Job Description

Job Description

Medical Director of Revenue Integrity – Physician AdvisorLocation: Cheyenne, WYSpecialty: Administration / Physician AdvisorCandidate Type: MD or DONon-Profit: 501(c)(3)Position OverviewSeeking a Medical Director of Revenue Integrity to serve as a Physician Advisor and key member of the executive leadership team. This physician leader will drive effective utilization of healthcare services, optimize revenue integrity operations, and support compliance, documentation excellence, and value-based care initiatives across the organization.Position Highlights Executive-level leadership role Oversight of CDI, Coding, and Utilization Review Chair of Utilization Management Committee Direct collaboration with CMO and CFO Strategic influence on value-based care initiatives Active participation in denial management and payer relations Opportunity to shape physician documentation and practice standardsCore Responsibilities Provide functional leadership for revenue integrity including CDI, Coding, and UR Oversee optimization of revenue cycle systems and processes Perform medical necessity reviews and level-of-care determinations Conduct peer-to-peer discussions with payer medical directors Provide feedback to physicians regarding LOS, documentation, and quality metrics Educate physicians on ICD and DRG coding guidelines Collaborate with CDI and coding teams to optimize query practices and DRG assignment Support denial management including RAC reviews Report practice pattern trends to leadership and service lines Participate in readmission reduction and cost containment initiatives Support payer and physician contract processes for quality measures Assist in development of evidence-based protocols and standards of careKnowledge, Skills & Leadership Competencies Strategic planning and operational leadership Revenue cycle and payer relations expertise Regulatory compliance knowledge Advanced understanding of Medicare Two-Midnight Rule Strong background in utilization management and documentation integrity Process improvement and quality improvement expertise Ability to educate and influence physicians and stakeholders Patient safety and risk mitigation knowledge Collaborative leadership style with strong communication skillsMinimum Qualifications MD or DO degree Unrestricted Wyoming medical license (or ability to obtain) Minimum 10 years of healthcare or patient care experience Minimum 2 years experience in revenue cycle, utilization management, coding, CDI, or regulatory programs Active American College of Physician Advisors membership ABQAURP certification or ACPA-C certification within 6 months of start datePreferred Qualifications Certified Medical Director (CMD) Internal Medicine background with Hospital Medicine experience Medical billing, coding, or abstracting experience InterQual experience MCG experienceCompensation & Benefits Competitive executive compensation Comprehensive benefits package 501(c)(3) eligibilityCommunity Highlights – Cheyenne, Wyoming Capital city with strong regional presence Access to Rocky Mountain outdoor recreation Proximity to Fort Collins and Denver Family-friendly community with Western heritage

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