Program Integrity Director Jobs in Roxboro, NC (NOW HIRING)

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Patient Revenue Management Organization
Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health.
The Director of Clinical Documentation Improvement (CDI) is responsible for the strategic direction, operational oversight, and performance management of all Clinical Documentation Integrity functions within the Mid-Revenue Cycle division of the Patient Revenue Management Organization (PRMO). Reporting directly to the AVP, Revenue Cycle and HIM, this role provides leadership for inpatient CDI initiatives that support documentation integrity, coding accuracy, quality outcomes, severity/risk capture, reimbursement optimization, regulatory compliance and clinical validation.
The Director partners collaboratively with physician leadership, Hospital Coding, Quality, Compliance, Information Technology, and Revenue Cycle Operations to ensure complete, accurate, and timely clinical documentation reflective of patient acuity and services rendered. This leader is responsible for advancing CDI strategy through analytics, technology optimization, workflow standardization, provider education, and emerging technologies including AI-enabled CDI solutions and clinical documentation tools.
The Director promotes organizational goals related to quality outcomes, Vizient performance methodology, compliant reimbursement practices, and enhanced provider engagement in documentation integrity.
Duties and Responsibilities of this Level

• Provide strategic and operational leadership for all CDI functions across the health system.
• Develop and implement CDI strategies that support documentation integrity, quality outcomes, reimbursement optimization, regulatory compliance, and clinical validation.
• Collaborate with physician leadership, Hospital Coding, Case Management, Quality, Compliance, Information Technology, and Revenue Cycle teams to improve documentation accuracy and operational performance.
• Lead provider education and engagement initiatives related to clinical documentation standards, regulatory requirements, quality metrics, and reimbursement methodologies.
• Oversee CDI technology initiatives, including AI-enabled CDI tools, analytics platforms, EHR optimization, and provider documentation template/content support.
• Monitor and analyze CDI performance metrics including CMI, SOI/ROM, query activity, quality indicators, and reimbursement impact to drive continuous improvement.
• Ensure CDI policies, procedures, workflows, and internal controls comply with organizational, state, and federal requirements, as well as applicable coding and documentation guidelines.
• Lead, develop, and support CDI staff through performance management, training, and professional development initiatives.
• Manage departmental budget, vendor relationships, staffing resources, and operational priorities.
• Support organizational culture initiatives that promote collaboration, accountability, diversity, equity, inclusion, and continuous improvement.

Required Qualifications at this Level
Education:
Bachelor's degree required. Master's degree in Health Administration, Nursing, Health Information Management, Business Administration, or related healthcare field preferred.
Experience:
Eight years of progressive healthcare management, CDI, Hospital Coding, revenue cycle, or consulting experience required, of which at least five years must include leadership responsibility for people, programs, or projects. Experience leading Clinical Documentation Improvement programs within an acute care or integrated healthcare system environment strongly preferred.
Preferred experience with:

• Vizient methodology and quality performance metrics
• AI-enabled CDI technologies and workflow optimization tools
• Provider documentation template/content build and EHR optimization
• Physician engagement and education initiatives
• Clinical validation processes
• Cross-functional Revenue Cycle and Hospital Coding operations

Degrees, Licensure, and/or Certification:
One or more of the following certifications is preferred:

• CCDS (Certified Clinical Documentation Specialist)
• CDIP (Certified Documentation Integrity Practitioner)
• RHIA, RHIT, CCS, CCS-P, or RN licensure

Other relevant healthcare revenue cycle or coding certifications.
Knowledge, Skills, and Abilities:
Technical: Strong understanding of Clinical Documentation Integrity operations, workflows, and best practices. Knowledge of inpatient and outpatient reimbursement methodologies, coding principles, DRG/APR-DRG methodologies, and quality reporting measures. Understanding of Vizient methodology, benchmarking, and performance analytics. Experience with CDI technology platforms, AI-enabled CDI solutions, and EHR systems. Knowledge of regulatory and compliance requirements related to CDI, coding, reimbursement, and clinical documentation. Experience with process improvement methodologies, operational analytics, and performance management.
Non-Technical: Strong leadership presence and strategic thinking capabilities. Proven ability to build, lead, and develop high-performing teams. Excellent collaboration and relationship-building skills across physician and administrative stakeholders. Strong written, verbal, and presentation communication skills. Ability to influence organizational change and drive accountability across a matrixed environment. Strong analytical and decision-making skills. Commitment to operational excellence, compliance, and continuous improvement.
Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions:
Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.