CDI, and Auditing?
We're seeking a seasoned and strategic CDI/Auditor Leader to join our growing team and elevate our audit and provider education programs to the next level. This is a full-time, non-contract position with comprehensive benefits. The position is remote but must be in Eastern time zone.
Personalized Health Partners (PHP) is an innovative medical practice dedicated to delivering personalized care that aligns with each patient's goals and enhances quality of life. Through our comprehensive provider solutions and convenient telehealth services, we offer a modern approach to healthcare that is responsive, accessible, and deeply individualized.
As part of the CommuniCare Health Services family—an organization with over 40 years of trusted healthcare experience—PHP is rapidly expanding across six states, bringing high-quality, patient-centered care to more communities every day. Lead and mentor a high-performing remote team of auditors and CDI professionals in the delivery of compliant, accurate, and timely risk adjustment audits.
Oversee workflows, quality assurance, and process improvement initiatives to ensure excellence in clinical documentation integrity.
Partner cross-functionally with internal departments to drive performance and compliance.
Serve as a subject matter expert on HCC risk adjustment (v28), CMS guidelines, and audit best practices.
10+ years of experience in risk adjustment and auditing with a proven track record of success.
~5+ years of leadership experience managing and developing clinical and/or coding teams.
~3+ years of experience in provider education, with the ability to translate complex coding guidelines into actionable insights.
~ Recent hands-on experience with v28 HCC coding and guidelines is required.
~ Committed to high standards, team development, and continuous improvement.
