At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.
As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.
Position Summary
Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across individuals’ clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we’re able to close critical care and social gaps, as well as manage risk for individuals who need help the most. This leads to better outcomes and a better experience for everyone involved. Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations.
Signify’s intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million individuals each year while helping payers and providers more effectively implement value-based care programs.
Signify Health is recruiting for an Executive Director, Coding and Education who will manage the team responsible for reviewing and coding diagnoses secured from the licensed independent practitioner’s in-home health assessments ensuring quality documentation and clinical consistency. This position develops strategy behind all processes related to the coding of completed evaluations and coded evaluations. This position also gives direction to CDI Specialists and Coders on the correct processes and procedures for reviewing and coding in-home assessments, and ensures collaboration between CDI and Coding departments.
This role requires extensive interaction and collaboration with physicians, departmental leadership, operational leadership, and staff. You will be responsible for ensuring that coding conforms to generally accepted professional standards such as the Official Coding Guidelines for Coding and Reporting approved by the American Hospital Association, the American Health Information Management Association, CMS, and NCHS. You will have the opportunity to work across the organization with multiple stakeholders in Network Management, Operations, Clinical, Legal, Tech, and Product. This role will report to our SVP, Risk Adjustment.
Position Responsibilities
Oversees hiring, training, and supervisory processes for staff responsible for clinical documentation improvement, coding and education. Ensures standardized onboarding and ongoing training for all employee roles.
Works strategically with leadership to ensure we are meeting corporate goals and client deliverables while managing the workforce in accordance with product pacing and quality.
Coordinates strategies to establish high-level quality and production targets relating to the CDI, Education and Coding Departments based on organization objectives. Ensure timely record completion.
Develops strategic processes to improve and achieve optimal efficiency in file processing as well as accuracy/completeness.
Establishes processes and allocates resources dedicated to prepare pertinent weekly and monthly department metrics and status relating to the performance of CDI, Education and the Coding Department to be shared with senior management and stakeholders.
Develops methodology and establishes implementation of CDI, Education, and Coding Department policies and procedures, including medical terminology, and related compliance processes.
Responsible for executing clinical operations to ensure compliance with policies and procedures in support of organization’s objectives.
Reviews and directs the team in reviewing physicians’ in-home health assessments to determine compliance with Signify Health processes and discrepancies in coding.
Ensures that all coding and education practices meet CMS guidelines and compliance policies of Signify Health.
Maintains an objective quality program that ensures compliance with CMS and ICD-10 coding requirements.
Conducts review of quality assurance issues and provides timely feedback of these issues to the appropriate department(s).
Identifies opportunities for improvement in physician documentation and develop strategy for implementing such improvements cross-functionally.
Interprets, provides feedback and acts as a subject matter expert of CMS regulations related to CDI and Coding practices.
Manages outsourced vendors, including service level agreements (SLAs).
Develops strategic relationships with internal and external leaders to provide continuous communication regarding the company’s CDI, Coding, and Education processes and guidelines.
Effectively uses financial information for strategic and operational decision-making, participate in preparing annual budgets, monitor financial performance, and meet agreed-upon metrics.
Works in partnership with other departments to efficiently address and resolve escalated issues arising from operations.
Required Qualifications
The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company’s business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:
10+ years of management experience in a clinical setting, working and interacting with CDI, Coding, and Education teams. Remote team management experience preferred.
Expertise in CMS risk adjustment coding and RADV compliance standards.
Coding certification through AHIMA or AAPC in good standing.
ICD-10 proficiency with demonstrated educational path.
CRC required.
Education
Bachelor's degree in Nursing, Business or Health Information Management preferred.
Pay Range
The typical pay range for this role is:
$131,500.00 - $303,195.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 09/19/2025
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
