Director, Consulting Services - Pediatric Charge Capture

Job Description

Job Description

Description:

Summary:

Healthrise is seeking an experienced Director of Consulting Services to lead a pediatric charge capture engagement at our client's children's hospital. This individual will serve as the subject matter expert assessing CDM and charge capture workflows, with a focus on perioperative (PeriOp) services. They will identify opportunities, estimate ROI and incremental revenue potential, and support implementation of approved remediation activities.

The engagement runs in two phases. The assessment phase lasts about two to three months, and the implementation phase lasts about three to four months. The Director will present findings to client revenue cycle leadership, build the associated workplan, and partner with client teams to put changes into practice. Findings will be delivered to the client's corporate revenue cycle leadership and, when applicable, may be implemented across the broader system. The client operates on Epic, so hands-on Epic experience and knowledge are required.

This role is ideal for a hands-on, detail-oriented professional with pediatric or perioperative charging expertise, who can move quickly into a complex service line and turn assessment findings into clear, actionable results.

Travel to Texas is anticipated primarily in the first month of the engagement, including the project kick-off and an initial client site visit. After that, the role transitions to remote, with additional travel only as needed to support the engagement. 

Key Responsibilities:

• Assess applicable CDM and charge capture workflows at the client's children's hospital, including operational workflows and relevant technical build opportunities.

• Identify charge capture opportunities specific to perioperative workflows and estimate the associated ROI and potential incremental revenue opportunity.

• Review assessment findings with client leadership to confirm opportunities are properly identified and validated, and develop an associated workplan.

• Support implementation of approved assessment findings intended to improve charge capture performance and help the client pursue identified incremental revenue opportunities, including:

– Developing training materials and updated workflows for distribution to staff and leadership, and facilitating training sessions as needed.

– Partnering with Epic technical teams to implement charging clean-up processes, such as updating charge codes, removing charges, and improving overall charging methodology.

– Partnering with client Revenue Integrity teams to implement process changes and updates to communication workflows.

– Establishing standard governance and operating procedures as needed.

• Evaluate CDM structure, charge capture workflows, and coding alignment with CPT, HCPCS, ICD-10, and payer-specific requirements as they relate to pediatric and perioperative services.

• Analyze documentation, coding patterns, and charge utilization to identify optimization opportunities and root causes of revenue variance and reimbursement risk.

• Develop structured findings, gap analyses, and prioritized recommendations aligned to regulatory guidance and industry best practices.

• Partner with client operational leaders, revenue integrity, compliance, and clinical departments (including perioperative and surgical services) to drive adoption of recommended changes.

• Support development of executive-level summaries outlining financial impact, compliance exposure, and implementation roadmap.

• Use Epic to validate charge logic, identify trends, and support data-driven recommendations.

• Maintain project documentation including status updates, issue tracking, and mitigation strategies.

• Travel to the client site as required (see Travel below).

Requirements:

• Active CCS, CPC, or equivalent coding credential.

• Demonstrated hands-on charge capture, CDM, and coding experience in a pediatric or children's hospital setting.

• Experience with perioperative / surgical services charging strongly preferred.

• Prior experience leading or participating in charging assessments and CDM reviews.

• Epic experience and working knowledge required, including charge logic, charge routing, and charging build.

• Experience with CDM structure, maintenance practices, and charge capture workflows.

• Experience developing training materials and facilitating training for operational staff and leadership.

• Ability to interpret data, estimate financial impact, and translate findings into actionable operational recommendations.

• Strong written and verbal communication skills, with the ability to present findings to operational and executive stakeholders.

• Ability to work independently across both the assessment and implementation phases.

• Consulting experience strongly preferred but not required.

• Willingness and ability to travel as described above.