The Vice President, Clinical Documentation Integrity (CDI) is a business unit leader accountable for the strategy, growth, operational performance, and market reputation of the organization's Inpatient and Outpatient CDI practice. Serving academic health systems and other complex provider organizations as core clients, this leader sets the vision for CDI program design and delivery while positioning the practice for expansion into a broader, consulting-oriented services model.
This role blends clinical documentation expertise, executive presence, and commercial acumen. The VP is the face of the practice with client executives and prospects, the architect of scalable CDI program models, the steward of program performance and quality, and a close operating partner to the sales organization in pursuing and winning new business. Success is measured by client outcomes, program integrity and compliance, team development, and profitable growth of the practice.
Essential Duties & Responsibilities
Program Development — Inpatient & Outpatient CDI
- Design, standardize, and continuously evolve the practice's Inpatient and Outpatient CDI program models, including operating playbooks, workflows, query standards, staffing models, and technology enablement.
- Establish Outpatient CDI capabilities for risk-adjusted and value-based settings, including HCC capture, prospective (point-of-care) review, and audit-ready documentation practices.
Executive Interaction & Change Leadership
- Engage C-suite and physician leaders (CMO, CMIO, CFO, VP of Revenue Cycle, service-line chiefs) with credibility and presence as a recognized subject-matter expert in CDI.
- Translate CDI performance into the language of quality, reimbursement integrity, physician workflow, and organizational reputation to secure executive sponsorship.
- Lead change management across clinical and revenue-cycle stakeholders — shaping behavior, provider engagement, and adoption in complex, often matrixed academic environments.
Program Metrics, Performance & Continuous Improvement
- Continuously evaluate program metrics and performance to identify opportunities for improvement, expansion, and additional client value.
- Own the practice's KPI framework across Inpatient and Outpatient CDI setting targets, monitoring trends, and driving corrective action.
- Use data and analytics to surface documentation gaps, benchmark client performance against peers, and quantify financial, quality, and compliance impact.
- Establish audit and quality-assurance routines to safeguard query integrity, coding accuracy, and defensibility under payer and regulatory review.
Practice Leadership in New Business Growth
- Serve as the program head and senior expert representing the organization's CDI capabilities during new business growth opportunities.
- Lead solution design and scoping for prospective engagements, tailoring program models to each client's structure, acuity, and payer mix.
- Act as an at-the-hip partner to the sales executive throughout the business development lifecycle — from targeting and discovery through proposal, pursuit, and close.
- Provide clinical and operational credibility in sales conversations, shaping value propositions, ROI narratives, and proof points for prospective clients.
- Contribute to proposals, statements of work, pricing assumptions, and pursuit strategy; support renewals and organic expansion within existing accounts.
- Feed market intelligence, client needs, and emerging service opportunities back into practice strategy and offering development.
Team Leadership & CDI Operations Management
- Recruit, develop, mentor, and retain a high-performing team of CDI leaders, specialists, and consulting associates; build a bench for growth.
- Set performance expectations and productivity standards (e.g., records reviewed per FTE, query volume and quality) and manage them with coaching and accountability.
- Oversee onboarding, ongoing competency validation, inter-rater reliability, and continuing education aligned to evolving coding guidelines and payer rules and establish and enforce compliant query policies, escalation pathways, and documentation-of-record practices consistent with AHIMA/ACDIS guidance.
- Manage the practice's operating budget, utilization, and resource allocation across engagements to deliver on financial and quality targets and collaborate with HIM, coding, revenue integrity, quality, and compliance functions to ensure end-to-end alignment of the documentation-to-reimbursement continuum.
- Stay current on regulatory change (IPPS/OPPS updates, ICD-10-CM/PCS, MS-DRG and APR-DRG methodology, HCC/RAF model changes) and translate implications into program action.
Required Qualifications & Experience
- Extensive experience leading and developing CDI programs at large health systems, including large academic medical centers, and all associated operational, clinical, and stakeholder complexity.
- Active licensure as a Registered Nurse (RN) or physician (MD/DO) is required.
- At least one recognized CDI/coding certification is required (e.g., CCDS, CDIP, or CCS). Additional certifications (e.g., CCDS-O, CRC, CDEO, CDI-related credentials) are viewed favorably.
- Demonstrated command of CDI methodology across the documentation-to-reimbursement continuum — compliant queries, MS-DRG/APR-DRG, CC/MCC, SOI/ROM, CMI, mortality/PSI/HAC, and coding integrity.
- Progressive leadership experience with accountability for teams, budgets, and measurable program outcomes.
- Exceptional executive communication and presence, with a track record of influencing physician and C-suite stakeholders and driving change.
- Bachelor's degree required; advanced degree (MSN, MHA, MBA, or clinical doctorate) preferred.
Preferred Qualifications & Experience
- Consulting engagement experience leading CDI program design, implementation, and/or improvement for external client organizations.
- Experience leading Outpatient CDI initiatives in complex, risk-bearing environments — Medicare Advantage, ACOs, capitated and value-based arrangements — including HCC/RAF optimization and prospective review.
- Experience building, leading and/or establishing pediatric CDI programs within children’s hospitals and/or large networked acute care specialty centers.
- Experience supporting business development and sales pursuits, including solution design, proposals, and executive client presentations.
- Familiarity with leading CDI technology platforms, NLP/computer-assisted documentation, and analytics tooling.
- Experience preparing organizations for and defending payer, RAC, and RADV audits.
Remote or hybrid role with travel up to approximately 50%, dependent on client engagements, pursuits, and business needs.
Requires the ability to work across multiple client time zones and to present in on-site executive and physician settings.
