Internal Consultant - CRI CDM & Pricing

Corporate Revenue Integrity Internal Consultant

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

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

Education:

Required - High school diploma or equivalent.

Preferred - Bachelor's degree in a related field or an advanced degree in finance, accounting, business/health administration.

Work Experience:

Required - 10 years of related professional experience;

OR

5 years related professional experience with a bachelor's degree.

Certifications:

Preferred - Related professional certification (e.g. CIA, CPA, CISA, CPC; CCS, etc.).

Knowledge Skills and Abilities (KSAs):

• 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.
• Ability to travel throughout and between facilities and work a flexible schedule (e.g. 24/7, weekend, holiday, on call availability).

Job Duties:

• 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.

The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Sedentary Work - Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met. Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid. There is no occupational risk for exposure to communicable diseases.

Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.