Consulting Director, Clinical Documentation / Integrity

Job Family:

Finance & Accounting Consulting

Travel Required:

Up to 75%+

Clearance Required:

None

What You Will Do

Guidehouse is engineering revenue cycle and clinical integrity on a platform that can power the future of health services reimbursements. Complexity, friction and duplicity impede healthcare transactions. Our Finance group is focused on ensuring healthcare providers align contracts with the right reimbursement strategies/operations and engineer revenue cycle operations, simplify consumer experience, and minimize administrative cost. Our approach is to strategically and operationally elevate the entire healthcare experience for patients leveraging our full scope of reimbursement capabilities along with cutting-edge technology in machine learning, automation, and financial technology to reimagine revenue cycle.

You will be responsible for managing client relationships, overseeing account projects, and delivery of work. This position requires outstanding client management, problem-solving, and communication skills; experience leading complex revenue cycle engineering and operations spanning multiple teams and stakeholders; and managing C-suite relationships and communications. In this role, you will drive internal strategic and operational initiatives at the convergence of clinical documentation, risk adjustment and the electronic health record. Guidehouse is engineering revenue cycle and clinical integrity on a platform that can power the future of health services reimbursements. Complexity, friction and duplicity impede healthcare transactions. Our Finance group is focused on ensuring healthcare providers align contracts with the right reimbursement strategies/operations and engineer revenue cycle operations, simplify consumer experience and minimize administrative cost. Our approach is to strategically and operationally elevate the entire healthcare experience for patients leveraging our full scope of reimbursement capabilities along with cutting-edge technology in machine learning, automation and financial technology to reimagine revenue cycle.  Responsibilities Include:

Key Responsibilities:

• Support the growth of the team: help hire, develop, and mentor team members; plan by identifying and addressing bottlenecks, gaps, and risks
• Develop and maintain strong client relationships that provide leverage for decision-making and effective change management
• You will refine Guidehouse Clinical Documentation and Quality solutions and shape our consulting team and deliverables to identify and analyze current clinical documentation and coding to align and achieve excellence in risk adjustment, clinical documentation efficiency and medical management.
• Disciplined and focused on business growth, project execution and client satisfaction.  You will develop efficient workflows and implement technology solutions within the operating systems.
• Contribute to the design, documentation, and execution of repeatable and scalable client clinical integrity frameworks and client deliverables.
• You will provide account management strategies that deliver an industry leading client experience
• Work cross-functionally within Guidehouse revenue cycle/finance teams as well as our broader portfolio of healthcare services to bring integrated sustainable solutions to healthcare clients
• Proactively contribute to the strategic direction and priorities for the finance/RCM Operations team

What You Will Need:

• 10+ yrs. working in health system complex clinical documentation/quality/finance operations with a heavy focus leading clinical documentation/integrity strategy and operations design and implementation.
• Demonstrated success in complex problem solving and root cause analysis and structured solutioning to better engineer clinical documentation and coding for the consumer, business and clinician to measurably improve satisfaction and impact.
• 7+ yrs. experience independently owning senior level stakeholder relationships/communication and accountability for delivering successful cross-functional project outcomes
• 3+ yrs. management consulting experience managing client and internal teams responsible for revenue cycle engineering and operational effectiveness
• Proficient understanding of EMR applications (Epic and Cerner)
• 10+ yrs. exploring, interpreting and designing process workflows, data, and metadata to synthesize and execute strategies for process improvement
• You have the ability to quickly synthesize information and data and present to senior level stakeholders
• 3+ yrs. selling consulting or professional services (heavily preferred)
• Ability to create standardized processes with strong organization, time management and project management skills
• Bachelor's Degree from accredited college or university
• Travel up to 70% of the time to client site(s)

What Would Be Nice to Have:

• RHIA or RN, CCDS, CDIP, coding certifications
• Experience reimbursement requirements
• Working knowledge of the reimbursement requirements and guidelines
• Able to educate and present to clinicians and finance executives
• Graduate degree from accredited college or university MBA, MHA, MSA
• Working knowledge of AI and automation

The annual salary range for this position is $179,000.00-$298,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may be eligible for a discretionary variable incentive bonus

• Parental Leave and Adoption Assistance

• 401(k) Retirement Plan

• Basic Life & Supplemental Life

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability

• Student Loan PayDown

• Tuition Reimbursement, Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program

• Mobility Stipend

About Guidehouse

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.  Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.  Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.