Senior Director Advisory Services, Clinical Integrity

Senior Director Advisory Services, Clinical Integrity

Senior Director Advisory Services, Clinical Integrity

About the Practice

Premier’s Financial Transformation Advisory Practice reimagines the entire patient financial journey, helping health systems achieve sustainable margin improvement through an integrated, enterprise-wide approach. Rather than pursuing isolated improvements, our team works across three interconnected pillars:

• Revenue Cycle: Reducing revenue leakage, accelerating cash flow, improving operational efficiency, and elevating the patient financial experience.
• Managed Care: Strengthening payer accountability, contracting strategy, reimbursement integrity, and payer performance.
• Clinical Integrity: Aligning clinical care, documentation, utilization, coding, and reimbursement to improve financial performance, quality, compliance, and patient outcomes.

Because clinical decisions, documentation, payer requirements, and revenue-cycle outcomes are interconnected, our consultants work across traditional organizational boundaries. We combine trusted advisory relationships with clinical expertise, advanced analytics, automation, and AI-enabled solutions to identify opportunities, implement sustainable improvements, and quantify measurable value.

What you will be doing:

Reporting to Clinical Integrity practice leadership, the Senior Director serves as a senior clinical, strategic, and business leader within Premier’s Clinical Integrity service line. This position is responsible for leading complex engagements across multiple clients, managing senior client relationships, supporting portfolio growth, developing consulting talent, and ensuring measurable clinical, operational, and financial outcomes.

The Senior Director provides leadership across three primary Clinical Integrity domains:

• Clinical documentation and coding integrity: CDI strategy, documentation accuracy, coding validation, severity and risk capture, clinical validation, and reconciliation of documentation, coding, billing, and payment outcomes.
• Utilization management and patient status: Medical necessity, admission status, observation management, utilization review, length of stay, prior authorization, physician advisory services, and care-management workflow optimization.
• Clinical denials and appeals: Denial prevention, clinical and medical-necessity appeals, peer-to-peer strategy, payer escalation, root-cause analysis, and integration of denial findings into upstream clinical and operational improvements.

The Senior Director connects these domains with Revenue Cycle and Managed Care leaders to address payer friction, reimbursement variance, preventable denials, clinical-financial leakage, and contract-performance opportunities.

This position manages a portfolio of complex client engagements and is accountable for engagement quality, financial performance, client satisfaction, talent development, and demonstrated value realization. The Senior Director works in partnership with Clinical Integrity practice leadership on service-line execution, executive relationships, market positioning, and growth.

Core Expectations

• Build effective relationships with client clinical, operational, and financial leaders and support Clinical Integrity practice leadership in executive-level client discussions.
• Partner with Clinical Integrity practice leadership to translate the service line’s strategic direction, market positioning, solution roadmap, and growth priorities into executable delivery and business-development plans.
• Lead complex, enterprise-level transformation programs across multiple clients and workstreams.
• Translate clinical, operational, payer, and financial data into prioritized recommendations and quantified improvement opportunities.
• Integrate Clinical Integrity solutions with Premier’s Revenue Cycle, Managed Care, Clinical Transformation, analytics, and technology capabilities.
• Support client retention, account expansion, and new business development through high-quality delivery and relationship development.
• Mentor and develop Directors and other team members while providing delivery leadership to Managers, Senior Consultants, Consultants, and clinical subject-matter experts.
• Maintain accountability for utilization, engagement margin, delivery quality, client satisfaction, and measurable client outcomes.
• Contribute to Premier’s market presence through industry engagement, speaking opportunities, publications, and client-facing thought leadership.

Key Responsibilities

• Responsibility #1 – Client Delivery and Senior Client Leadership (40%)

• Provide senior leadership and strategic oversight for complex Clinical Integrity engagements.

• Serve as the senior day-to-day client leader for assigned engagements, coordinating with Clinical Integrity practice leadership on executive relationships, strategic decisions, and escalations.

• Lead client discussions and provide subject-matter guidance on clinical documentation integrity, coding integrity, utilization management, patient status, clinical denials, appeals, and payer-related clinical-financial performance.

• Lead enterprise diagnostic assessments that distinguish documentation, coding, clinical validation, utilization, workflow, payer, and contract-related root causes.

• Oversee the development of transformation roadmaps, implementation plans, governance structures, and performance-management systems.

• Ensure recommendations are supported by clinically credible and financially defensible analyses.

• Establish value-realization approaches that connect interventions to revenue recovery, denial avoidance, cost reduction, capacity improvement, compliance, quality, and patient outcomes.

• Support Clinical Integrity practice leadership in executive steering committees, leadership workshops, and C-suite or board-level presentations.

• Maintain accountability for engagement scope, economics, risk, staffing, quality, and client satisfaction.

• Ensure successful implementation and achievement of targeted financial, operational, and clinical outcomes.

• Manage complex clinical, regulatory, payer, and client issues, escalating significant strategic or relationship concerns to Clinical Integrity practice leadership.

• Identify potential account-growth opportunities and collaborate with practice leadership to develop expanded client partnerships.

• Responsibility #2 – Business Development and Portfolio Growth (25%)

• Contribute to Clinical Integrity sales, revenue, pipeline, and account-growth objectives.

• Develop relationships with clinical, operational, and financial leaders within existing and prospective client organizations.

• Identify and qualify opportunities across clinical documentation integrity, coding integrity, utilization management, patient status, physician advisory services, clinical denials, appeals, and related technology solutions.

• Lead or contribute to discovery discussions, solution design, proposal development, statements of work, presentations, pricing, negotiations, and contracting activities.

• Develop integrated solutions that connect Clinical Integrity with Revenue Cycle and Managed Care needs.

• Collaborate with Clinical Integrity practice leadership and Premier’s commercial, account-management, and practice leaders to identify and pursue market opportunities.

• Support cross-selling opportunities across Premier’s broader portfolio.

• Contribute to the evaluation of strategic alliances, vendors, and technology solutions that support the Clinical Integrity portfolio.

• Generate potential business opportunities through industry relationships, networking, conferences, and client interactions.

• Contribute to annual pipeline development, forecasting, and growth-planning activities.

• Responsibility #3 – Practice and Solution Development (20%)

• Lead assigned initiatives and contribute to the development and enhancement of Premier’s Clinical Integrity methodologies, offerings, tools, and intellectual property.

• Develop integrated approaches connecting clinical documentation, coding, utilization, denials, payer performance, and financial outcomes.

• Establish standards for engagement quality, clinical and financial validation, case reconciliation, performance measurement, and financial value attribution.

• Advance the appropriate use of analytics, automation, artificial intelligence, and workflow technologies while maintaining necessary clinical oversight and validation.

• Monitor regulatory, reimbursement, and payer developments and translate those changes into client strategies and potential market offerings.

• Collaborate with Revenue Cycle, Managed Care, Clinical Transformation, analytics, and technology leaders to develop cross-practice solutions.

• Identify