Director of Enterprise Charge Description Master

Catholic Health • Melville, NY

8d • Hybrid

About The Position

The Director of Enterprise Charge Description Master (CDM) provides strategic and operational leadership for the health system’s charge infrastructure, ensuring accuracy, compliance, and alignment with reimbursement and financial performance objectives. Reporting to the Vice President of Revenue Cycle, this role is accountable for the governance, integrity, and optimization of all charge-related activities across the enterprise. This position plays a critical role in driving net revenue performance by ensuring compliant charge capture, defensible pricing strategies, and accurate reimbursement across all care settings. The Director partners closely with Revenue Cycle, Finance, Managed Care, Clinical Operations, IT, and Procurement to standardize processes, mitigate revenue leakage, and support system-wide financial sustainability. In addition, the role leads the evaluation of new services, procedures, and technologies through a multidisciplinary governance structure. This includes assessing reimbursement, cost, and margin implications to inform decision-making and ensure alignment with organizational growth and profitability targets.

Requirements

• Advanced knowledge of CPT, HCPCS, ICD-10, DRG, OPPS, APC, and managed care reimbursement methodologies
• Strong analytical, financial, and strategic pricing capabilities
• Demonstrated expertise in regulatory compliance and audit risk mitigation
• Strong project management and organizational skills
• Excellent written, verbal, and interpersonal communication skills
• Ability to lead cross-functional teams and influence decision-making at all levels
• Ability to manage multiple priorities in a fast-paced environment
• Demonstrated ability to use MS Office and presentation tools as necessary
• Bachelor’s Degree in Healthcare Administration, Business, Finance, or related field required (or equivalent experience)
• 7–10 years of Revenue Cycle experience with functional expertise / hands on ownership of CDM governance, revenue integrity, and reimbursement optimization across multiple care settings (acute, ambulatory, post acute).
• Demonstrated outcomes improving net revenue, reducing charge lag/leakage and strengthening audit and compliance performance
• Experience with EPIC (Resolute, Charge Router, Charge Review WQs) with experience leading large scale CDM builds, conversions and pricing initiatives.
• Payer and Reimbursement expertise across Medicare, Medicaid, Commercial 3rd party payers: OPPS, Fee Schedules, and value based models

Nice To Haves

• Dual competency in coding and revenue integrity (CPT/HCPC/ICD-10) with the ability to translate regulatory requirements into operational CDM strategy.
• Clinical background (e.g., nursing, allied health, or clinical operations) preferred to support alignment between clinical services, documentation, and charge capture
• Recognized certifications: RHIA, RHIT, CCS, CPC (or equivalent); advanced certifications in revenue integrity or compliance are a plus
• Financial acumen with experience in pricing strategy, cost modeling, and margin analysis tied to new services and technology
• Strong cross functional leadership with a track record of influencing Finance, Managed Care, Clincal Ops, and IT to drive enterprise adoption

Responsibilities

• Provide enterprise oversight of CDM structure, ensuring accuracy of CPT/HCPCS codes, revenue codes, charge descriptions, and methodologies
• Ensure compliance with CMS, Medicare transmittals, NCCI edits, OPPS/EAPG, and payer-specific requirements
• Lead quarterly and annual CDM updates, including regulatory changes (MUEs, Modifier 25, IP-only procedures, NTAP, pass-through devices)
• Develop and maintain CDM policies, procedures, and audit controls to mitigate compliance risk and revenue leakage
• Oversee EPIC CDM build integrity across all modules (Willow, Optime, Radiant, EpicCare IP/OP)
• Ensures compliance with the Federal transparency laws including any necessary preparation and submission of charge files and posting of files.
• Lead development and execution of system-wide strategic pricing initiatives, aligning to market conditions and reimbursement methodologies
• Identify revenue opportunities through charge capture improvement, under-coded services, and reimbursement variance analysis
• Partner with Managed Care, Revenue Cycle and Finance, ensuring CDM structure is in compliance with payer contract terms (DRG, OPPS, APC, Fee Schedules)
• Monitor billing accuracy, denial trends, and charge-related revenue leakage and make recommendations for billing alternatives and or modifications to charges, contracts and build.
• Ensure CDM changes are operationalized within clinical and departmental workflows
• Standardize charge capture processes and work queues (CFB, DFB, charge review) to improve clean claim rates and reduce DNB
• Oversee resolution of CDM related charge errors and EPIC work queue management (error pools, charge reconciliation)
• Collaborate with Revenue Integrity, HIM, and Clinical departments to ensure alignment between documentation, coding, and charging
• Active participant in the Enterprise New Products Committee
• Evaluate new procedures, services, devices, and technologies prior to implementation
• Collaborate with Patient Access, Managed Care, Billing, Finance, Procurement, and Clinical leadership to ensure: Appropriate coding, charge build, and pricing strategy, Coverage, authorization, and reimbursement validation, Coding in accordance to payer processing and reimbursement terms, Financial viability and margin expectations prior to go-live
• Monitor post-implementation performance including volume, reimbursement, and margin outcomes
• Oversee integration and optimization of CDM tools (EPIC, FinThrive, 3M, KnowledgeSource)
• Partner with IT and DTS to manage system edits, code integration, and automation opportunities
• Ensure third-party systems (Radiation Oncology, Cardiology, Laboratory, Blood Bank) align with enterprise CDM structure
• Develop and maintain reporting and dashboards to monitor CDM performance and revenue impact
• Serve as enterprise subject matter expert for CDM, charging, and reimbursement
• Lead cross-functional collaboration across Revenue Cycle, Finance, IT, Managed Care, and Clinical Operations
• Provide education and training on CDM updates, regulatory changes, and charging practices
• Drive accountability for compliance, operational performance, and financial outcomes
• Strong project management skills in the areas of managing and updating workflows, technical documentation, and other associated materials related to large scale implementation projects
• Excellent written communication, verbal communication, interpersonal, time management, and organizational skills
• Ensure adherence to all Federal, State, and regulatory requirements including Medicare, Medicaid, and HIPAA
• Maintain compliance with organizational policies, procedures, and security standards
• Conduct activities consistent with CHS policies and non-discrimination standards

Benefits

• generous benefits packages
• generous tuition assistance
• a defined benefit pension plan
• a culture that supports professional and educational growth

What This Job Offers

• Job Type: Full-time
• Career Level: Director