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GUGuidehouse is a global consultancy providing advisory, digital, and managed services to commercial and public sector clients, enabling them to navigate complex challenges with innovative solutions.
Guidehouse is currently seeking Revenue Cycle Management (RCM) professionals in support of our Military Health System client. These teammates will bring a vast range of experiences across RCM within an electronic health record (EHR). The candidate should have experience working in Federal Healthcare space, and preferably the Defense Health Agency, the Services, and/or Health Affairs. The candidate will lead the development of work products and deliverables; establish relationships with primary clients and stakeholders; and identify opportunities to improve processes. The candidate will also support business development across the MHS.
The Revenue Cycle Modernization & Innovation (RCMI) Senior Solution Technical Expert (SSTE) assists the Military Health System client with optimization, reconfiguration, and enhancements to the RCM capabilities within an EHR.
Provide health informatics subject matter expertise in support of the working groups and assist in the response to and management of requests specific to designated care areas.
Analyze current coding workflows in MHS GENESIS and identify inefficiencies.
Design and implement optimized coding workflows that align with RCM goals.
Configure automated routing of coding tasks based on encounter type, provider specialty, and documentation completeness.
Collaborate with IT and clinical teams to ensure workflow changes are technically feasible andclinically appropriate.
Ensure workflows support accurate and compliant coding practices (ICD-10, CPT, HCPCS).
Integrate coding edits and validation rules to reduce denials and improve first-pass yield.
Monitor updates to coding guidelines and incorporate changes into workflow logic.
Develop a continual improvement process model to establish/improve products, services, and processes related to the sustainment of the MHS GENESIS.
Review and make recommendations to improve end-to-end workflows that meet expected outcomes (e.g., clinical needs, data quality) and patient/provider experience.
Support data governance, data management, automation/Robotic Process Automation (RPA) activities, security, metadata and user communities.
Perform Oracle Health (Cerner) EHR configuration support tasks and review/update builds.
Assist with the design of clinical workflows that incorporate business functions.
Establish ongoing support and feedback mechanisms to collect user input for continuous improvement; leverage LightsOn to make recommendations on process improvements.
Support Revenue Cycle activities, such as charge capture, patient access, medical coding, and revenue cycle optimization.
Provide health informatics subject matter expertise.
Create visual dashboards and presentations using MHS Data; develop slides / analysis using dashboards.
Assist with development, maintenance, and iterative improvement of working groups/project teams, including charter development, schedule working group/project meetings, track tasks to completion, and assist with planning and execution of workshops/summits
Participate in the development and maintenance of a collaborative relationship with VA counterparts
Contribute to Innovation/Academics/Interoperability such as pilots and use-cases to leverage MHS GENESIS
Develop dashboards and reports based on government lead priorities.
Lead the development of work products and deliverables; manage recurring tasks and work products.
Work with executives and other business leaders to identify opportunities for improvement.
Develop slide decks / presentations and Memorandums to/from DoD Senior Leaders
Collaborate with stakeholders to track progress on MHS initiatives to meet legislative and Departmental requirements
Bachelor’s Degree in Business, Management, Healthcare Administration, Business Analysis, Statistics, or related field
Minimum of FOUR (4) years’ experience is preferred with direct Oracle/Cerner EHR RCM Solution initial builds, trouble shooting, issue resolution, and system reconfigurations.
Minimum of FOUR (4) years of experience in project management / management consulting / Implementation lead
Must be U.S. citizen and be able to obtain a Public Trust clearance
Possess skill sets to flawlessly perform as technical build and system configuration expertise for MHS GENESIS RCM optimization, reconfigurations, and enhancements to existing and future identified gaps impacting workload and revenue capture.
Demonstrate ability to oversee and independently development, implementation, and validation testing of MHS GENESIS systematic builds within the RCM solution sets.
Experience with ticket queuing system issue resolution processes.
Professionally interact with identified RCM internal and external functional stakeholders to seamlessly implement resolutions to existing and/or future issues or requirement enhancements/optimizations.
Experience with development, modification, optimization, and integration of RCM workflows into clinical workflows. This requirement also involves knowledge of system errors caused by outdated or incorrectly built workflows with ability to troubleshoot/identified impacted workflows requiring review and potential medication.
MHS business knowledge and experience to support DHA RCM functional stakeholders with Defense Health Agency, Defense Health Networks, and Miliary Treatment Facility communications, education, and training to expedite enhanced end user learning and understanding.
Experience with educational course material design and build for DHA MHS GENESIS RCM Solution Owner Teams, and intermediate and advanced end user training that includes Edit Failures from the Alpha ii Scrubber and SSI Clearinghouse Scrubber. Identification of missing training components impacting end users’ ability to consistently complete encounters in streamlined and expedited manner.
Understanding of the clinical/business workflows and human factors/usability standards
Ability to develop dashboards using data visualization applications such as Tableau or Microsoft Power BI
Knowledge of the use of Microsoft Office Products and related applications
Ability to work with stakeholders to assess potential risks.
Ability to translate business requirements into non-technical and technical documents
Demonstrates abilities and success with identifying and addressing client needs: actively participating in client discussions and meetings; communicating a broad range of firm services; preparing concise, accurate documents
Must be organized, self-motivated and able to multitask in a fast paced and dynamic work environment
Demonstrated ability to excel both independently and as a team member in a lively, collaborative environment
Possess an acute awareness of organizational cultures and political savvy
Excellent written and verbal communication skills, including ability to present to executive leadership
Ability to managing deadlines and recurring deliverables
Demonstrated experience with the DoD; Military Health System experience a plus.
Experience with leading small teams, coaching and collaborating with colleagues, providing feedback and guidance on work performance.
Certified Revenue Cycle Representative (CRCR)
Knowledge of the healthcare sector, including such domains as public health, provider, and life sciences.
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.
Personal and Family Sick Time & Company Paid Holidays
Position may be eligible for a discretionary variable incentive bonus
Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
Tuition Reimbursement, Personal Development & Learning Opportunities
Corporate Sponsored Events & Community Outreach
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.
Full Time
Salary: 80k-133k USD
United States +/- 0 hoursLearn more about Guidehouse and their company culture.
At the heart of what we do is a culture of purpose-driven consulting that empowers us to tackle some of the most pressing challenges faced by both commercial and public sector clients. Guidehouse, a next-generation global consultancy, is committed to leveraging our vast expertise to help clients navigate complexities across diverse industries and geographies. Our teams are dedicated to innovating solutions that disrupt traditional consulting delivery models, thus fostering collaborations that create resilient and transformative outcomes.
Founded in 2018 and with roots extending from PricewaterhouseCoopers LLP's public sector work, we have built a reputation for not only providing advisory, digital, and managed services but for genuinely impacting the sectors we serve, including national security, healthcare, energy, and infrastructure. With over 16,000 professionals, we are devoted to outwitting complexity and achieving meaningful change through integrity, inclusivity, and sustainability. Our commitment does not end with exceptional service delivery; we also prioritize social responsibility and strive to enhance the communities in which we operate. In essence, Guidehouse is not just guiding clients; we are pioneering paths for future innovation and success.
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