Senior Strategic Consultant Revenue Integrity

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 The Wilshire Group, a renowned boutique consulting firm in Los Angeles, specializes in revenue cycle optimization and fostering effective collaboration between operational and IT facets. With a robust track record of aiding over 100 healthcare systems nationwide, our team thrives on professionalism, efficiency, and adaptability. Our core values- professionalism, efficiency, and flexibility- underscore our commitment to creating an inclusive and dynamic workplace. We embrace diverse narratives and believe in offering opportunities to exceptional individuals who bring their best to the table. Join us at The Wilshire Group, a place where talented professionals find a home to showcase their skills and contribute meaningfully to the healthcare landscape. Contract Role: Senior Strategic Consultant Revenue Integrity Location: California (Client Site – Some Travel Required) Duration: 6+ Months Contract (W2) Compensation: $90/hour (Non-benefited) Position Overview We are seeking a highly experienced Senior Strategic Consultant of Revenue Integrity to support a large healthcare organization in California. This role will focus on revenue cycle optimization, revenue integrity, and Epic system enhancements, working closely with both operational and IT stakeholders. This individual will play a critical role in driving performance improvements, optimizing workflows, and supporting ongoing Epic initiatives, including post-live optimization and strategic revenue cycle transformation efforts.

Key Responsibilities

• Serve as a strategic advisor to Revenue Cycle and Revenue Integrity leadership
• Lead and support Epic revenue cycle optimization initiatives, including Hospital Billing (HB) and Professional Billing (PB)
• Partner with clinical, operational, and IT teams to improve charge capture, billing workflows, and reimbursement performance
• Evaluate and enhance:
• Charge capture processes
• CDM (Charge Description Master) strategy and maintenance
• Workqueues and claim edits
• Denial prevention and revenue recovery workflows
• Provide project management leadership across multiple initiatives:
• Implementation planning
• Operational readiness
• Go-live and post-live support
• Facilitate cross-functional meetings, including executive-level reporting and strategy sessions
• Translate operational needs into Epic system design and build enhancements
• Support workflow redesign and process improvement initiatives
• Ensure compliance with payer, regulatory, and internal revenue integrity standards
• Assist with financial reporting, analytics, and performance tracking

Required Qualifications

• 10+ years of Epic Revenue Cycle experience
• Deep expertise in:
• Epic Resolute Hospital Billing (HB)
• Epic Resolute Professional Billing (PB)
• Proven experience in:
• Revenue Integrity
• Charge capture optimization
• CDM management and consolidation
• Denial management and claims optimization
• Strong background in Epic system build, configuration, and workflow design
• Experience leading large-scale implementations or optimizations within complex health systems
• Demonstrated ability to work as a liaison between operations and IT
• Strong project management and stakeholder engagement skills

Preferred Qualifications

• Epic Certifications in one or more:
• Resolute Hospital Billing
• Resolute Professional Billing
• Prelude / ADT / MyChart
• Experience with Epic reporting tools:
• Reporting Workbench
• SlicerDicer
• Dashboards and Reporting Universes
• Experience in academic medical centers or multi-hospital systems
• Background in integrated clinical charge capture and workflow optimization

Key Competencies

• Strategic thinking with a strong execution focus
• Ability to influence executive stakeholders
• Analytical problem-solving skills
• Strong communication and facilitation abilities
• Ability to operate independently in a consulting environment

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