[{"city": "Detroit", "company": "Henry Ford Health System", "country": "United States", "country_short": "USA", "date_new": "2026-03-30 23:42:13", "description": "General Summary:\n  \nThe System Physician Advisor for CDI serves as a key liaison between Quality, clinical teams, CDI specialists, coding professionals, and hospital leadership. This role ensures accurate, complete, and compliant clinical documentation that reflects the true severity of illness, risk of mortality, and quality of care provided across Henry Ford Health. The advisor will champion documentation integrity initiatives, educate providers, and drive improvements that directly impact quality outcomes, compliance, and organizational performance. The Physician Advisor will work the quality team to prioritize CDI efforts that support top-decile quality outcomes, as measured through Vizient expected performance, CMS Programs, Leapfrog, and U.S. News & World Report.\n  \nReporting Structure:\n  \n\u2022 Direct: Chief Utilization Officer\n  \n\n  \n\u2022 Dotted Line: Chief Quality Officer\n  \nPrimary Responsibilities:Documentation Integrity\n  \n \u00b7          Review inpatient medical records for accuracy, completeness, and compliance with regulatory standards.\n  \n\n  \n \u00b7          Ensure documentation reflects the true severity of illness, risk of mortality, and medical necessity.\n  \nPhysician Education & Support\n  \n \u00b7          Provide ongoing education to physicians and advanced practice providers regarding documentation improvement.\n  \n\n  \n \u00b7          Serve as a resource for clinical staff on coding, DRG assignment, and documentation requirements.\n  \nCollaboration\n  \n \u00b7          Partner with the CQO, Quality Team, CMOs, Clinical Documentation Improvement (CDI) specialists, coders, and hospital CDI physician advisors.\n  \n\n  \n \u00b7          Act as a bridge between clinical and administrative departments to align documentation with organizational quality goals.\n  \nQuality & Compliance\n  \n \u00b7          Monitor documentation trends and identify opportunities for improvement.\n  \n\n  \n \u00b7          Ensure compliance with CMS, Joint Commission, and other accrediting bodies.\n  \n\n  \n \u00b7          Participate in audits and assist with appeals related to clinical documentation and DRG denials.\n  \n\n  \n \u00b7          Drive initiatives that improve quality scores, patient safety indicators, and risk-adjusted outcomes.\n  \nCollaboration\n  \n \u00b7          Advise hospital leadership on documentation practices impacting quality scores, reimbursement, and compliance.\n  \n\n  \n \u00b7          Contribute to policy development and CDI program strategy.\n  \nSystem Definitions for Diagnosis\n  \n \u00b7          Develop and maintain standardized definitions for diagnoses across the health system to ensure consistency in documentation and coding.\n  \n\n  \n \u00b7          Collaborate with CDI teams, coding professionals, and clinical leadership to align definitions with regulatory requirements and organizational goals.\n  \n\n  \n \u00b7          Provide guidance to physicians and CDI specialists on applying these definitions in clinical documentation.\n  \nKey Performance Indicators (KPIs):\n  \n \u00b7          Query Response Rate: Percentage of physician queries answered within 48 hours.\n  \n\n  \n \u00b7          DRG Accuracy: Rate of correct DRG assignment post-review.\n  \n\n  \n \u00b7          Severity of Illness (SOI) & Risk of Mortality (ROM) Capture: Improvement in case mix index and quality metrics.\n  \n\n  \n \u00b7          Denial Reduction: Percentage decrease in DRG-related denials.\n  \n\n  \n \u00b7          Education Impact: Number of physicians trained and improvement in documentation compliance scores.\n  \n\n  \n \u00b7          Vizient Expected Mortality Index \n  \n\n  \n \u00b7          Vizient Expected Length of Stay (LOS) Index \n  \n\n  \n \u00b7          Observed-to-Expected (O/E) Mortality \n  \n\n  \n \u00b7          O/E Readmissions \n  \n\n  \n #PR \n  \n\n  \nMinimum Qualifications:\n  \n \u00b7          Doctoral degree in Medicine (MD or DO).\n  \n\n  \n \u00b7          Unrestricted Michigan medical license and DEA certification.\n  \n\n  \n \u00b7          Board certification in a clinical specialty.\n  \n\n  \n \u00b7          Minimum 5 years of clinical practice; prior leadership experience preferred.\n  \n\n  \n \u00b7          Knowledge of CDI, coding, and quality improvement principles.\n  \n\n  \n \u00b7          Familiarity with EMR systems (Epic preferred) and ICD-10 coding standards.\n  \n\n  \n \u00b7          Preferred: Certification from ABQAURP or ACPA-C.\n  \nSkills & Competencies:\n  \n \u00b7          Strong communication and interpersonal skills.\n  \n\n  \n \u00b7          Ability to influence and engage physicians and multidisciplinary teams.\n  \n\n  \n \u00b7          Analytical ability to interpret data and drive improvements.\n  \nOrganizational Expectations:\n  \n \u00b7          Demonstrates professionalism and respect in all interactions.\n  \n\n  \n \u00b7          Maintains confidentiality of patient and business information.\n  \n\n  \n \u00b7          Adheres to HFH policies, medical staff bylaws, and performance standards.\n  \n\n  \n \u00b7          Act as a resource and collaborate with hospital CDI physician advisors\n  \n\n  \n#PR\n  \n\n  \n\n  \n\n  \nAdditional Information\n  \n\n  \n\n  \n+ Organization: Corporate Services\n  \n\n  \n+ Department: Internal Phys Advisor Svcs\n  \n\n  \n+ Shift: Day Job\n  \n\n  \n+ Union Code: Not Applicable\n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \n     Additional Details \n  \n\n  \n This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above. \n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \nOverview\n  \n\n  \n Henry Ford Health partners with millions of people on their health journey, across Michigan and around the world. We offer a full continuum of services \u2013 from primary and preventative care to complex and specialty care, health insurance, a full suite of home health offerings, virtual care, pharmacy, eye care and other health care retail. With former Ascension southeast Michigan and Flint region locations now part of our team, Henry Ford\u2019s care is available in 13 hospitals and hundreds of ambulatory care locations. Based in Detroit, Henry Ford is one of the nation\u2019s most respected academic medical centers and is leading the Future of Health: Detroit, a $3 billion investment anchored by a reimagined Henry Ford academic healthcare campus. Learn more at  henryford.com/careers  . \n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \nBenefits\n  \n\n  \n \n  \n\n  \n The health and overall well-being of our team members is our priority. That\u2019s why we offer support in the various components of our team\u2019s well-being: physical, emotional, social, financial and spiritual. Our Total Rewards program includes competitive health plan options, with three consumer-driven health plans (CDHPs), a PPO plan and an HMO plan. Our team members enjoy a number of additional benefits, ranging from dental and eye care coverage to tuition assistance, family forming benefits, discounts to dozens of businesses and more. Employees classified as contingent status are not eligible for benefits.    \n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \nEqual Employment Opportunity/Affirmative Action Employer\n  \n\n  \n        Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is \n  \n\n  \n         committed to the hiring, advancement and fair treatment of all individuals without regard to \n  \n\n  \n         race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, \n  \n\n  \n         weight, marital status, family status, gender identity, sexual orientation, and genetic information, \n  \n\n  \n         or any other protected status in accordance with applicable federal and state laws. \n  \n\n  \n\n  \n\n  \n\n  \n\n  \n\n  \n", "location": "Detroit, MI", "reqid": "265204", "state": "Michigan", "state_short": "MI", "title": "System Physician Advisor - Clinical Documentation Integrity (CDI)", "uid": null, "guid": "A7C8E203D16049BBA56659C0DBEC7BD0", "url": "https://xerox.jobs/A7C8E203D16049BBA56659C0DBEC7BD024"}, {"city": "Athens", "company": "Trinity Health", "country": "United States", "country_short": "USA", "date_new": "2026-03-26 03:35:39", "description": "**Employment Type:**\n  \nFull time\n  \n**Shift:**\n  \n\n  \n**Description:**\n  \n\n  \nTHIS IS A 1099 POSITION\n  \n\n  \nThe Physician Advisor serves as a physician leader responsible for improving clinical documentation accuracy, case mix index (CMI), medical necessity compliance, utilization management, and hospital throughput.\n  \n\n  \nThe Physician Advisor works collaboratively with physicians, case management, clinical documentation integrity (CDI), quality, and revenue cycle teams to ensure appropriate patient status determinations, documentation accuracy, regulatory compliance, and optimal use of hospital resources.\n  \n\n  \nThis role provides in person, peer-to-peer physician engagement and education to support compliant documentation, reduce denials, decrease avoidable length of stay, and ensure appropriate utilization of hospital services.\n  \n\n  \n**Key Responsibilities and Essential Functions**\n  \n\n  \n**Clinical Documentation & Case Mix**\n  \n\n  \n+ Partner with CDI specialists to improve clinical documentation accuracy and completeness\n  \n+ Provide physician-to-physician education on documentation requirements related to:\n  \n+ Severity of illness\n  \n+ Risk of mortality\n  \n+ CC/MCC capture\n  \n+ DRG assignment\n  \n+ Assist with case mix index (CMI) improvement initiatives\n  \n+ Review complex cases for documentation opportunities that accurately reflect patient acuity\n  \n\n  \n**Utilization Management & Length of Stay Optimization**\n  \n\n  \n+ Provide physician guidance for medical necessity determinations\n  \n+ Review cases for appropriate inpatient vs observation status\n  \n+ Support case management staff with complex utilization reviews\n  \n+ Conduct peer-to-peer reviews with payers\n  \n+ Collaborate with care management teams to identify and address barriers to timely discharge\n  \n+ Work with clinical teams to reduce avoidable length of stay and excess days\n  \n+ Participate in daily multidisciplinary rounds and discussions to address throughput challenges and delayed discharges\n  \n+ Work with our Internal Medicine Residents to teach them what a Physician Advisor does and how to align and balance patient care with the KPI\u2019s the Physician Advisor works on to improve.\n  \n\n  \n**Opportunity Days Reduction**\n  \n\n  \n+ Review cases with extended length of stay to identify clinical, operational, or documentation barriers contributing to opportunity days\n  \n+ Partner with case management, nursing leadership, and service line leaders to address drivers of avoidable hospital days\n  \n+ Provide physician leadership in resolving delays related to:\n  \n+ Clinical decision-making\n  \n+ Documentation gaps\n  \n+ Discharge readiness\n  \n+ Specialist consultation delays\n  \n+ Support hospital initiatives aimed at improving patient flow and capacity management\n  \n\n  \n**Denials Prevention & Appeals**\n  \n\n  \n+ Review payer denials related to:\n  \n+ Medical necessity\n  \n+ Level of care\n  \n+ DRG downgrades\n  \n+ Write and support clinical appeal letters\n  \n+ Participate in denials management strategy\n  \n+ Identify systemic issues contributing to denials and implement improvement strategies\n  \n\n  \n**Physician Engagement & Education**\n  \n\n  \n+ Provide education to medical staff on documentation, utilization management, and efficient care delivery\n  \n+ Present findings at:\n  \n+ Medical staff meetings\n  \n+ Service line meetings\n  \n+ Quality committees\n  \n+ Serve as a physician champion for documentation improvement, medical necessity compliance, and hospital throughput\n  \n\n  \n**Quality & Compliance**\n  \n\n  \n+ Ensure hospital practices align with:\n  \n+ CMS Conditions of Participation\n  \n+ Medicare documentation rules\n  \n+ Two-midnight rule\n  \n+ Utilization review regulations\n  \n+ Partner with Quality and Compliance departments to ensure regulatory alignment\n  \n\n  \n**Data Review & Performance Improvement**\n  \n\n  \n+ Monitor, analyze, and actively strive to improve key hospital performance metrics including, but not limited to:\n  \n+ Case Mix Index (CMI)\n  \n+ Length of Stay Index (Observed vs Expected LOS and %GMLOS)\n  \n+ Opportunity Days\n  \n+ Observation rates\n  \n+ Medical necessity denial rates\n  \n+ CC/MCC capture rate\n  \n+ Identify opportunities for clinical, operational, and documentation improvement\n  \n\n  \n**Qualifications:**\n  \n\n  \n**Required**\n  \n\n  \n+ MD or DO degree from an accredited institution\n  \n+ Board Certified in a recognized medical specialty\n  \n+ Active unrestricted medical license to practice medicine in the state of Georgia.\n  \n+ Minimum of 5 years clinical practice experience\n  \n+ Experience working in hospital-based care\n  \n+ Demonstrated leadership, people management, and team building skills\n  \n+ Must have excellent time management skills to develop organized work processes in a high-volume environment with rapidly changing priorities.\n  \n+ Ability to develop and implement strategic clinical plans\n  \n+ Excellent oral and written communication skills\n  \n+ Ability to interact effectively with key internal and external constituents using collaboration and customer service skills that promote excellence in the patient experience.\n  \n\n  \n+ Customer service orientation\n  \n+ Demonstrated confidence, initiative, and integrity in work practices\n  \n+ Goal-directed and well organized\n  \n+ High level of dependability and accuracy\n  \n+ Ability to work independently\n  \n+ Strong negotiation and persuasion skills\n  \n+ Adept at conflict management\n  \n+ Ability to function within a stressful environment\n  \n\n  \nStrong computer skills and working knowledge of EMR\u2019s\n  \n\n  \n+ A broad knowledge base of health care delivery and case management within a managed care environment\n  \n+ Comprehensive knowledge of Utilization Review, levels of care, and observation status\n  \n\n  \n**Preferred**\n  \n\n  \n+ Prior experience as a Physician Advisor, Medical Director, or Utilization Review physician\n  \n+ Experience with:\n  \n+ Clinical Documentation Integrity (CDI)\n  \n+ Utilization Management\n  \n+ Revenue cycle operations\n  \n+ Denials management\n  \n+ Length of stay improvement initiatives\n  \n+ Knowledge of:\n  \n+ MS-DRG reimbursement\n  \n+ Case Mix Index\n  \n+ CMS inpatient admission criteria\n  \n\n  \n+ Certification such as:\n  \n+ CHCQM-PHYADV (Certified Physician Advisor)\n  \n+ Additional advanced degree (MBA, MPH, MMM, etc)\n  \n\n  \n+ Awareness of healthcare reimbursement systems (HMO, PPO, PPS,CMS)\n  \n\n  \n**Our Commitment**\n  \n\n  \nRooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.\n\nOur Commitment to Diversity and Inclusion\n  \nTrinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.\n  \nOur dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.\n  \nEOE including disability/veteran", "location": "Athens, GA", "reqid": "00656091", "state": "Georgia", "state_short": "GA", "title": "Physician Advisor- Utilization Management & Clinical Documentation Integrity- ONSITE", "uid": null, "guid": "416D9B19AD344996B6692A7CFBC84E80", "url": "https://xerox.jobs/416D9B19AD344996B6692A7CFBC84E8024"}]