Medical Director, Physician Advisor Services, Care Progression

Sutter Health•Sacramento, CA

1d•Onsite

About The Position

Provides strategic and operational leadership with a focus on optimizing performance in care progression, clinical documentation integrity (CDI), utilization review/management, and clinical revenue cycle management. Ensures alignment with organizational goals, regulatory compliance, and the delivery of high-quality, cost-effective care. Oversees individual physician advisors in each domain, fostering collaboration, accountability, and continuous improvement. Success will be measured by improvements in care efficiency, documentation accuracy, denial rates, revenue integrity, and provider engagement.

Requirements

Doctorate: Graduate of an accredited medical school
MD-Doctor of Medicine
12 years recent relevant experience.
Excellent interpersonal communication and negotiation skills.
A broad knowledge base of health care delivery and case management within a managed care environment.
Comprehensive knowledge of Utilization Review, levels of care, and observation status.
Post-acute levels of care such as Home Health, Hospice, AIM, and Palliative Care.
SNF, LTAC, B&C, Sub-acute, Acute rehab.
Must be able to effectively communicate with, and promote cooperation and collaboration between individuals including patients/families/caretakers, physicians, nurses and other ancillary partners.
Ability to work independently and exercise sound judgment in interactions with physicians, payers, and patients and their families.
Demonstrates commitment to service excellence in all patient, family and employee interactions and in performing all job responsibilities.
Functions in a manner to promote quality patient care and assure a positive patient experience.
Excellent verbal and written communication skills.
Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.
Intermediate computer skills.
Ability to promote teamwork and to effectively function in teams.
Ability to interact effectively with key internal and external constituents using collaboration, and customer service skills that promote excellence in the patient experience.

Nice To Haves

Proficient Knowledge of coding and DRG assignment process preferred.

Responsibilities

Provides strategic and operational leadership with a focus on optimizing performance in care progression, clinical documentation integrity (CDI), utilization review/management, and clinical revenue cycle management.
Ensures alignment with organizational goals, regulatory compliance, and the delivery of high-quality, cost-effective care.
Oversees individual physician advisors in each domain, fostering collaboration, accountability, and continuous improvement.
Success will be measured by improvements in care efficiency, documentation accuracy, denial rates, revenue integrity, and provider engagement.