Physician Advisor: CDI, Utilization & Denials Leader

American College of Physician Advisors (ACPA); Dayton (OH); On-site; USD 180,000 - 240,000; Full time

Job summary

Premier Health in Dayton, OH seeks a Physician Advisor to lead CDI/Utilization Management, focusing on documentation accuracy, denial prevention, and appropriate level-of-care determinations across the health system. You will collaborate with CDI, Coding, UR, Care Management, and Quality teams to optimize observation rates, denials outcomes, and CMI.

The role emphasizes expert second-level reviews, provider education, and active participation in system-wide initiatives to improve mortality, LOS,

Qualifications

• MD or DO physician, Ohio license or eligibility
• Minimum 3 years clinical practice; CDI/utilization/quality improvement preferred
• Strong communication and teaching skills; peer-to-peer discussions experience

Responsibilities

• Provide secondary CDI and Coding reviews escalated by CDI/Coding teams
• Lead provider education on documentation, medical necessity, denial prevention and quality alignment
• Collaborate with CDI, Coding, UR, Care Management, Quality and Denials for accurate level-of-care determinations
• Analyze CMI trends and support Vizient benchmarks; refine dashboards with Digital Health
• Support appeals with payer medical directors and contribute to system-wide education tools

Skills

CDI leadership

Utilization management

Denials resolution

Provider education

Data-driven improvement

Education

MD or DO

Tools

Epic

InterQual/MCG

Job description

Premier Health in Dayton, OH seeks a Physician Advisor to lead CDI/Utilization Management, focusing on documentation accuracy, denial prevention, and appropriate level-of-care determinations across the health system. You will collaborate with CDI, Coding, UR, Care Management, and Quality teams to optimize observation rates, denials outcomes, and CMI.

The role emphasizes expert second-level reviews, provider education, and active participation in system-wide initiatives to improve mortality, LOS,