Q&A: CDI career ladders

Q: I am working on developing a career ladder for the CDI team at my organization. Could you provide any input or possible model examples?

A: A career ladder can help CDI professionals feel appreciated for their hard work and years of experience and ensure that an organization holds on to valuable senior staff members. Having additional professional growth opportunities beyond the standard CDI specialist staff level allows senior staff to avoid professionally without leaving their organization or switching career paths.

However, the particular details of the ladder structure will necessarily differ from organization to organization based on the needs of the department and the staff’s areas of expertise. While some may implement a traditional ladder structure where staff members climb the rungs based on seniority or additional certifications, others may create specialized positions within their CDI department to allow CDI staff members to grow into their unique areas of expertise.

“We do not have a ladder per se amongst the CDI positions but we have developed a few key advanced CDI positions to support our team,” says Carrie Willmer, BS, BSN, RN, CCDS, CDIP, director of CDI at SCL Health System in Broomfield, Colorado. The positions created include:

• CDI specialist—24 positions across seven acute care facilities (mix of on-site and remote hybrid staffing model)
• CDI lead—four positions (this position does 50% CDI specialist reviews and 50% lead responsibilities)
• CDI educator—one position
• CDI auditors—three positions, one focused full time on DRG validation denials
• CDI/Coding liaison—one position
• CDI data analyst—new position still under development
• CDI managers—two positions
• CDI director—one position

“We had looked into a clinical ladder model but are more aligned with what [Willmer] outlined using CDI positions,” adds Mary Stroble, MSN, RN, director of CDI at BJC HealthCare in St. Louis. “Our strategy for the different areas of responsibility for a CDI program such as education, process, and technology, etc. are separated into functional teams. […] This allows us some flexibility in hiring and also moving people around to the areas they have interest in.” Her facility also has CDI specialists of varying levels, as well as CDI supervisors and management.

Editor’s note: This question was answered by members of the ACDIS Leadership Council. For more information about the Council, please contact Linnea Archibald (larchibald@acdis.org).