Director, Quality, Clinical Coding and Documentation

Herself Health

Location

Remote

Posted

1 month ago

Department

Clinical Operations

What they actually want (must-haves)

Bachelor’s degree in health information management, nursing, healthcare administration, or a related field; equivalent experience will be considered.
Active coding certification — CPC, CRC, CCS, CCS-P, RHIA, or RHIT. CRC (Certified Risk Adjustment Coder) strongly preferred.
Seven or more years of progressive experience in medical coding, risk adjustment, or clinical documentation integrity, including three or more years in a leadership or program ownership role.
Deep working knowledge of the CMS-HCC risk adjustment model, including the V24-to-V28 transition and its practical implications for documentation and capture.
Demonstrated experience building or substantially rebuilding a risk adjustment or CDI program, not solely operating an inherited one.
Direct experience with RADV or payer audit response, including medical record defensibility review.

Nice to have

Experience in value-based, capitated, or full-risk primary care — particularly senior-focused or Medicare Advantage populations.
Clinical background (RN or LPN) in addition to coding credentials.
CDI certification — CDIP, CCDS, or CCDS-O.
Experience in a high-growth or multi-site organization where infrastructure had to be built alongside operations.
Experience with CAHPS, HOS, or patient experience improvement work.

What the job really is

The Director of Quality, Clinical Coding and Documentation at Herself Health is responsible for overseeing the quality of care and accuracy of clinical documentation and coding for women on Medicare. This role involves designing and leading programs to improve HEDIS and Star Ratings performance, managing risk adjustment strategies, and ensuring compliance with coding standards. The director will also educate clinicians, optimize workflows, and lead a team dedicated to enhancing healthcare quality for women aged 65 and older.

Things to weigh

Remote work with occasional travel required.
The role demands a high level of accountability and leadership in a complex healthcare environment.
No specific salary or benefits package mentioned in the posting.

Job score3/5

Benefits1/5

Freshness4/5

Career value5/5

Role clarity5/5

Pay transparency0/5

Applying to Herself Health?

See how your résumé matches this role — and tailor it from what actually gets interviews.

Calculate resume score Generate resume to apply

Job Link →