Position Summary
The Revenue Integrity team is currently seeking a Managing Consultant to join their team. This position requires a highly motivated problem solver with strong analytical, organizational, project management, and client relationship skills. An individual with an entrepreneurial spirit and an ability to apply creative solutions is a natural fit for this position. The Managing Consultant will be responsible for both executing and overseeing qualitative and quantitative engagement workstreams. Responsibilities include designing financial analyses, developing and presenting client deliverables, managing client relationships, conducting industry research, leading project teams, and contributing to business development and practice growth.
Travel Requirements
Willing to travel consistently (50%-80%), depending on project requirements and client expectations, is required for this position.
Responsibilities
- Plan and manage small- to medium-sized Revenue Integrity engagements and discrete workstreams within larger, multidisciplinary engagements. Lead initiatives across the Revenue Integrity continuum, including Charge Description Master governance, charge capture, charge reconciliation, charging compliance, revenue integrity-related denials prevention, and financial opportunity realization.
- Lead current-state assessments of Revenue Integrity operations, quantify financial and compliance opportunities, identify root causes, and develop prioritized recommendations and implementation roadmaps.
- Assess and analyze charge-generation and charge-capture workflows to identify potential revenue leakage and compliance risks.
- Review and draft Revenue Integrity-related policies and procedures and recommend opportunities for improvement.
- Develop and maintain effective relationships with client executives, operational leaders, and other key stakeholders throughout the engagement lifecycle.
- Apply relevant technology, analytical methods, and financial models to develop practical, data-driven solutions to complex client challenges.
- Develop analyses and financial models using transactional, financial, and client-provided data.
- Develop and manage project charters, work plans, budgets, staffing plans, timelines, risks, deliverables, and benefit realization models and schedules. Monitor performance against established financial, operational, and compliance targets to support successful project execution and engagement profitability.
- Lead the design and implementation of future-state Revenue Integrity processes, governance structures, controls, policies, and monitoring tools.
- Lead the development, quality review, and presentation of client deliverables, findings, and recommendations.
- Lead and collaborate with Revenue Integrity team members to develop and refine methodologies, analytical tools, implementation playbooks, and supporting documentation.
- Lead project teams, delegate responsibilities, monitor progress, facilitate internal and client meetings, and review work products for completeness, accuracy, and analytical rigor.
- Present findings, recommendations, project progress, risks, and financial results to senior client stakeholders, including Revenue Cycle executives, compliance leaders, clinical leaders, CFOs, and other executive leaders.
Qualifications
- A Bachelor's or Master's degree (e.g., BS, BBA, MBA, MHA, M.A., M.S., etc.) with a preferred focus in Management, Accounting, Finance, Healthcare Administration, Business Administration, Health Information Management or related discipline.
- 5+ years of consulting and/or industry experience in Revenue Integrity, Charge Integrity, or related revenue cycle functions, including demonstrated experience leading performance improvement, process redesign, reimbursement, and revenue recovery initiatives.
- Demonstrated operational expertise in one or more of the following areas: Charge Description Master governance and maintenance, charge capture, charge reconciliation, Revenue Integrity, denials prevention, HIM/coding, outpatient clinical documentation improvement, pricing, reimbursement, and charging compliance.
- Working knowledge of Medicare IPPS, OPPS, and ASC payment systems and their impact on charging, coding, billing, and reimbursement practices.
- Working knowledge of clinical documentation, charge-generation, charge-capture, and charge-reconciliation processes across high-volume, revenue-producing hospital departments.
- Working knowledge of applicable charging, coding, billing, reimbursement, compliance, and price transparency requirements, including the ability to assess the operational and financial impact of regulatory changes.
- Familiarity with clinical operations and patient financial services workflows
- Strong written, verbal, and presentation skills, including the ability to communicate complex findings and recommendations to executive, operational, clinical, and compliance stakeholders
- Strong proficiency in Microsoft Office applications, including Word, PowerPoint, Excel, and Outlook
- Applicable industry certification is preferred (e.g., RHIA, RHIT, CPC, COC, CCS, CRIP or other AHIMA / AAPC / AAHAM certification).
- Familiarity with various EMRs (e.g., Epic, Oracle Health/Cerner, Altera/Allscripts, MEDITECH, and athenahealth/IDX)
Managing Consultant Salary Range: $120,000 - $165,000 per year
Senior Managing Consultant Salary Range: $135,000 - $200,000 per year
Job title and compensation to be determined based on qualifications and experience.
Candidate must be able to submit verification of his/her legal right to work in the U.S., without company sponsorship.
