Clinical Document Integrity Specialist 2, Managed Care Network Development Med Mgmt-Boca Raton, FT, 8:30A-5P

Job Description - Clinical Document Integrity Specialist 2, Managed Care Network Development Med Mgmt-Boca Raton, FT, 8:30A-5P (159321)

Job Description

Clinical Document Integrity Specialist 2, Managed Care Network Development Med Mgmt-Boca Raton, FT, 8:30A-5P-159321

Baptist Health is the region''s largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 26 years, we''ve been named one of Fortune''s 100 Best Companies to Work For, and in the 2025-2026 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 63 high-performing honors.

What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients'' shoes ourselves and that shared experience fuels out commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact - because when it comes to caring for people, we''re all in.

At Baptist Health, we're committed to supporting our employees at every stage of their journey, both personally and professionally. Our approach is rooted in a "grow our own" philosophy, designed to help our team members build meaningful, long-term careers with us, supported by benefits that make a real difference, including:

• Career growth and development opportunities, with clear pathways and ongoing support
• Comprehensive health and wellness resources that go beyond traditional benefits
• A wellness program that can help employees eliminate their medical plan deductible, reducing out-of-pocket healthcare costs
• Tuition reimbursement to support continued learning and advancement
• And so much more

Together, these benefits and others reflect our commitment to caring for our people, so they can build fulfilling careers with us while making a meaningful impact every day.

Description

Responsible for improving overall quality and completeness of clinical documentation through advanced concurrent review of inpatient records to support accurate, clinically valid code assignment, severity of illness and risk of mortality capture, quality outcomes, and appropriate reimbursement. Facilitates documentation modifications through extensive interaction with physicians, nursing, other caregivers, and coding staff to ensure documentation accurately reflects services rendered and the patient's clinical condition for DRG-based payors. Uses integrated health record workflows, technology-enabled review worklists, and data-informed insights to prioritize cases with the greatest documentation and clinical validation impact, ensuring accuracy of information used to measure and report provider and medical center outcomes. Provides ongoing education and coaching on documentation, best practices, regulatory expectations, and program goals and participates in team meetings and continuous improvement activities. Scope to include all inpatient payors including Medicare, Medicare Advantage, commercial, Exchange, and other applicable payors. Uses technology supported worklists, analytics, and AI assisted prioritization where available. Supports transition from CDEOne to Epic CDI workflows with planned go live in July 2027 and collaborates on DRG encoder integration such as TruBridge. Estimated salary range for this position is $74100.20 - $96330.26 / year depending on experience.

Qualifications

Degrees:

• MD / DO.

Licenses & Certifications:

• Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Integrity Practitioner (CDIP).

Additional Qualifications:

• International medical school graduates preferred; RN with advanced degree (MBA or related) may be considered.
• Four years of recent adult, pediatric, obstetric, inpatient medical, surgical, and critical care experience, plus five years of CDI experience in adult/pediatric inpatient and critical care settings required.
• I preferred CDI certification (CCDS or CDIP).
• Experience with integrated EHRs, web-based applications, InterQual or similar tools, and technology-enabled workflow and analytics preferred.
• Leadership experience and knowledge of legal aspects of coding; Medicare MS-DRG and Medicaid APR-DRG; utilization and case management, discharge planning, and managed care preferred.
• Basic Windows-based computer skills required.
• Knowledge of official coding guidelines, AHA Coding Clinic, CMS guidance, and compliant documentation clarification consistent with AHIMA-ACDIS query guidance required.
• Experience using integrated electronic health records and CDI workflows, including readiness for transition from CDEOne to Epic CDI with planned go live in July 2027.
• Experience with analytics, reporting, and AI assisted review prioritization tools preferred.
• Familiarity with DRG encoder and DRG validation tools including TruBridge preferred.

Minimum Required Experience: 5 Years

Job

Corporate

Primary Location

Boca Raton

Organization

Corporate

Schedule

Full-time

Job Posting

May 27, 2026, 9:30:00 AM

Unposting Date

Ongoing

EOE, including disability/vets