Managing Consultant – Revenue Integrity, Healthcare

🕒 Outubro 20

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $120.000 - $165.000 / ano

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

💼 Consultor

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Berkeley Research Group (BRG)

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

🏗️ Construção

📦 Logística

🎖️ Defesa

💰 Venture Round em 2020-07

Construction • Logistics • Defense

A BRG combina credenciais acadêmicas de renome mundial com expertise empresarial testada em campo, criada para agilidade e conectividade, o que nos diferencia e coloca nossos clientes à frente. Nossos especialistas de primeira linha incluem líderes experientes da indústria, acadêmicos renomados e cientistas de dados pioneiros. Juntos, eles trazem uma diversidade de experiências comprovadas do mundo real para economia, disputas e investigações; finanças corporativas; e serviços de melhoria de desempenho que abordam os desafios mais complexos para organizações ao redor do mundo. Nossa estrutura única nutre os relacionamentos interdisciplinares que nos dão a vantagem, estabelecendo as bases para insights mais informados e pensamentos mais originais e incisivos de perspectivas diversas que, quando combinados com nosso alcance e recursos globais, nos tornam exclusivamente capazes de enfrentar os desafios de nossos clientes.

Descrição

• 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 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 • 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 financial, operational, and compliance targets to support 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 methodologies, analytical tools, implementation playbooks, and supporting documentation • Lead project teams, delegate responsibilities, monitor progress, facilitate internal and client meetings, and review work products • 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

🎯 Requisitos

• Willing to travel consistently (50%–80%), depending on project requirements and client expectations • 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 • Demonstrated experience leading performance improvement, process redesign, reimbursement, and revenue recovery initiatives • Operational expertise in 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 • 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 • Familiarity with clinical operations and patient financial services workflows • Strong written, verbal, and presentation skills • Strong proficiency in Microsoft Office applications, including Word, PowerPoint, Excel, and Outlook • Familiarity with various EMRs, including Epic, Oracle Health/Cerner, Altera/Allscripts, MEDITECH, and athenahealth/IDX • Applicable industry certification is preferred (e.g., RHIA, RHIT, CPC, COC, CCS, CRIP or other AHIMA / AAPC / AAHAM certification) • Must be able to submit verification of legal right to work in the U.S., without company sponsorship

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