Senior Managing Consultant, Revenue Integrity
A leading global consulting firm is seeking a Senior Managing Consultant, Revenue Integrity to join its growing healthcare advisory practice. This individual will serve as a trusted advisor to hospitals, health systems, and other healthcare organizations, leading complex Revenue Integrity and performance improvement initiatives that drive financial, operational, and compliance outcomes. The role offers significant client exposure, leadership responsibility, and the opportunity to help shape strategic transformation efforts across the healthcare industry.
Location
- Remote with travel required based on client needs
- Approximately 50% travel
Qualifications
- 8+ years of consulting and/or healthcare industry experience within Revenue Integrity, Charge Integrity, Revenue Cycle, or related areas
- Demonstrated experience leading revenue optimization, process improvement, reimbursement, and revenue recovery initiatives
- Deep expertise in Revenue Integrity operations, including Charge Description Master (CDM) management, charge capture, charge reconciliation, denials prevention, HIM/Coding, outpatient CDI, reimbursement strategy, and payer contracting
- Strong understanding of Medicare reimbursement methodologies, including IPPS, OPPS, and ASC payment systems
- Experience assessing charging, coding, billing, reimbursement, and compliance processes across healthcare organizations
- Knowledge of healthcare regulatory requirements and the impact of regulatory changes on charging and reimbursement practices
- Familiarity with clinical operations, patient access, business office functions, and revenue cycle workflows
- Strong financial analysis, data modeling, project management, and problem-solving skills
- Excellent executive communication, presentation, and stakeholder management capabilities
- Industry certifications such as RHIA, RHIT, CPC, COC, CCS, CRIP, or similar credentials preferred
- Experience with healthcare technology platforms including Epic, Cerner/Oracle Health, MEDITECH, Allscripts, Athenahealth, or similar systems preferred
Responsibilities
- Lead complex Revenue Integrity consulting engagements focused on financial performance improvement, compliance enhancement, and operational transformation
- Assess charge capture, charge generation, and charge reconciliation workflows to identify revenue leakage and improvement opportunities
- Evaluate Revenue Integrity policies, procedures, controls, and governance frameworks and develop recommendations for optimization
- Conduct quantitative and qualitative analyses utilizing operational, financial, and transactional healthcare data
- Develop financial models, business cases, and executive-level recommendations to support client decision-making
- Lead current-state assessments and design future-state Revenue Integrity operating models and processes
- Manage project plans, workstreams, timelines, and deliverables across multiple client engagements
- Develop and present findings, recommendations, and strategic solutions to executive stakeholders, including CFOs, Revenue Cycle leaders, Compliance leaders, and operational executives
- Mentor and collaborate with consulting team members to strengthen methodologies, analytical frameworks, and engagement delivery
- Build and maintain strong client relationships while serving as a trusted advisor throughout engagements
- Support business development initiatives, industry research, proposal development, and practice growth efforts
- Contribute to the continued development of Revenue Integrity consulting tools, playbooks, and best practices
FAQs
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