Director HIM, Coding Growth & Client Solution

Role Description

• Build trusted-advisor relationships with healthcare executives (CFOs, VPs of Revenue Cycle, HIM Directors, and CMOs).
• Conduct virtual and on-site visits to mine existing accounts for and develop new business prospects.
• Partner with Sales, Account Management and Marketing to build target lists, executive briefings, capability presentations, and client-specific value narratives.
• Build market visibility and business pipeline by publishing white papers, delivering webinars, and actively representing the firm through speaking engagements at key industry forums (including AHIMA, AAPC, HFMA, HIMSS, and specialty coding roundtables).
• Lead structured discovery workshops to map client revenue cycles (front-end, mid-cycle workflows like CDI/coding, and back-end billing/denials).
• Quantify operational baselines using key RCM performance metrics (DNFB, coder productivity, denial categories, case-mix index, and HCC RAF capture).
• Identify tangible value levers — net revenue uplift, denial reduction, AR-days compression, CMI capture, audit recovery avoidance, FTE arbitrage — and intangible value levers — physician satisfaction, CDI maturity, compliance posture, audit defensibility, leadership bandwidth, scalability and time-to-staff.
• Specifically target complex specialty coding gaps where the firm has differentiated capability: IP DRG validation, IR/Cardiology, Oncology, Trauma, Transplant, ED Pro-Fee, Same-Day-Surgery, Multi-Specialty Surgical, HCC / RADV, and CDI-coupled coding.
• Translate findings into a quantified Opportunity Assessment with a defensible business case, baseline vs. future-state model, and ROI / payback narrative.
• Partner with pricing and finance to co-create creative commercial constructs (FTE, per-chart, outcome-linked, or hybrid models).
• Lead RFI / RFP responses end-to-end: storyboarding, win-theme development, content orchestration across SMEs, orals preparation, and final negotiation support.
• Drive opportunities to closure — manage internal stakeholders, mitigate competitive threats, navigate procurement, and ensure executable, profitable, transitionable deals are signed.
• Partner with Transition and Delivery to ensure committed outcomes are operationally realistic and successfully handed over post-signature.
• Serve as the senior US-based SME on complex coding domains by staying current with CMS rule cycles (IPPS, OPPS, MPFS, MS/APR-DRG), AHA Coding Clinic, CPT Assistant, payer policy shifts, OIG work plans, and emerging audit/denial trends; translate these complex regulatory updates (including ICD-10, CPT, E&M MDM guidelines, and HCC v24/v28) into client-relevant talking points and unique proposal differentiators.
• Coach Sales, BD and Account Management on specialty-specific value stories, objection handling and credible technical positioning.
• Work seamlessly across Sales, Solution Architecture, Operations, Quality, CDI, Compliance, Pricing, Legal, Transition and Technology to engineer winning, deliverable solutions.
• Provide structured feedback to internal Operations and Technology teams regarding market gaps and emerging AI/autonomous coding needs.
• Influence go-to-market strategy, target segmentation, ICP refinement, packaging and pricing of the complex coding portfolio.
• Ensure every proposed solution is HIPAA-compliant, audit-defensible and aligned to AHIMA / AAPC ethical coding standards.
• Champion the firm's quality framework (IQ / EQ, FMEA-based CoE constructs, calibration, root-cause and CAPA discipline) in every customer conversation and commitment.
• Comply with all internal policies and procedures, including those related to HIPAA, information security, and data privacy.
• Maintain a current view of US RCM and coding-outsourcing market dynamics — competitor offerings, pricing benchmarks, payer-policy shifts (Medicare / Medicaid / commercial), labor market, and technology disruption (autonomous coding vendors, GenAI in coding).
• Provide structured market intelligence inputs to leadership for annual strategy and capability investment decisions.

Qualifications

• Demonstratable depth in at least two complex coding specialties.
• Fluency in US revenue cycle economics — payer mix, contract constructs, denial taxonomies, AR behavior, audit exposure (RAC/MAC/OIG/payer), and case-mix dynamics.
• Proven ability to convert technical discovery into quantified business cases and executive-grade narratives.
• Strong commercial instinct — pricing constructs, deal economics, risk-sharing models, contract negotiation.
• Demonstrated track record of winning multi-million-dollar coding / RCM outsourcing engagements.
• Credible at the CFO / VP-RCM / CMO table; able to flex from physician-leader conversations to procurement and CFO discussions in the same day.
• Outstanding written communication — proposals, white papers, executive memos; outstanding verbal — discovery interviews, orals, conference keynotes.
• Skilled in modern presentation craft (PowerPoint storytelling, data visualization, board-grade decks).
• Understands what global / blended delivery actually requires — transitions, training, quality, productivity, audit, governance — and never over-commits.
• Strong project-management discipline; can run multiple parallel pursuits without dropping commitments.
• Self-directed, hunter mentality, comfortable with ambiguity and travel-heavy schedules.
• High integrity, customer-obsessed, collaborative across geographies and time zones (including India delivery counterparts).
• Demonstrates analytical rigor and problem-solving across both qualitative and quantitative inputs.

Requirements

• Bachelor’s degree in HIM, nursing, life sciences, business or a related discipline (or equivalent advanced formal training).
• Active AHIMA credential (RHIA, RHIT, or CCS) and/or AAPC credential (CPC, COC, CIC, CRC, CPMA).
• Minimum 12–15 years of progressive experience in US medical coding and revenue cycle management, with direct exposure to outsourced-services, provider, or payer settings.
• Minimum 5 years in a customer-facing growth, solutioning, consulting, or business development capacity within an RCM/coding services organization.
• Proven, hands-on expertise in at least two complex coding domains (e.g., Inpatient DRG, Interventional Radiology/Cardiology, Oncology, ED Pro-Fee, HCC/risk adjustment, or CDI-coupled coding).
• Demonstrated success authoring winning proposals and driving multi-million-dollar outsourcing engagements to closure.
• Direct experience working alongside global/blended (onshore + offshore) delivery teams.

Preferred Education and Experience

• MBA or equivalent graduate degree.
• Additional credentials such as CCDS, CDIP, CPMA, CRC, or specialized audit/compliance certifications.
• Prior experience at a top-tier RCM outsourcing firm.
• Familiarity with leading autonomous-coding/AI-assisted coding platforms (e.g., Fathom, CodaMetrix, Nym) and their commercial frameworks.
• Proficiency with standard enterprise platforms including MS Office (Word, Excel, PowerPoint), CRM tools (Salesforce/HubSpot), and market EHRs/Encoders (Epic, Cerner, 3M 360).

Work Environment

• This job operates in a remote home office environment.
• This role routinely uses standard office equipment such as computers and phones.

Physical Demands

• Occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear.
• Must occasionally lift or move up to 25 pounds.
• Specific vision abilities required include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.

Position Type/Expected Hours of Work

• This is a full-time position.
• Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m.
• This position occasionally requires long hours and weekend work.

Travel

• Up to 50–60% travel, predominantly domestic US travel to current and prospective customer sites, industry conferences and internal pursuit meetings.
• Periodic international travel to delivery hubs (including India) is expected.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Employees may perform other duties as assigned.