Remote Revenue Integrity & CDM Operations Leader

The Wilshire Group; United States; Remote; USD 91,000 - 129,000; Full time

Job summary

The Wilshire Group is seeking an experienced Revenue Integrity & CDM Operations Manager for a 6+ month contract with remote work options. The role focuses on leading CDM strategy, optimization, and compliance initiatives across a large healthcare environment, collaborating with finance, clinical, IT, and compliance teams to ensure accurate charge capture and reimbursement optimization.

The ideal candidate has strong CDM expertise, leadership capabilities, and a passion for improving revenue

Qualifications

• 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.
• Epic experience in hospital billing (Epic required).
• Analytical, organizational, and problem-solving skills.
• Ability to manage multiple priorities in a fast-paced consulting environment.

Responsibilities

• 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.

Skills

CDM management

Revenue integrity

Analytical skills

Leadership

Charge capture

Education

Bachelor’s degree in Healthcare Administration/Health Information Management/Finance

Tools

Epic

Job description

The Wilshire Group is seeking an experienced Revenue Integrity & CDM Operations Manager for a 6+ month contract with remote work options. The role focuses on leading CDM strategy, optimization, and compliance initiatives across a large healthcare environment, collaborating with finance, clinical, IT, and compliance teams to ensure accurate charge capture and reimbursement optimization.

The ideal candidate has strong CDM expertise, leadership capabilities, and a passion for improving revenue