Revenue Cycle Senior Solution Tech Expert - Health Information Management Coding Specialist

Revenue Cycle Management Senior Solution Technical Expert

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 and clinically 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.

What You Will Need:

• 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.

What Would Be Nice To Have:

• 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.
• PMP or CAPM Certification.
• Certified Revenue Cycle Representative (CRCR).
• Knowledge of the healthcare sector, including such domains as public health, provider, and life sciences.

The annual salary range for this position is $80,000.00-$133,000.00. 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.

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.

• 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 EmployerProtected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with