You Opportunity

We are seeking a CDI Consultant that is clinically-informed, coder-certified and responsible for driving documentation quality and provider education at the practice level. This role sits at the intersection of clinical knowledge, risk adjustment expertise, and coding accuracy, serving as a trusted resource for providers, a frontline education delivery channel for the CDI team, and a concurrent reviewer of clinical documentation. The CDI Consultant develops and delivers targeted education, contributes to clinical content libraries leveraged across the organization, and supports the vetting of CDI technology and AI suspecting tools. This role operates with significant autonomy in the field, requires strong clinical credibility, and is held to the same coding accuracy standards as the broader CDI department. The CDI Consultant reports directly to the VP, CDI & Coding Operations with a dotted-line to clinical leadership.

What You Will Do

Provider Education & Practice Engagement

• Deliver targeted, intervention-based education with prioritization driven by practice performance data

• Facilitate one-on-one provider education sessions, including DSP documentation coaching, ICD-10-CM specificity guidance, and clinical scenario-based learning

• Participate in Pod meetings, RMO sessions, and practice-facing touchpoints to deliver vignette-style CDI education and reinforce documentation best practices

• Design and maintain practice-specific education plans based on coding data, RAF trend analysis, and recapture opportunity outputs

• Support provider understanding of point-of-care tools, suspect delivery outputs, and documentation expectations tied to CDI (Clinical Documentation Integrity) program goals

• Respond to education needs and engagement escalations for practices with persistent documentation gaps

• Monitor performance against practice-specific education plans, and propose and act upon improvement plans

• Lead provider-facing webinars and educational sessions

Clinical Content Development

• Build and maintain the CDI clinical content library, including condition-specific advisories, documentation tip sheets, and slide-ready education modules, for use by RMO and CDI staff

• Develop specialty-specific and prevalence-adjusted educational materials that align with CMS documentation standards and reflect real clinical scenarios

• Collaborate with the VP, CDI & Coding Operations and QA Lead to ensure all clinical content reflects current coding guidelines and risk adjustment requirements

• Support the creation of provider-facing survey content, webinars, and self-service education resources within the CDI SharePoint knowledge hub

Concurrent & Documentation Review

• Conduct concurrent documentation reviews, evaluating clinical support for active diagnoses and identifying documentation gaps prior to or following encounters

• Review coding outputs against clinical documentation to assess accuracy, specificity, and completeness; flag discrepancies for QA escalation or provider follow-up

• Apply MEAT criteria in documentation review; identify conditions requiring addendum, query, or provider education

• Contribute to the development of concurrent review workflows and eligibility criteria in coordination with the CDI Operations Lead and VP

Cross-Functional Collaboration & Reporting

• Partner with RMOs, market medical directors, and practice-facing staff to align education delivery with population health and performance priorities

• Coordinate with the CDI Operations Lead for EMR access needs, and workflow logistics for education and review activities

• Track and report on education delivery, concurrent review activity, and provider engagement outcomes against established benchmarks

• Escalate compliance concerns, coding accuracy issues, and documentation risks to the VP, CDI & Coding Operations in a timely manner

What Will Make You Successful Here

Education

• Bachelor’s degree in Health Information Management, Nursing, Healthcare Administration, or a related clinical or health sciences field preferred

Experience

• 5+ years of experience in clinical documentation integrity, coding operations, risk adjustment, or a related field

• Demonstrated experience delivering provider education or clinical training in an ambulatory or value-based care setting

• Prior experience conducting concurrent or retrospective documentation review

Licensure & Certifications

• Active CRC (Certified Risk Coder) certification required in addition to a CPC (Certified Professional Coder) or CCS (Certified Coding Specialist). Active CDI certification required, the CDEO (Certified Documentation Expert Outpatient, CDIP (Certified Documentation Improvement Practitioner), or CCDS-O (Certified Clinical Documentation Specialist – Outpatient) or equivalent credential issued by AAPC or AHIMA

• Certification must be current and in good standing at time of hire; maintenance of certification is required as a condition of employment

Skills & Competencies

• Strong working knowledge of risk adjustment coding, methodology (v24/v28), and CMS documentation standards

• Demonstrated ability to apply DSP/MEAT and clinical criteria in documentation review and provider education contexts

• Proven ability to communicate complex clinical and coding concepts to non-coding clinical audiences (providers, care teams)

• Strong client-facing skills with the ability to educate stakeholders, identify improvement opportunities, and deliver actionable feedback and recommendations

• Ability to successfully build strong client relationships

• Excellent verbal and written communication skills, including ability to navigate difficult conversations and respond to both positive and negative customer feedback with professionalism and accountability

• Strong organizational skills with the ability to manage a portfolio of practices and prioritize independently

• Experience working in Medicare Advantage, ACO REACH, or MSSP risk adjustment environments

The following qualifications are preferred but not required.

• Registered Nurse (RN) or Nurse Practitioner (NP) licensure, or equivalent clinical licensure in an allied health field, preferred but not required; coding certification and risk adjustment experience takes precedence

• Experience with AI-assisted suspecting tools or NLP-based CDI platforms

• Familiarity with concurrent review program design

• Background in ambulatory CDI or outpatient risk adjustment

• Prior work within a value-based care organization or ACO at scale (10,000+ attributed lives)

Perks/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.

• 401(k) plan effective the first of the month after your start date; 100% match 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.

• Opportunity to help build a market leader in value-based healthcare at a rapidly growing organization.

Disclaimer:

*Please Note: At no time during our screening, interview, or selection process do we ask for additional personal information (beyond your résumé) or account/financial information. We will also never ask you to purchase anything, nor will we ever interview you via text message. Any communication received from a Vytalize Health recruiter during your screening, interviewing, or selection process will come from an email ending in @vytalizehealth.com.