Revenue Integrity & CDM Operations Manager

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

Wilshire hires only the brightest and most experienced professionals in the healthcare revenue cycle management industry. Wilshire will take the time to get know you and your employment history. We will then place you in a role that will lead to a path of career success.

About The Wilshire Group At The Wilshire Group , we partner with healthcare organizations across the country to solve complex revenue cycle and operational challenges. As a boutique consulting firm based in Los Angeles, we bring deep expertise, strategic thinking, and hands-on collaboration to every engagement. Our team has supported more than 100 healthcare systems nationwide, helping organizations improve financial performance, strengthen operational workflows, and bridge the gap between clinical operations and technology. We are looking for professionals who are proactive, adaptable, collaborative, and excited to make a measurable impact in healthcare.

Revenue Integrity & CDM Operations Manager 6+ Month Contract | Remote | W2 | $80/hour

Position Overview

We are seeking an experienced Revenue Integrity & CDM Operations Manager to lead Charge Description Master (CDM) strategy, optimization, and compliance initiatives for a large healthcare environment. This role is ideal for someone who combines strong technical CDM expertise with leadership, operational insight, and a passion for improving revenue cycle performance. The ideal candidate understands the full revenue integrity landscape and can collaborate across finance, compliance, clinical, and IT teams to ensure accurate charge capture, regulatory compliance, and reimbursement optimization.

What You’ll Do

• 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

What We’re Looking For: Required Qualifications

• Bachelor’s degree in Healthcare Administration, Health Information Management, Finance, or related field
• 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
• Experience working within hospital billing and physician billing (Epic required)
• Strong analytical, organizational, and problem-solving skills
• Ability to manage multiple priorities in a fast-paced consulting environment

Preferred Qualifications

• RHIA, RHIT, CPC, CCS, or similar certification
• Experience supporting large healthcare systems or consulting engagements
• Advanced Excel, reporting, or data analysis skills
• Experience leading charge capture optimization or revenue integrity initiatives

Why Join The Wilshire Group?

• Opportunity to work with nationally recognized healthcare systems
• Collaborative and highly experienced consulting team
• Flexible, remote work environment
• Meaningful, high-impact healthcare projects
• Fast-moving environment where your expertise is valued and visible

Wilshire is honored that you have taken the time to review/apply to our open position.