Interim Charge Strategy & Cost Analyst

The Interim Enterprise Charge Strategy & Cost Analyst determines how supply and procedural cost should be represented in the health systems harge structure - not simply whether an item should carry a charge. The consultant builds and validates a reproducible supply-to-charge decision methodology, models the gross revenue, expected reimbursement, NPSR and margin consequences of each recommendation, secures Finance approval, partners with Revenue Integrity to build the approved logic, tests it at the claim level before production, and monitors realized performance afterward.

The role is analytic and advisory. It does not own the CDM, does not own the item master, and does not make unilateral pricing decisions. It owns the analysis and the recommendation that those owners act on.

Core accountabilities include: supply-to-charge analysis, reportability & billability determination, packaging & bundling evaluation, cost-to-charge methodology design, financial modeling, governance & approval, build partnership & claim testing, post-implementation monitoring, and methodology documentation.

Required

• Seven or more years in hospital or health system revenue integrity, reimbursement, chargemaster, or healthcare financial analysis, including direct accountability for charge structure or reimbursement modeling.

• Demonstrated experience in an acute care system of comparable complexity - multi-campus, with surgical, interventional cardiology and other high-supply-intensity service lines.

• Direct, hands-on OPPS and IPPS reimbursement analysis experience, including packaging determination and cost-to-charge ratio work.

• Demonstrated experience modeling the financial impact of charge structure changes prior to implementation, and validating results afterward against actual remittance.

• Working knowledge of item master to CDM mapping and supply charge capture workflow.

• Advanced Excel and working SQL capability, evidenced by exercise.

• Bachelor's degree in finance, accounting, health administration, health information management or a related field.

Strongly Preferred

• Cerner / Oracle Health revenue cycle and chargemaster experience. Meditech exposure is a meaningful plus to support one of their other campuses.

• Coding or revenue cycle credential: CCS, COC, CPC, RHIA, or CRCR / CHFP.

• Prior consulting or interim leadership experience - the ability to enter an organization, build credibility quickly, and produce inside a defined window.

• Experience with contract modeling tools and payer contract interpretation.

• Prior exposure to 340B program mechanics and drug acquisition cost reporting.

• Experience in a West Virginia, Kentucky or Ohio market, or comparable rural-plus-tertiary system configuration.

Typical Backgrounds That Fit

• Director or Manager of Revenue Integrity at a mid-to-large health system who has personally owned CDM strategy and reimbursement modeling.

• Chargemaster / reimbursement consultant from a healthcare advisory or Big Four practice with hands-on client delivery, not just methodology authorship.

• Senior reimbursement or decision support analyst from health system Finance who has moved upstream into charge strategy.

• Supply chain value analysis leader who has developed genuine reimbursement fluency - less common, but very effective when present.