The Wilshire Group

Program Manager

• Seek opportunities to collaborate with stakeholders, customers, and impacted departments to recommend appropriate training solutions and program improvements
• Develops, maintains, and/or delivers curriculum to support revenue cycle operations
• Work with operational managers to review key performance indicators (KPIs) to identify training opportunities/improvements
• Gathers information, assesses needs, and prepares reports on training needs based on operational education requests
• Collaborates with all levels of employees and management to facilitate, engage, and positively influence the instructional and training environment
• Plans, develops, and/or presents training materials, tools, and information regularly
• Interprets and shares reports on current training program impact and efficacy
• Provide support to Revenue Cycle Leaders for current and future training needs
• Understand revenue cycle metrics for incorporation into training objectives
• Utilize appropriate formats and platforms for training content development and delivery
• Identify areas of opportunity for optimization and improvement within educational programming
• Synthesize information received from operational leaders for incorporation into existing training
• Develop goals and priorities for educational programming
• Design and implement appropriate plans to meet goals.

Revenue Cycle Academy Program Manager

Project Manager

• Provide executive-level leadership for Epic implementation and optimization initiatives across hospital and ambulatory environments.
• Direct all phases of Epic project lifecycle: assessment, design, build, testing, go-live, stabilization, and long-term optimization.
• Lead revenue cycle, HIM, coding, and documentation workflows through integrated Epic and third-party system deployments.
• Develop and execute comprehensive project plans, ensuring alignment across operational leaders, IT analysts, and vendor partners.
• Manage cross-functional teams, including analysts, business SMEs, operations leaders, and clinical partners.
• Oversee governance, communication plans, risk mitigation, scope management, resource allocation, and executive reporting.
• Serve as key liaison between operations and IT, translating business needs into technical design and system configuration.
• Conduct operational workflow assessments, identify underutilized functionality, and guide optimization to improve performance.
• Manage third-party integrations such as 3M 360, coding products, claim attachment systems, and payer platform tools.
• Ensure regulatory compliance across HIM, documentation, coding, correspondence, and revenue cycle functions.
• Lead multi-site Epic go-lives, including readiness assessments, command center planning, end-user training strategy, and post-live stabilization.

Epic Implementation Executive – Project Manager

• Conduct prospective reviews of charge capture practices in the clinical departments and report findings, provide education to staff responsible for charge capture, coordinate charge capture improvement tools in collaboration with Revenue Cycle IT team, evaluate revenue impact, monitor ongoing compliance and expected versus actual revenue changes. Report potential compliance issues for further analysis and follow-up to the Compliance Department.
• Facilitate clinical SME use of Vitalware for submitting CDM requests with a focus on regulatory coding, compliance and adherence to internal guidelines regarding CDM maintenance, standard naming conventions and pricing integrity.
• Lead the approval of CDM new charges.
• Update and distribute regulatory guidance changes.
• Create and distribute the monthly newsletter.
• In collaboration with Compliance Department, provide education to clinical department staff regarding CPT codes, HCPCS codes, revenue codes and modifiers and their compliance use.
• Lead projects to improve revenue compliance, efficiencies in the charge capture process,and CDM charge structures.
• Perform basic financial analyses to report the impact of payment changes resulting frompayer practices and CMS regulation changes. Reports financial impact of charge capture practice changes and corrections to current practices. Communicate findings fully with clinical departments and executive team.
• Reviews EPIC WQs, conduct research needed to resolve the account issues and identify gross and/or net revenue benefit expected from all account corrections completed.
• Review Vitalware CCA file daily to discover and identify system compliance issues and revenue opportunities, conduct root cause analyses to correct identified charge capture issues, and report the gross and net revenue differential resulting from each discovery and correction completed.
• Develop criteria for reporting revenue performance to a variety of audiences including faculty, DFA’s, Division and Clinic Chiefs, the Director of Revenue Integrity, and others as appropriate.
• Responsible for presenting reports to a variety of audiences. Such reports will be accompanied by a thorough understanding of content and reasonable explanations for variations from the budget.

Revenue Integrity Program Manager

Operations

• Manage day-to-day HB outsourced operations across the hospital, ASC, and outpatient settings.
• Serve as the liaison between internal finance teams and the outsourced billing partner.
• Monitor KPIs, including DNFB, AR days, and clean claim rate; implement corrective actions as needed.
• Oversee the integration of newly acquired entities and ensure alignment with organizational revenue cycle policies.
• Identify process improvement opportunities and ensure adherence to payer compliance and regulatory standards.
• Collaborate with leadership to optimize workflows and maintain financial integrity.

Revenue Cycle Operations Manager

Frontend Engineer

• Assess current front-end processes within clinic settings and identify transition roadmap to RC ownership.
• Lead efforts to standardize and centralize registration, scheduling, and RTE workflows.
• Collaborate with clinic managers and RC leadership to ensure seamless handoff of patient access responsibilities.
• Train front-end teams on best practices to enhance patient experience and improve data accuracy.
• Support system optimization, testing, and policy development for front-end operations.

Front-End Revenue Cycle Lead – Dental & Ambulatory Practices

Strategy

• Lead and manage full-cycle revenue cycle transformation and implementation projects, including assessment, design, build, testing, training, and go-live support.
• Act as a strategic advisor to health system executives on optimizing Patient Access, HIM, Coding, and Clinical Documentation workflows.
• Oversee revenue cycle readiness for enterprise initiatives such as Epic Refuel, 3M 360/Single Path implementation, and front-end denial management programs.
• Direct cross-functional project teams, ensuring coordination between operations and IT to meet project milestones, budgets, and deliverables.
• Conduct workflow optimization sessions and translate business requirements into actionable system configurations and operational plans.
• Provide mentorship and training to client teams to sustain long-term improvement.
• Develop and present executive-level dashboards, ROI analyses, and key performance reports.
• Collaborate with partner organizations to ensure seamless implementation and data integrity across integrated systems.

Senior Strategic Advisor – Revenue Cycle Implementation

Manager

• Lead high-profile group to improve revenue results across clinical and financial processes
• Provide guidance and expertise to CDM and Revenue Integrity staff and facility and clinic department leaders
• Review, identify, and analyze CPT changes related to quarterly and annual AMA CPT updates and regulatory changes by timelines set
• Analyze changes to coding and billing rules and adapt systems and processes accordingly
• Process CDM requests, research references and regulations, and assign charge codes per system policies and direction from Revenue Integrity Liaisons
• Work with Revenue Integrity Liaisons and clinical departments to create new CDM items and pricing for new services and items
• Provide mentoring, guidance, and assist development of CDM Coordinator and other CDM efforts
• Emphasize project management, data analysis, and payor contract optimization to maximize reimbursement

Revenue Integrity Manager

Analyst

• Epic Analysts (Tier I or II) to join our consulting team. This role is fully remote with minimal travel requirements. Analysts will support day-to-day Epic operations, build, and optimization while collaborating with hospital stakeholders to ensure clinical and operational excellence.
• Provide Epic application support, build, and configuration for assigned modules.
• Troubleshoot system issues and work with end-users to ensure seamless functionality.
• Collaborate with hospital IT and clinical teams to optimize workflows.
• Document technical requirements and implement approved system changes.
• Participate in testing, training, and go-live activities as needed.

Epic Analyst, Tier II

• The Wilshire Group is seeking experienced Epic Analysts (Tier I or II) to join our consulting team. This role is fully remote with minimal travel requirements. Analysts will support day-to-day Epic operations, build, and optimization while collaborating with hospital stakeholders to ensure clinical and operational excellence.
• Responsibilities: Provide Epic application support, build, and configuration for assigned modules.
• Troubleshoot system issues and work with end-users to ensure seamless functionality.
• Collaborate with hospital IT and clinical teams to optimize workflows.
• Document technical requirements and implement approved system changes.
• Participate in testing, training, and go-live activities as needed.
• Qualifications: 5+ years of Epic experience in a hospital or healthcare setting.
• Current Epic certification(s) in assigned module(s).
• Strong understanding of healthcare operations and workflows.
• Experience with Epic implementations preferred.
• Bachelor’s degree preferred (or equivalent experience).

Tier I Epic Analyst

• Lead build, testing, and optimization efforts within Epic.
• Provide technical and operational expertise for assigned module(s).
• Coordinate with client leadership, analysts, and clinical stakeholders to align system functionality with organizational goals.
• Mentor and support Epic Analysts on project tasks.
• Participate in system upgrades, integration, and workflow redesign.
• About the Role: The Wilshire Group is looking for a highly skilled Epic Lead Analyst to guide implementation and optimization efforts across Epic modules. The Lead Analyst will serve as a subject matter expert and mentor for the analyst team, ensuring successful project delivery and system adoption.

Lead Analyst, Epic

• Epic Implementation Analyst to support client hospitals during system implementation and post-go-live optimization. This role will focus on ensuring Epic functionality aligns with clinical and business needs, providing both technical and workflow expertise.
• Actively participate in new Epic implementations and system optimization projects.
• Collaborate with hospital leadership, clinicians, and IT staff to ensure seamless integration.
• Translate hospital operational needs into Epic workflows and system configuration.
• Support testing, training, and cutover/go-live activities.
• Provide post-go-live support and optimization guidance.