Director of Health Information Management; HIM

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Full Time Houston, TX, US

Nexus Health Systems is seeking an experienced and strategic healthcare leader to serve as our Director of Health Information Management (HIM) and Clinical Documentation Integrity (CDI). This system-level role provides leadership for health information management, coding support, and clinical documentation integrity across the organization.

The Director ensures the accuracy, completeness, confidentiality, and regulatory compliance of the legal health record while strengthening documentation practices, reducing discharged-not-final-billed (DNFB) accounts, preventing denials, and supporting accurate and timely reimbursement. This leader will collaborate closely with providers and teams across Utilization Review, Case Management, Coding, Billing, Clinical Operations, Compliance, Information Technology, and Revenue Cycle.

Nexus Health Systems provides specialized healthcare services to children, adolescents, and adults with complex medical, behavioral, neurodevelopmental, and rehabilitation needs. Across our continuum of care, we are committed to delivering individualized treatment, improving patient outcomes, and supporting patients and families through compassionate, interdisciplinary care.

• Provide strategic and operational leadership for HIM and CDI functions across Nexus Health Systems.
• Direct daily HIM operations, including medical record completion, deficiency management, document integrity, release of information, coding support, payer record requests, record corrections, and amendments.
• Lead, develop, and evaluate HIM staff while overseeing staffing, scheduling, workload distribution, cross-training, competencies, and performance expectations.
• Establish standardized policies, workflows, productivity expectations, quality measures, and escalation procedures across the organization.
• Serve as the primary HIM subject-matter expert and escalation point for medical record integrity, documentation, disclosure, coding support, and information governance matters.
• Evaluate technology, automation, work queues, reporting tools, and workflow improvements that enhance productivity, record integrity, and revenue cycle performance.

• Lead the organization’s CDI program, including targeted concurrent and retrospective documentation reviews.
• Prioritize reviews based on clinical complexity, payer risk, reimbursement impact, denial trends, and organizational needs.
• Identify documentation gaps, conflicting information, clinical validation concerns, and opportunities for greater specificity.
• Initiate compliant provider queries when documentation clarification is required.
• Educate physicians, advanced practice providers, clinical leaders, and other staff regarding documentation requirements, medical necessity, coding implications, and recurring deficiencies.
• Partner with Coding to support accurate diagnosis and procedure assignment, principal diagnosis selection, and DRG or APR-DRG validation when applicable.
• Ensure provider queries are clinically supported, appropriately written, non-leading, and compliant with established standards.

• Develop a closed-loop process among HIM/CDI, Utilization Review, Case Management, Coding, and Billing to resolve and prevent documentation, authorization, coding, and billing issues.
• Review HIM-related DNFB accounts and ensure record-completion, coding, and documentation barriers are assigned, escalated, and resolved promptly.
• Support payer audits, medical record requests, claim appeals, denials, clinical validation disputes, and reimbursement-related activities.
• Monitor denial and underpayment trends involving documentation, coding, medical necessity, and medical record submission.
• Translate findings into provider education, corrective action, and sustainable process improvements.
• Develop and communicate HIM/CDI performance metrics, operational trends, compliance risks, and financial outcomes to Revenue Cycle and executive leadership.
• Help improve clean claim submission, accelerate cash flow, and reduce preventable revenue leakage.