Managing Consultant - Revenue Integrity - Healthcare

We do Consulting Differently The Integrated Health Solutions (IHS) practice at Berkeley Research Group (BRG) provides end-to-end advisory support to healthcare providers, payers, investors, and other stakeholders navigating complex strategic, operational, financial, and clinical challenges. Led by seasoned healthcare executives, operators, and clinicians, IHS partners with organizations to drive sustainable performance improvement and long-term growth through strategic growth design, operating model transformation, AI and digital enablement, clinical quality and patient care optimization, and revenue strategy—helping clients build resilient, future-ready healthcare enterprises in an increasingly complex environment.

Our four core service offerings include:

Business Transformation Advisory Margin & Operational Improvement Clinical & Quality Transformation AI & Digital Solutions Margin & Operational Improvement drives measurable financial improvement by providing clients with comprehensive solutions designed to increase revenue, optimizing cost containment strategies. This division utilizes innovative approaches to transform operating models and deliver true sustainable margin improvement. Our team of operation leaders, business analysis ts and deep subjects matter experts focus on implementing solutions around the following focus areas:

Workforce productivity and Human Resources Supply chain and Corporate Overhead performance

Revenue Cycle effectiveness

Managed care, Revenue Integrity and Pricing Strategies Ambulatory Operations and Physician Enterprise The Revenue Cycle team is currently seeking a Managing Consultant to join their team. This position requires a highly motivated problem solver with solid analytical ability, strong organizational skills, and a desire to advance within the organization. An individual with an entrepreneurial spirit and an ability to apply creative solutions is a natural fit for this position.

The work of a Managing Consultant will involve both execution and oversight of engagement work stream initiatives that may be either qualitative or quantitative in nature, and responsibilities include: design of financial analysis, development and presentation of client deliverables, management of existing client relationships, industry research, and expansion of business.

Willing to travel consistently (50% - 75%), depending on project requirements and client expectations, is required for this position.

Responsibilities Assess and analyze charge generation and charge capture workflows to identify potential revenue leakage issue(s) and/or compliance risks

Review and/or draft Revenue Integrity related policies and procedures to identify improvement recommendations

Perform detailed research and analysis (e.g., gather, review, and summarize literature and data from the public domain, specialized industry resources, or client, public, and commercial databases).Demonstrate creativity and efficient use of relevant software tools, analytical methods, and computer models to develop solutions.

Develop analyses and financial models using transactional data, financial data, and/or client provided data.

Develop and execute workplans for assigned project work Draft client deliverables for review by project lead/manager

Work collaboratively with internal Revenue Integrity team members to develop methodology and documentation

Participate in a team environment and prioritize assignments and responsibilities to meet goals and deadlines; facilitate internal meetings as appropriate

QualificationsA 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.
4-8 years of consulting and/or industry work experience in Revenue Integrity and/or Charge Integrity including performance and process improvement, revenue management and redesign, and reimbursement and recovery strategies. Job title and compensation to be determined based on qualifications and experience.

Operational expertise with a primary focus on Charge Description Master (CDM) Management, Charge Capture, Revenue Integrity, Denials Prevention, HIM/Coding/Outpatient Clinical Documentation Improvement, Denials Prevention, and Payer Contracting.

Understanding of the Medicare IPPS, OPPS and ASC payment systems

Understanding of documentation and various charge capture and charge generation processes across high-volume, revenue-producing hospital departments

Understanding of charge reconciliation processes

Familiarity with compliance principles as related to Revenue and Charge Integrity Familiarity with regulatory changes that impact charging practices

Familiarity with clinical operations and billing office workflows

Strong verbal and written communication and presentation skills

Strong proficiency in MS Office applications, including Word, PowerPoint, Excel, Access, and Outlook Applicable industry…