Managing Consultant (Healthcare Revenue Integrity)

Location: Remote - USA; consistent travel of 50%–80% may be required depending on project and client requirements.

Salary: $120,000–$165,000 per year for Managing Consultant; $135,000–$200,000 per year for Senior Managing Consultant. Final title and compensation depend on qualifications and experience.

Company

hirify.global provides consulting and advisory services across healthcare performance improvement, corporate finance, disputes and investigations, economics, and technology-enabled solutions.

What you will do

• Plan and manage small- to medium-sized Revenue Integrity engagements and workstreams covering charge description master governance, charge capture, charge reconciliation, charging compliance, denials prevention, and revenue opportunity realization.
• Assess current-state Revenue Integrity operations, quantify financial and compliance opportunities, identify root causes, and develop recommendations and implementation roadmaps.
• Analyze charge-generation and charge-capture workflows, transactional and financial data, revenue leakage, compliance risks, and reimbursement impacts.
• Design and implement future-state processes, governance structures, controls, policies, monitoring tools, and financial models.
• Manage project charters, work plans, budgets, staffing, timelines, risks, deliverables, benefit realization schedules, and engagement profitability.
• Lead project teams, manage client relationships, review and present deliverables, and communicate findings, recommendations, risks, and financial results to executive, operational, clinical, and compliance stakeholders.

Requirements

• Bachelor’s or Master’s degree, such as BS, BBA, MBA, MHA, M.A., or M.S.; preferred focus in Management, Accounting, Finance, Healthcare Administration, Business Administration, Health Information Management, or a related discipline.
• 5+ years of consulting and/or industry experience in Revenue Integrity, Charge Integrity, or related revenue cycle functions, including experience leading performance improvement, process redesign, reimbursement, and revenue recovery initiatives.
• Operational expertise in one or more of the following: 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.
• Working knowledge of clinical documentation, charge-generation, charge-capture, and charge-reconciliation processes across high-volume, revenue-producing hospital departments.
• Working knowledge of charging, coding, billing, reimbursement, compliance, and price transparency requirements, including the operational and financial impact of regulatory changes.
• Familiarity with clinical operations, patient financial services workflows, and various EMRs, including Epic, Oracle Health/Cerner, Altera/Allscripts, MEDITECH, and athenahealth/IDX.
• Strong written, verbal, and presentation skills for communicating complex findings and recommendations to executive, operational, clinical, and compliance stakeholders.
• Strong proficiency in Microsoft Word, PowerPoint, Excel, and Outlook.
• Ability to submit verification of legal right to work in the U.S. without company sponsorship.

Nice to have

• Applicable industry certification such as RHIA, RHIT, CPC, COC, CCS, CRIP, or another AHIMA, AAPC, or AAHAM certification.

Culture & Benefits

• Remote work arrangement with project-dependent travel expectations.
• Work within an interdisciplinary consulting environment combining healthcare executives, operators, clinicians, analysts, academics, consultants, and data scientists.
• Exposure to strategic growth, operating model transformation, AI and digital enablement, clinical quality, patient care optimization, and revenue strategy engagements.
• Equal opportunity employment practices are provided in accordance with applicable law.