Sid Raghavan

Background

About Sid Raghavan

Sid Raghavan, MD, FACP, CHCQM-PHYADV, CPE is an accomplished physician executive with extensive experience in clinical operations, utilization management, revenue integrity, governmental compliance, and payer relationships. As the inaugural Director of Physician Advisor Services, Dr. Raghavan implemented Sutter Health's first systemwide internal physician advisor program where he provides leadership across 21 hospitals in Northern California, accounting for nearly acute care beds. In this role, Dr. Raghavan standardized systemwide secondary utilization review, clinical denials management, health plan peer-to-peers, and Medicare billing compliance, leading to millions of dollars in savings and revenue recovery. He also serves as an expert advisor in payer disputes, governmental claim audits, and hospital admission policies. Prior to that, Dr. Raghavan served as Associate Director of Utilization Management at Sutter Medical Group where he contributed to managed care strategy for several thousand at-risk member lives. During his clinical tenure, Dr. Raghavan held positions as a Hospitalist at Sutter Medical Center in Sacramento, California and as an Assistant Professor of Medicine at Northwell Health in New Hyde Park, New York.As a consultant for several Independent Review Organizations over the course of his career, Dr. Raghavan has advised payors and providers on payment disputes involving medical necessity, level of care, and DRG assignment. He has also published and presented extensively on performance improvement initiatives related to transitions of care, readmission reduction, and hospital throughput.Dr. Raghavan received his medical degree from St. George’s School of Medicine and completed his residency in Internal Medicine at Stony Brook University Hospital. He is board-certified in Internal Medicine, Healthcare Quality Management with a subspecialty in Physician Advisory, and is a Certified Physician Executive.