Ochsner Health-posted 3 months ago
Mid Level
New Orleans, LA

This role is part of the Corporate Revenue Integrity (CRI) team and plays a key role in supporting strategic pricing initiatives across a large, multi-entity health system. The scope includes acute care hospitals, long-term acute care facilities, rural health clinics, critical access hospitals, and provider-based clinics, with responsibility for both technical and professional fee pricing. The Internal Consultant works independently within approved pricing methodologies and regulatory frameworks to analyze pricing requests, evaluate facility pricing structures, and audit fee schedules for accuracy and consistency. The role requires the ability to confidently make and support recommendations based on data-driven analysis. Candidates must be comfortable working in a fast-paced environment with tight deadlines, and navigating the complexities of a large, integrated health system.

  • Apply approved pricing methodologies to daily pricing requests across diverse facility types.
  • Conduct ongoing audits of fee schedules to identify inconsistencies and opportunities to strengthen pricing integrity.
  • Collaborate with clinical, financial, and operational teams to ensure pricing decisions are informed, executable, and aligned with organizational standards.
  • Facilitates processes/operations required for new services/location, service location changes, and new technology/equipment to ensure accurate and complete set-up and implementation.
  • Support Epic CDM workflows and maintain pricing accuracy across systems.
  • Contribute to high-visibility projects with zero-error tolerance.
  • Stay current with federal and state regulatory requirements related to pricing transparency, reimbursement, and charge structure compliance.
  • Participates in research, training, and education that supports the project.
  • Escalates issues that may not put the project at risk; recommends solutions.
  • Ensures data integrity and quality control.
  • Ensures projects remain within budget.
  • Performs other related duties as required.
  • High school diploma or equivalent.
  • 10 years of related professional experience; OR 5 years related professional experience with a bachelor's degree.
  • Mastery-level Excel skills (advanced formulas, modeling, pivot tables, etc.).
  • Strong communication skills to engage effectively with stakeholders at all levels.
  • Deep understanding of reimbursement models across various facility types.
  • Proficiency in Epic charging workflows and CDM management.
  • Exceptional attention to detail and organizational skills.
  • Ability to confidently present and support pricing recommendations.
  • Commitment to staying informed on regulatory changes impacting pricing and CDM practice.
  • Ability to work in a fast-paced environment with tight deadlines, and navigating the complexities of a large, integrated health system.
  • Proficiency in using computers, software, and web-based applications.
  • Strong interpersonal and leadership skills.
  • Organizational, time management, and project management skills.
  • Bachelor's degree in a related field or an advanced degree in finance, accounting, business/health administration.
  • Related professional certification (e.g. CIA, CPA, CISA, CPC; CCS, etc.).
  • 401k
  • health_insurance
  • dental_insurance
  • vision_insurance
  • life_insurance
  • disability_insurance
  • paid_holidays
  • paid_volunteer_time
  • tuition_reimbursement
  • professional_development
  • flexible_scheduling
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