Director of Coding Operations

Healthcare documentation is broken. Nestmed is fixing it with an AI platform that gives clinicians their time back.

In just one year, we’ve scaled to support tens of thousands of clinicians across more than a million patient visits. We're now the trusted partner for over 60 home health agencies, including 7 of the top 10 enterprises in the US.

Our founding team—hailing from Stanford, YC, Google, and Meta—is backed by the founders of PayPal and Plaid to build the essential infrastructure for the future of the $500B home healthcare industry.

Location: Remote (U.S.)

Department: Clinical Operations

The Role

This is not a traditional coding-manager role measured by charts cleared per day. As Director of Coding Operations, you will partner directly with some of the largest home health and hospice enterprises in the country, helping them raise the compliance and quality of their coding by putting the most advanced technology in the industry to work.

You will own coding accuracy, compliance, and throughput across our network, and lead a large team of expert-level certified coders who operate as the human layer above our AI: auditing, validating, and resolving the complex cases that demand real clinical judgment.

You will work step by step with some of the largest enterprises in the industry, serving as a trusted partner and an extension of their team, accountable for the quality and compliance of their coding day in and day out.

You are the clinical-coding authority inside Nestmed, the trusted advisor to our enterprise customers, and the voice of the coder inside the product.

The bar is non-negotiable: we expect a level of coding quality and compliance that is unparalleled in the industry. Our technology makes a far more comprehensive review possible than has ever existed in home health and hospice, surfacing what manual, sample-based review has always missed. Your job is to hold that standard and prove it, on every chart, for every customer.

What You'll Do

• Lead the team: Lead a large team of expert-level certified coders, mentoring them into the auditor-and-complex-case role that AI-native coding demands

• Advise enterprises: Partner with enterprise customers as their coding-quality advisor, tuning their coding workflows and translating their compliance goals into measurable gains in accuracy and audit-readiness

• Own quality: Own coding accuracy, PDGM and hospice coding integrity, OASIS-coding alignment, and audit-readiness across the agency network

• Improve the product: Partner with product and engineering to continuously improve coding accuracy and workflows, bringing the coder's perspective to how the AI drafts, where humans review, and how edge cases route

• Evolve quality: Strengthen our quality and review frameworks, closing the feedback loops that turn coder corrections into measurable model gains

• Measure: Set and report on coding KPIs (accuracy, turnaround, productivity) for both internal teams and customer-facing reviews

• Stay current: Stay ahead of CMS guidance and each ICD-10-CM update cycle, and translate regulatory change into workflow rules and model behavior

• Advise internally: Serve as the coding subject-matter expert for customers, clinical leadership, and internal teams

What You Bring

• 7+ years in medical coding with 3+ in a leadership or management role; home health and/or hospice required

• Active credential: HCS-D, HCS-H, BCHH-C, CCS, CPC, COC, or CDIP

• Deep PDGM and hospice coding expertise and fluent command of the ICD-10-CM Official Guidelines and OASIS coding implications

• Track record leading large coding teams and building or running coding quality programs that improve accuracy at scale

• Experience working with or advising enterprise clients, with the credibility and communication skills to be trusted by senior leaders at large agencies

• Comfort in a fast-moving, tech-first environment, and genuine enthusiasm for reshaping coding around AI rather than defending the status quo

• Strong data instincts: you reason about coding performance in metrics and feedback loops, not anecdotes

Nice to Have

• Experience at a health-tech or AI company, or hands-on work with computer-assisted or autonomous coding tools

• Multi-state, multi-agency, or enterprise coding operations experience

• Familiarity with major home health/hospice EMRs (HCHB, Kinnser/WellSky, Epic)

If you’re passionate about building high-impact products that solve real-world problems, we’d love to hear from you. Apply today!