RI Director

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.

We are currently offering a contracted interim position at one of US News Best Hospitals 2022-23.  This position caters to top performers seeking a professional environment that acknowledges and values their dedication and proficiency.  While this role doesn’t offer benefits, it presents an opportunity to work within an organization that encourages talented individuals to surpass conventional boundaries.

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.

Why Wilshire? Employee Testimonial

“The number of RCM subject matter experts I get to work with each day is unreal.  Working alongside and as part of this team to help shape the RCM space is exciting.”-Patti Consolver, Director of Business Development 

Job Title: Interim Revenue Integrity (RI) Director
Location: Remote (covering hospitals in Maryland and two additional locations)
Job Type: Full-Time, Interim (Up to 6 Months) offering $90.00-$100.00 per hour

Position Overview:
We are seeking an experienced Interim Revenue Integrity (RI) Director to oversee revenue integrity operations across three hospitals, including one located in Maryland. This full-time, remote role is ideal for a senior-level professional with a strong background in hospital revenue cycle operations and proven experience managing professional billing (PB) operations. Prior experience with Maryland’s unique healthcare reimbursement models (e.g., Global Budget Revenue system) is highly preferred.

Key Responsibilities:

• Lead and manage the Revenue Integrity function across three hospital sites, ensuring compliance, accuracy, and efficiency in charge capture and billing processes.

• Oversee and support professional billing (PB) operations, including optimization of workflows, charge reconciliation, and revenue leakage prevention.

• Collaborate with Patient Financial Services, Compliance, Coding, and Clinical departments to ensure accurate and timely revenue recognition.

• Provide strategic direction to ensure regulatory and payer-specific compliance, especially related to Maryland’s healthcare regulations and All-Payer Model.

• Conduct audits and implement controls to monitor charge capture and billing accuracy.

• Train and mentor RI and PB teams to build operational excellence and ensure alignment with best practices.

• Identify areas for process improvement and develop action plans to enhance revenue outcomes.

Qualifications:

• Minimum of 7 years of progressive experience in hospital Revenue Integrity or Revenue Cycle leadership roles.

• Direct experience managing Professional Billing (PB) operations is required.

• Strong understanding of hospital charge capture, compliance, and payer reimbursement.

• Familiarity with Maryland’s hospital payment system (e.g., HSCRC, GBR) is highly preferred.

• Ability to lead cross-functional teams remotely and influence key stakeholders.

• Bachelor’s degree in healthcare administration, finance, or related field; Master’s degree preferred.

• Certifications such as CHRI, CHC, or CPC are a plus.

Contract Details:

• Duration: Up to 6 months

• Location: Remote

• Start Date: ASAP