Program Manager, Strategic Pricing - Revenue Management

The Program Manager of Pricing Strategies is responsible for collecting and monitoring the organization’s pricing, expense, and budget data. This includes, but is not limited to, collaborating with the vendor responsible for the organizational Charge Description Master (CDM), and maintaining Price Transparency and annual updates. This position will also contribute to the development of strategic pricing of retail services through bundling of services offered to the communities we serve.

Essential Job Functions

• Support Finance and leadership teams in analyzing budgets, revenue changes, and fiscal activities to identify trends, ensure compliance, and recommend improvements for revenue generation and expense reduction.

• ​Manage data modeling and query processes (e.g., SQL, EPIC Clarity) to derive actionable insights supporting strategic pricing, vendor assessments, and other initiatives.

• Contribute to the development and maintenance of pricing strategies, including strategic bundling of medical services, analysis of payer contracts, and competitive fee reviews.

• Review and update the chargemaster to ensure accuracy, compliance with billing regulations, and alignment with industry standards.

• Research and recommend updates to policies and procedures related to charge capture, price estimates, and billing compliance.

• Collaborate with operational leaders and vendors to manage charge descriptions, cost center assignments, EPIC charge entry, and reimbursement impacts.

• Oversee CMS and commercial payer updates, ensuring compliance with federal and state guidelines for price transparency and timely communication across the ministry.

• Research and implement pricing strategies for shoppable services, including surgery pricing schedules and market expansion opportunities.

• Provide analytical support to leadership, legal, and audit teams to address billing and compliance issues, and communicate updates to affected departments.

• Perform ad hoc analyses to address questions from leadership, develop relationships with key stakeholders, and maintain knowledge of revenue cycle processes.

This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Employees may be required to perform other job-related duties as required by their supervisor, subject to reasonable accommodation.

Education

• Bachelor’s degree in business, healthcare administration, or related field (required)

Work Experience

• 4+ years’ experience in healthcare revenue cycle or revenue management (required).

• 2+ years’ experience using Microsoft Office programs, role-specific software programs, and SQL, especially for the use of performing complex analysis of data and database maintenance (required).

• Working knowledge of CPT/HCPCS, UB-04 Revenue Coding, modifiers, billing regulations, DRG’s and APCs (required)

• Previous experience using Epic hospital, physician, and ambulatory resolute models (required).

• Understanding of the CDM and its relationship to related areas such as the General Ledger, cost Accounting, Productivity, Cost Reporting and Budget (preferred).

• Knowledge of clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy, Respiratory Therapy, Cardiology, or Oncology (preferred).

Working Conditions

Periods of high stress and fluctuating workloads may occur.

Long-distance or air travel as needed- not to exceed 10% travel.

General work at home office environment.

Prolonged periods of working alone.                                                                     

Skills

Hard/Tech/Clinical Skills:

• Budgeting & Financial Acumen​

• Advanced Microsoft Office Suite

• Analyzing data or information

• Communication, presentation

• SQL working with large data sets

• Build reports in Epic, Slicer Dicer, Revenue Cycle Analytics

• Meeting deadlines

Soft/Interpersonal Skills:

• Attention to detail

• Critical thinking

• Problem Solving

• Teamwork

• Active listening

• Relationship building

• Organization and planning

• Prioritization Time management

• Ability to work independently and collaboratively