Vice President- Clinical Documentation Integrity, and Coding Operations

Vytalize Health

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About The Position

The Vice President of Clinical Documentation and Integrity (CDI) and Coding Operations leads enterprise-wide CDI and risk adjustment strategy, driving performance across ACO and private payer value-based care programs. This role partners closely with clinical, operational, analytics, executive, and vendor stakeholders to scale effective, compliant CDI programs aligned with organizational goals. The Vice President oversees CDI and coding operations, optimizes workflows, drives provider engagement, ensures accurate and complete risk adjustment submissions, and monitors performance metrics and regulatory changes—building a culture of accountability, quality, and continuous improvement.

Requirements

• Bachelor’s degree in Healthcare Administration, Business, or a related field required; advanced degree preferred.
• Minimum of 10 years of experience in risk adjustment operations, coding, or healthcare management.
• Proven track record of leading CDI and coding initiatives with measurable improvement/business impact
• Experience leading large-scale, multi-unit programs in a healthcare setting.
• Extensive experience in collaborating with executive leadership and cross-functional teams.
• Expert level knowledge of CMS-HCC models, coding standards, claims data lifecycle and submission systems
• Strong executive presence, influencing skills and ability to drive change across matrixed organization
• Experience building and expanding CDI coding team with experience coaching and mentoring managers and coders
• In-depth knowledge of risk adjustment processes, coding guidelines, and regulatory requirements
• Proficiency in data analysis and performance metric tracking and reporting out on performance
• Excellent communication and interpersonal skills for engaging with stakeholders at all levels
• Strategic thinker with excellent analytical, critical thinking, problem solving, and relationship building skills who can manage complex, multi-faceted programs
• Skill with managing onshore and offshore vendors, and partnership optimization
• Ability to travel as needed to support national operations and vendor partnerships

Nice To Haves

• Certified Professional Coder (CPC) or related certification preferred.

Responsibilities

• Lead clinical documentation and integrity operations and central programs to support all practices with Vytalize Health
• Collaborate with the business product team, clinical and non-clinical team members to implement programs across practices and at scale
• Own end-to-end performance outcomes of CDI program; identify key leading and lagging performance metrics to monitor progress and impact of CDI programs and operations
• Track and trend risk adjustment data, and translate into actionable insights to support medical management, quality initiatives and operational improvements
• Develop comprehensive practice and provider educational programs and engagement plans that can be scaled and customized
• Measure and monitor impact of coding education programs
• Partner with practices and Vytalize team members to improve day-to-day practice workflows, billing and revenue cycle processes, and optimize the use of EMR and/or other electronic tools to support CDI initiatives
• Drive innovation and efficiency in risk capture methodologies and coding operations
• Coach and mentor managers to develop a culture of continuous feedback, recognition, and improvement, driving accountability and standard work
• Promote a culture of accountability, innovation, compliance and collaboration
• Oversee multiple vendor partnerships and monitor production and impact
• Serve as subject matter expert on all aspects of risk adjustment policy changes and risk scoring methodologies
• Stay informed of and communicate changes to regulatory coding guidance
• Maintain knowledge of industry trends and perspectives on coding guidance
• Ensure the accuracy and completeness of data submissions and risk scores for ACO and private payer value based care contracts
• Support troubleshooting and resolution through multi-department and external vendor collaboration

Benefits

• Competitive base compensation
• Annual bonus potential
• Health benefits effective on start date
• Health & Wellness Program; up to $300 per quarter for your overall well-being available on start date
• 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary
• Unlimited (or generous) paid "Vytal Time", and 5 paid sick days after your first 90 days
• Company paid STD/LTD
• Technology setup
• Ability to help build a market leader in value-based healthcare at a rapidly growing organization

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Number of Employees: 251-500 employees