Lead Consultant, Healthcare Improvement - Clinical Documentation Integrity

Lead Consultant, Healthcare Performance Improvement - Clinical Documentation Integrity

The Performance Improvement Healthcare Consulting team helps healthcare organizations achieve sustainable results by addressing margin erosion through targeted improvement strategies. By aligning strategic, operational, and financial initiatives, they identify opportunities and support leadership in implementing impactful changes. With a focus on strengthening margins, the team empowers providers to fulfill their mission and thrive in today’s evolving healthcare environment.

• Conduct CDI program assessments and evaluate workflows to identify improvement opportunities.
• Identify documentation gaps impacting CC/MCC, SOI/ROM, HCCs, and DRG assignment.
• Recommend and implement strategies to improve documentation quality, compliance, and coding accuracy.
• Develop and maintain CDI policies, procedures, and best practices.
• Review clinical documentation and diagnostic data to identify missed severity and risk adjustment opportunities.
• Collaborate with coding teams to ensure accurate code assignment and analyze audit trends to support mitigation strategies.
• Deliver education for clinicians and CDI specialists on documentation standards, query compliance, DRG impacts, and record review best practices.
• Create tailored educational resources, including tools, job aids, and reference materials.
• Analyze CDI performance metrics such as CMI, DRG shifts, query response rates, and reconciliation accuracy.
• Develop dashboards and reports to present actionable insights to executives and clinical leaders.
• Manage client work streams, updates, and deliverables, ensuring timely, high-quality outcomes.
• Prepare proposals, executive summaries, and project documentation.

• Bachelor’s degree in a healthcare‑related field.
• 5+ years of related healthcare experience, including 2+ years in Clinical Documentation Improvement.
• Hands‑on experience with CDI or Electronic Health Record (EHR) documentation platforms.
• Strong knowledge of DRG methodology, CC/MCC structure, and Hierarchical Condition Categories (HCCs).
• Proficiency in Microsoft Excel and ability to interpret clinical data.
• Willingness to travel up to 60% based on client needs.

• Master’s Degree.
• Registered Nurse.
• Prior Consulting experience.
• Experience leading CDI program redesign or expansion.
• Familiarity with quality reporting and risk adjustment metrics.
• CCDS, CDIP, or equivalent certification.

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