Internal Consultant CRI CDM & Pricing

Weve made a lot of progress since opening the doors in 1942 but one thing has never changed - our commitment to serve heal lead educate 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 -Bachelors 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 bachelors 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.

This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety patient privacy and/or other compliance-related concerns.

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.

Physical and Environmental Demands
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 (Occasionally: activity or condition exists up to 1/3 of the time) and/or a negligible amount of force frequently (Frequently: activity or condition exists from 1/3 to 2/3 of the time) 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.

Are you ready to make a difference Apply Today!

Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.

Please refer to the job description to determine whether the position you are interested in is remote or on-site. Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado California Hawaii Illinois Maryland Minnesota New Jersey New York Vermont Washington and Washington D.C.

Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website or if you need an accommodation to complete the application process please contact our HR Employee Solution Center at (select option 1) or. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

Ochsner is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to any legally protected class including protected veterans and individuals with disabilities.