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 emerging healthcare trends and contribute to the development of innovative service offerings.
• Produce thought leadership through conference presentations, webinars, publications, benchmark studies, and other market-facing content.
• Help define and standardize leading practices for Clinical Integrity assessments and implementation engagements.

Responsibility #4 – Talent and Service-Line Leadership (10%)

• Provide leadership across a portfolio of engagements rather than managing only a single project or workstream.
• Mentor and develop Directors and other team members while providing delivery leadership to Managers, Senior Consultants, Consultants, and clinical subject-matter experts.
• Participate in workforce planning, recruiting, interviewing, hiring, onboarding, performance management, and succession planning.
• Lead staffing and resource-planning discussions across multiple engagements.
• Help build scalable clinical expertise and delivery capacity across the practice.
• Provide performance coaching and career-development guidance.
• Foster a culture of clinical rigor, accountability, collaboration, innovation, and measurable impact.
• Identify high-potential talent and support advancement within the organization.

Responsibility #5 – Professional Development and Training (5%)

• Complete all required training annually.
• Maintain current knowledge of applicable clinical, regulatory, reimbursement, payer, and industry requirements.
• Maintain current knowledge of clinical documentation and coding guidance, utilization-management practices, and emerging technologies.
• Lead internal educational sessions and knowledge-sharing activities.
• Support the development of training materials and leading practices within areas of expertise.

​Required Qualifications

Work Experience:

Years of Applicable Experience - 10 or more years

Education:

Bachelors (Required)

 

Preferred Qualifications

Nursing Background, Education, and Licensure

• Current or former Registered Nurse, including associate-, diploma-, or bachelor’s-prepared nurses, required.

• Prior direct clinical nursing practice required.

• Current or ongoing RN licensure is not required for this position.

• Master’s degree in nursing, healthcare administration, business administration, public health, or a related field preferred.

Work Experience

• Ten or more years of applicable healthcare experience.

• Seven or more years of progressive leadership experience in one or more of the following areas:

o Clinical documentation integrity

o Coding or clinical validation

o Utilization management

o Patient status and medical necessity

o Care management

o Physician advisory services

o Clinical denials and appeals

o Clinical-financial transformation

o Healthcare consulting

• Demonstrated experience leading complex, enterprise-wide clinical or clinical-financial transformation initiatives.

• Demonstrated ability to work effectively with C-suite executives and other senior health-system leaders.

• Experience managing multiple client engagements, senior client relationships, or multidisciplinary teams.

• Demonstrated ability to identify, quantify, implement, and sustain measurable clinical, operational, and financial improvements.

• Experience contributing to consulting sales, solution development, proposal development, or account expansion.

Skills

• Strong communication, facilitation, and presentation capabilities with senior client audiences.

• Ability to influence clinical, operational, financial, and executive stakeholders.

• Deep clinical knowledge combined with an understanding of healthcare finance, reimbursement, and payer requirements.

• Expertise across multiple Clinical Integrity domains, with the ability to connect clinical documentation, coding, utilization, denials, and reimbursement outcomes.

• Strong relationship-management, business-development, and consultative-selling skills.

• Ability to lead large, complex client engagements and multidisciplinary teams.

• Experience developing innovative solutions, methodologies, and consulting offerings.

• Proven people-leadership and talent-development capabilities.

• Advanced analytical, strategic problem-solving, and financial-management skills.

• Ability to translate complex clinical and financial findings into clear, actionable recommendations.

Experience

• Healthcare consulting or advisory-services experience strongly preferred.

• Leadership experience within a multi-hospital health system, academic medical center, integrated delivery network, or national healthcare organization.

• Experience spanning more than one Clinical Integrity domain.

• Experience contributing to new business development and the expansion of client relationships.

• Experience implementing technology-enabled Clinical Integrity solutions.

• Demonstrated record of producing measurable improvements in documentation accuracy, status accuracy, denial prevention, reimbursement, compliance, utilization, or capacity.

• Experience collaborating across clinical operations, finance, revenue cycle, managed care, care management, HIM, coding, compliance, and information technology.

Certifications

One or more relevant professional certifications preferred, including:

• CCDS or CCDS-O

• CDIP

• ACM or CMAC

• CPHQ

• CHCQM

• Lean Six Sigma

• Other relevant Clinical Integrity, utilization-management, quality, or healthcare leadership certification

Professional certifications are preferred but do not substitute for the required RN background and prior direct clinical nursing experience. Current RN licensure is not required.

Additional Job Requirements

• Adapt and reprioritize quickly while meeting deadlines.

• Communicate effectively with executive, clinical, operational, financial, and technical audiences.

• Make independent decisions and exercise sound judgment.

• Work collaboratively across teams, service lines, and client organizations.

• Operate computer programs and software effectively.

• Maintain strong attention to detail while leading multiple priorities.

• Travel as required to support client engagements, business-development activities, and industry events

 

Additional Job Requirements:

• Remain in a stationary position for prolonged periods of time 

• Be adaptive and change priorities quickly; meet deadlines 

• Attention to detail 

• Operate computer programs and software 

• Ability to communicate effectively with audiences in person and in electronic formats.   

• Day-to-day contact with others (co-workers and/or the public) 

• Making independent decisions 

• Ability to work in a collaborative business environment in close quarters with peers and varying interruptions 

 

Working Conditions: Remote

 

Travel Requirements: Travel 61-80% within the US

 

Physical Demands: Sedentary: Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves remaining stationary most of the time. Jobs are sedentary if movement is required only occasionally, and all other sedentary criteria are met.

 

Premier’s compensation philosophy is to ensure that compensation is reasonable, equitable, and competitive in order to attract and retain talented and highly skilled employees. Premier’s internal salary range for this role is $164,000 - $305,000. Final salary is dependent upon several market factors including, but not limited to, departmental budgets, internal equity, education, unique skills/experience, and geographic location. Premier utilizes a wide-range salary structure to allow base salary flexibility within our ranges.

Qualified full-time and part-time employees also receive access to the following benefits:

• Health, dental, vision, life and disability insurance

• 401k retirement program

• Paid time off

• Participation in Premier’s employee incentive plans

• Tuition reimbursement and professional development opportunities

Premier at a glance:

• Granted World's Most Ethical Companies, Ethisphere, 2008-2026

• Named U.S. News & World Report, Best Companies to Work For (2023, 2024, 2025)

• Accredited by Forbes: America’s Best Management Consulting Firms 2024-2025

• Given Modern Healthcare Best in Business Awards: Consultants- Healthcare Management

• Awarded Cigna Workforce Designation Gold Level Recipient (2016,2017,2019,2020,2021,2022,2023,2025)

For a listing of all of our awards, please visit the Awards and Recognition section on our company website.

Employees receive:

• Perks and discounts

• Access to on-site and online exercise classes

Premier is looking for smart, agile individuals like you to help us transform the healthcare industry. Here you will find critical thinkers who have the freedom to make an impact. Colleagues who share your thirst to learn more and do things better. Teammates committed to improving the health of a nation. See why incredible challenges require incredible people.
 

Premier is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to unlawful discrimination because of their age, race, color, religion, national origin, ancestry, citizenship status, sex, sexual orientation, gender identity, gender expression, marital status, familial status, pregnancy status, genetic information, status as a victim of domestic violence, covered military or protected veteran status (e.g., status as a Vietnam Era veteran, disabled veteran, special disabled veteran, Armed Forces Serviced Medal veteran, recently separated veteran, or other protected veteran) disability, or any other applicable federal, state or local protected class, trait or status or that of persons with whom an applicant associates. We also consider qualified applicants with criminal histories, consistent with applicable federal, state and local law. In addition, as a federal contractor, Premier complies with government regulations, including affirmative action responsibilities, where they apply.  EEO / AA / Disabled / Protected Veteran Employer.

Premier also provides reasonable accommodations to qualified individuals with a disability or those who have a sincerely held religious belief. If you need assistance in the application process, please reply to diversity_and_accommodations@premierinc.com or contact Premier Recruiting at 704.357.0022.

Personal Information submitted will be processed in accordance with Premier's Employee and Job Applicant Privacy Notice, which includes additional information about your privacy rights.