Medical Director- Physician Advisor Services

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Job Description:

Provides strategic leadership for Clinical Documentation Integrity (CDI) and Utilization Management (UM) initiatives across the organization. Partners with senior leadership and external stakeholders to set strategic direction and designs provider education programs that enhance documentation quality and utilization practices. Designs performance reporting frameworks, leads dissemination strategies, and chairs key performance committees.

Principle Responsibilities

• Strategic Leadership and Direction
  • Sets strategic direction for CDI and UM improvement initiatives in partnership with senior leadership and Optum.
• Education, Training and Tools
  • Designs provider documentation improvement training, education, tools, and implementation plans in partnership with Optum and Lead Providers.
  • Educates providers on documentation standards, tools and resources.
  • Builds and trials automated tools to improve documentation accuracy for providers.
• Performance Management and Reporting
  • Engages with payer partners to communicate clinical concerns at the leadership level regarding policies and denials.
  • Develops provider performance reporting structure for CDI and UM for providers in partnership with Optum.
  • Develops dissemination strategies for performance reporting in partnership with CDI and UM Lead Providers and Allina Performance Improvement Director.
  • Chairs performance committees for CDI and UM initiatives.
  • Supports physician advisors in navigating denials and appeals, providing clinical documentation expertise.
  • Provides direct feedback and coaching to providers and provider leadership.
• Clinical Care
  • Provides clinical care in setting of specialty expertise.
• Other duties as assigned.

Required Qualifications

• Doctoral/Ph.D. level advanced degree in Doctor of Medicine, Doctor of Osteopathic Medicine or foreign equivalent from an approved school of medicine and
• Completed a residency program as applicable to their clinical specialty
• 3+years of experience in Clinical Documentation Integrity and/or Utilization Management Medical Direction
• 2+years of demonstrated experience in designated medical specialty

Licenses/Certifications

• American College of Physician Advisors (ACPA), or Advanced Physician Advisor, or SHM preferred
• Licensed Physician - MN Board of Medical Practice required upon hire
• Licensed Physician - WI Department of Safety & Professional Services, if practicing in the state of WI required upon hire
• Board Certification in specialty that this role is leading required upon hire
• Drug Enforcement Agency Certificate required upon hire
• Prescription Monitoring Program required upon hire
• National Provider Identifier required upon hire
• PALS - Pediatric Advance Life Support - Multisource required upon hire depending on business unit within 180 days
• NRP - Neonatal Resuscitation - Multisource required upon hire depending on business unit within 180 days

Physical Demands

• Medium Work*:
• Lifting weight up to 32 lbs. occasionally (*Allina Safe Patient Moving Policy), up to 25 lbs. frequently

Pay Range

Benefit Summary

At Allina Health, we believe safe, compassionate care starts with supporting those who provide it. That's why we invest in your growth and well-being - professionally and personally. When you join our team, you'll have access to comprehensive benefits designed to support your mind, body, spirit, and community.

Benefits include:

• Health & Wellness - Competitive medical and dental plans, plus optional vision, legal, and other voluntary benefits.

• Financial Protection - Employer-paid life insurance, short-term and long-term disability coverage.

• Retirement Savings - Includes employer match and an annual Allina contribution to your 401(k) plan, plus options for supplemental savings and deferred compensation plans.

• Professional Support - Reimbursement for state licensure, DEA registration, and board certification fees.

• Malpractice Coverage - Employer-paid insurance, including tail coverage.

• Student Loan Assistance - Guidance through the Federal Public Service Loan Forgiveness Program (Allina Health is a 501(c)(3) eligible employer).

• Education & Development - Generous annual CME allowance and technology stipend.

• Well-Being - Access to the Center for Provider Well-being which is committed to the promotion of professional fulfillment through organization and individual initiatives, research and education.

• Additional Perks - Many positions include relocation assistance, a signing bonus, educational assistance, and immigration support. Contact the recruiter for eligibility & details.

*Benefit eligibility/offerings are determined by FTE and if you are represented by a union.