Revenue Integrity & CDM Operations Manager

The Wilshire Group is a boutique consulting firm partnering with healthcare organizations nationwide to solve complex revenue cycle and operational challenges. We are seeking an experienced Revenue Integrity & CDM Operations Manager to lead charge description master strategy, optimization, and compliance initiatives for a large healthcare environment.

Key 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.

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.
• Strong working knowledge of CPT, HCPCS, ICD-10, and payer reimbursement methodologies.
• Experience working within hospital and physician billing, with specific proficiency in Epic.
• Strong analytical, organizational, and problem-solving skills.

What we offer

• Opportunity to work with nationally recognized healthcare systems.
• Collaborative and highly experienced consulting team.
• Flexible, fully remote work environment.
• Meaningful, high-impact healthcare projects.