[Hiring] Revenue Integrity & CDM Operations Manager @The Wilshire Group

Role Description

We are seeking an experienced Revenue Integrity & CDM Operations Manager to lead Charge Description Master (CDM) strategy, optimization, and compliance initiatives for a large healthcare environment. This role is ideal for someone who combines strong technical CDM expertise with leadership, operational insight, and a passion for improving revenue cycle performance.

The ideal candidate understands the full revenue integrity landscape and can collaborate across finance, compliance, clinical, and IT teams to ensure accurate charge capture, regulatory compliance, and reimbursement optimization.

What You’ll Do

• Lead the strategic oversight, maintenance, and optimization of the Charge Description Master (CDM)
• Partner with operational, finance, clinical, compliance, and IT teams to improve revenue integrity processes
• Monitor and maintain compliance with CPT, HCPCS, ICD-10, CMS, and payer requirements
• Conduct CDM audits and identify opportunities for charge capture accuracy and reimbursement improvement
• Manage annual and ongoing code set updates, pricing reviews, and regulatory changes
• Analyze reimbursement trends and recommend operational and pricing enhancements
• Support system implementations, upgrades, and integrations impacting CDM workflows, including Epic
• Develop best practices and provide guidance to department leaders on CDM governance and charge capture processes
• Assist with resolving billing discrepancies, denials trends, and compliance risks
• Drive process improvement initiatives that enhance operational efficiency and financial performance

Qualifications

• Bachelor’s degree in Healthcare Administration, Health Information Management, Finance, or related field
• 5+ years of experience in Revenue Integrity, CDM management, hospital billing, or healthcare reimbursement
• Strong working knowledge of CPT, HCPCS, ICD-10, and payer reimbursement methodologies
• Experience working within hospital billing and physician billing (Epic required)
• Strong analytical, organizational, and problem-solving skills
• Ability to manage multiple priorities in a fast-paced consulting environment

Requirements

• RHIA, RHIT, CPC, CCS, or similar certification (preferred)
• Experience supporting large healthcare systems or consulting engagements (preferred)
• Advanced Excel, reporting, or data analysis skills (preferred)
• Experience leading charge capture optimization or revenue integrity initiatives (preferred)

Benefits

• Opportunity to work with nationally recognized healthcare systems
• Collaborative and highly experienced consulting team
• Flexible, remote work environment
• Meaningful, high-impact healthcare projects
• Fast-moving environment where your expertise is valued and visible