Physician Advisor - CDI, Coding & Quality Opportunity in Southwest Ohio

The Physician Advisor – CDI, Coding & Quality serves as a key clinical leader supporting Premier Health’s goals to advance documentation accuracy, revenue integrity, and quality performance across the health system. This role focuses on optimizing case mix index (CMI), risk adjustment, and clinical documentation excellence through collaboration with the CDI, Coding, and Quality teams.

The Physician Advisor provides expert second-level reviews, leads provider education, and partners closely with the CDI Manager, Coding Manager and interdisciplinary teams to ensure that documentation accurately reflects the clinical complexity, severity of illness, and quality outcomes of Premier Health’s patient population.

Key Responsibilities

1. Clinical Documentation Integrity (CDI) Leadership

• Provide secondary review of complex CDI and Coding queries escalated by the CDI and Coding teams.
• Review and resolve escalations involving Query disagreement, Clinical Validation, or incomplete response.
• Partner with the CDI Manager to establish standardized escalation criteria and ensure timely resolution of all high-impact queries.
• Conduct focused “second-look” reviews of no-CC/MCC or CC-only cases to identify missed documentation opportunities and support CMI improvement.
• Serve as a liaison between the CDI, Coding, and Physician teams to promote consistency in documentation practices.

2. Provider Engagement and Education

• Conduct one-on-one meetings with providers to review query metrics, patterns, and opportunities for improvement.
• Deliver targeted education sessions on documentation best practices, MCC/CC capture, and quality measure alignment.
• Participate in residency and faculty education (Internal Medicine, Family Practice, Trauma, Critical Care, etc.) including lectures and QIPS elective rotations on CDI and professional billing documentation.
• Partner with the CDI Manager and Quality leadership to develop and disseminate system-wide education tools and tip sheets.

3. CMI and Quality Improvement

• Analyze and communicate CMI trends by service line; support interventions to drive improvement aligned with Vizient benchmarks.
• Collaborate with Digital Health team to refine dashboards and enable data-driven improvement strategies. 
• Participate in pre-claim mortality and risk adjustment reviews, focusing on REM score optimization and accurate capture of clinical risk variables.
• Support PSI/HAC reviews from a CDI perspective in partnership with Quality and CDI teams.

4. Interdisciplinary Collaboration

• Serve as a clinical resource to the CDI, Coding, and Quality departments on complex documentation and regulatory compliance questions.
• Partner with Digital Health to support AI-enabled CDI nudges, EHR workflow optimization, and system note-template refinement and creation for service lines.
• Contribute to system-wide initiatives related to mortality O/E, LOS O/E, and cost efficiency performance, Vizient facility ranking and Elix Hauser risk adjustment methodologies.

Performance Expectations

• Achieve a sizeable conversion rate on escalated CDI/Coding queries.
• Demonstrate measurable CMI improvement in targeted service lines.
• Support system improvement in key Vizient metrics (Mortality O/E, Cost O/E, LOS O/E).
• Maintain provider query agreement rate ?80% and consistent educational engagement.

Qualifications

Education: Doctor of Medicine (MD) or Doctor of Osteopathy (DO) required.
Licensure: Active Ohio medical license (or eligibility for licensure).
Experience:
   – Minimum 3 years of clinical practice experience.
   – Prior involvement in CDI, and or quality improvement preferred 1-2 years’ experience
   – Strong working knowledge of ICD-10, MS-DRG/APR-DRG systems, and risk adjustment models Vizient, CMS, Elixhauser etc.
Skills:
   – Excellent communication and teaching skills.
   – Ability to interpret clinical and coding guidelines with precision.
   – Proficiency with EHR systems (Epic experience preferred).

Based in Dayton, Ohio, Premier Health (www.premierhealth.com) is committed to supporting the community through our mission: We Care. We Teach. We Innovate. We Serve.

Home to the region’s only adult Level I trauma center and the largest locally based clinical laboratory, Premier Health continues to build upon a more than 130-year legacy of providing clinical excellence and compassionate care to friends and neighbors across Southwest Ohio.

The health system offers award-winning care at five hospital sites: Miami Valley Hospital in Dayton with additional inpatient sites at Miami Valley Hospital South in Centerville and Miami Valley Hospital North in Englewood; Atrium Medical Center in Middletown; and Upper Valley Medical Center in Troy. In addition, Premier Health provides a comprehensive range of care choices at its emergency departments, Urgent Care locations, and more than 130 outpatient locations and affiliated primary care and specialty physician offices, as well as home health, mental health, and substance abuse services. 

The Sky’s the Limit in Dayton!

As the birthplace of aviation the sky is certainly the limit when it comes to the endless quality of life amenities that the Dayton area has to offer. Among the many reasons why the greater Dayton area is your destination are diverse neighborhoods, great school systems, superior healthcare and a host of leisure activities.

Dayton boasts culturally rich museums and visual art centers including The Dayton Art Institute, The Boonshoft Museum of Discovery, and the Schuster Performing Arts Center which hosts performances, exhibits, and events from first class world touring groups and popular community organizations such as the Dayton Philharmonic Orchestra, the Dayton Opera, and the Dayton Ballet. Dayton is also home to the United States Air Force Museum, the oldest and largest military and aviation museum in the country, featuring a fascinating collection of both modern and old-fashioned aerospace vehicles.

Known as the “Outdoor Adventure Capital of the Midwest”, Greater Dayton has the nation’s largest network of paved trails and Dayton’s Five Rivers MetroParks is one of the country’s best urban park systems with 16,000 acres of parkland offering a wide range of outdoor activities. The Dayton Dragons Minor League Baseball Team holds the record for the longest sellout streak in North American Professional Sports – selling out a record 1,441 consecutive home games over the past 22 years.

The northern Cincinnati region (Liberty Township, Mason, Middletown, Monroe, Trenton) offers:

• Top rated public school systems and a variety of private school choices. 
• Home to several universities
• Robust art programs including ballet, Broadway theater and museums
• Professional athletic teams, abundant gold courses, family friendly attractions
• Outstanding shopping and dining experiences 
• Easy access to two international airports for ease of travel
• Housing options ranging from a bustling downtown loft, a spacious country property or a charming neighborhood in the suburbs.