Hybrid Remote Director, CDI & DRG Downgrade Appeals (RN)

Director, CDI & DRG Downgrade Appeals (Remote)

We are seeking a talented Director of CDI & DRG Downgrade Appeals to lead our Clinical Documentation Improvement (CDI) and DRG Appeals team. This is a full-time, fully remote, and permanent leadership role.

About the Role:

• Oversee daily operations, staffing, workflow, and performance for the CDI and Appeals department.
• Drive improvements in clinical documentation quality and manage DRG downgrade appeals processes.
• Collaborate with providers, Physician Advisors, HIM teams, and leadership to ensure accurate documentation and optimal appeal outcomes.
• Analyze denial trends, develop education initiatives, and implement process improvements to enhance department KPIs.
• Lead, develop, and mentor team members, including hiring, training, and performance management.

What You’ll Need:

• Associate degree required; Bachelor’s degree preferred.
• Active CCDS or CDIP certification preferred.
• 5+ years of CDI leadership experience and 3+ years in DRG downgrade appeals.
• RN license preferred.
• Strong knowledge of healthcare regulations, CDI best practices, and appeals management.
• Proficiency in EHR systems, Microsoft Office, and data reporting tools.

What We Offer:

• $125K+ base salary plus up to 25% annual bonus potential
• 100% remote work flexibility
• Comprehensive benefits package (Medical, Dental, Vision, 401(k) with company contribution)
• Generous paid time off and paid holidays
• Professional development and career growth opportunities

Additional Details:

• Remote position with less than 10% travel.
• Standard hours: Monday–Friday, 8:00 AM–5:00 PM (some flexibility as needed).
• Requires occasional extended periods of computer work.

Ready to lead a high-impact team and make a real difference in healthcare quality?
Apply today!

Job Type: Full-time

Pay: From $125,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Experience:

• Inpatient CDI management/supervisory/director: 5 years (Required)
• DRG Downgrade appeals: 3 years (Required)

License/Certification:

• RN, CCDS, CDIP, or RHIA (Required)

Work Location: Remote