Consulting Director, Clinical Documentation / Integrity

Consulting Director, Clinical Documentation / Integrity

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Overview

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.

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.

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
• 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. 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
• 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 focus on 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

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
• 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. If you require an accommodation, contact Recruiting Accommodation at or All information will be kept confidential and used only to provide needed reasonable accommodation.

All communication regarding recruitment will be sent from Guidehouse email domains. Guidehouse does not charge a fee at any stage of the recruitment process. Never provide banking information to third parties. If you suspect a scam, report to Guidehouse’s Ethics Hotline or contact

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse.