Sr. Med Director - Physician Advisor

Legacy Health • Portland, OR

20d

About The Position

The Sr. Medical Director, Physician Advisors provides system-wide physician leadership and oversight for Legacy Health’s Utilization Management (UM), Clinical Documentation Integrity (CDI), and revenue integrity functions. The role is accountable for the strategy, standardization, performance, and direct supervision of the Physician Advisor Program, ensuring alignment across Care Management, Revenue Cycle, HIM/Coding, and medical staff.

Acting on behalf of system medical leadership, the Sr. Medical Director exercises independent clinical judgment with organizational impact, guiding medical necessity determinations, documentation integrity, denial prevention, and payer engagement. The role partners with executive and operational leaders to improve quality, optimize resource utilization, mitigate regulatory and financial risk, and ensure compliant reimbursement.

The Sr. Medical Director is the primary physician leader for physician advisory services, establishing standards of practice, driving performance outcomes, and influencing physician practice patterns through data-informed insights, education, and peer leadership. The position reports to the Associate Chief Medical Officer and maintains collaborative alignment with Care Management, Payer Strategies, and Revenue Cycle leadership to support consistent system-level execution of utilization and revenue integrity.

Requirements

• Graduate of an accredited U.S. medical school with an MD or DO, or equivalent in both Washington and Oregon.
• Minimum seven years of clinical practice and/or physician leadership experience.
• Expertise in utilization management, medical necessity, denials and appeals, and clinical documentation integrity.
• Strong understanding of healthcare finance, revenue cycle operations, and regulatory compliance.
• Demonstrated leadership, influence, and ability to manage physician teams.
• Excellent communication and executive-level presentation skills.
• MD or DO required.
• Unrestricted medical license in both Oregon and Washington.
• Board certification in a clinical specialty required.

Nice To Haves

• Three years of physician leadership, medical director, or UM/CDI/revenue cycle advisory experience preferred.
• American College of Physician Advisors certification, American Board of Quality Assurance and Utilization Review Physicians certification, Certified Healthcare Quality and Management certification, or equivalent preferred.

Responsibilities

• Establish and lead the system-wide strategy, standards, and operating model for Physician Advisor services across Utilization Management, Clinical Documentation Integrity, denials and appeals, and revenue integrity.
• Drive consistency and reliability of physician advisor practices through defined standard work, escalation pathways, and performance expectations across all sites and service lines, including service line agreements.
• Partner with Care Management, Payer Strategies, and Revenue Cycle leadership to align workflows, resources, and priorities and achieve system-level goals in utilization, documentation integrity, and compliant reimbursement.
• Provide direct supervision of the Physician Advisor Program.
• Guide medical necessity determinations, documentation integrity, denial prevention, and payer engagement.
• Partner with executive and operational leaders to improve quality, optimize resource utilization, and mitigate regulatory and financial risk.
• Establish standards of practice, drive performance outcomes, and influence physician practice patterns through data-informed insights, education, and peer leadership.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: Ph.D. or professional degree