Revenue Integrity & CDM Operations Manager

This role sits at the intersection of revenue cycle strategy, clinical operations, and healthcare finance, focusing on optimizing Charge Description Master (CDM) integrity across a complex hospital environment. You will lead initiatives that ensure accurate charge capture, regulatory compliance, and reimbursement optimization while collaborating with clinical, IT, compliance, and finance stakeholders. The position requires both strategic oversight and hands-on analytical depth, particularly in identifying revenue leakage and improving operational workflows. You will play a key role in shaping governance standards, improving billing accuracy, and supporting enterprise-wide system enhancements such as EMR integrations. This is a high-impact consulting engagement where your expertise directly influences financial performance and operational efficiency across healthcare systems.

Accountabilities

• Lead the end-to-end strategy, governance, maintenance, and optimization of the Charge Description Master (CDM), ensuring accuracy, compliance, and alignment with revenue integrity goals.
• Partner with cross-functional teams including finance, clinical operations, IT, and compliance to improve charge capture workflows and reduce revenue leakage.
• Conduct CDM audits, identify discrepancies, and implement corrective actions to improve billing accuracy and reimbursement outcomes.
• Manage updates to code sets, pricing structures, and regulatory requirements including CPT, HCPCS, ICD-10, and CMS guidelines.
• Analyze reimbursement trends, denial patterns, and operational data to recommend performance and pricing improvements.
• Support system implementations, upgrades, and integrations impacting CDM workflows, including EMR platforms such as Epic.
• Develop governance frameworks, best practices, and documentation to standardize CDM operations across departments.

Requirements

• Bachelor’s degree in Healthcare Administration, Health Information Management, Finance, or a related field.
• 5+ years of experience in Revenue Integrity, CDM management, hospital billing, or healthcare reimbursement operations.
• Strong knowledge of CPT, HCPCS, ICD-10, CMS regulations, and payer reimbursement methodologies.
• Hands-on experience with hospital billing systems and EMR platforms, with Epic preferred.
• Strong analytical, problem-solving, and organizational skills with the ability to manage multiple priorities in fast-paced environments.
• Experience working with healthcare data, reporting tools, and Excel-based analysis.
• Preferred certifications such as RHIA, RHIT, CPC, or CCS.
• Strong communication skills with the ability to collaborate across technical, clinical, and financial stakeholders.

Benefits

• Remote-first work model with flexibility.
• 6+ month contract engagement (W2 employment).
• Competitive hourly rate (approximately $80/hour).
• Opportunity to work with large-scale healthcare systems and high-impact revenue cycle initiatives.
• Exposure to complex enterprise environments and advanced healthcare technologies.
• Collaborative consulting environment with experienced industry professionals.
• Meaningful work focused on improving financial performance and patient billing accuracy.