Job Family:
Business Systems Analysis (ESA), Operational Effectiveness (ESA)

Travel Required:
Up to 10%

Clearance Required:
Ability to Obtain Public Trust

What You Will Do:

We are seeking experienced Revenue Cycle Management (RCM) professionals to support large-scale transformation initiatives within a Federal healthcare environment. These roles contribute to modernization efforts across enterprise electronic health record (EHR) platforms, including Oracle Health / MHS GENESIS, and support optimization of billing, coding, analytics, communications, and system workflows.

Candidates will collaborate with cross-functional stakeholders, develop high-quality deliverables, and drive improvements in revenue cycle performance, compliance, and operational efficiency.

Responsibilities are as follows, to include but not limited to:

Revenue Cycle Operations & Optimization

• Support end-to-end RCM functions including registration, coding, billing, claims, and reimbursement
• Analyze workflows and identify opportunities to reduce revenue leakage and improve efficiency
• Conduct charge capture validation and reconciliation between clinical and billing outputs
• Support Chargemaster (CDM) maintenance and optimization

System Configuration & EHR Support

• Assist in configuration, validation, and troubleshooting of EHR revenue cycle workflows (Oracle Health / Cerner / MHS GENESIS)
• Analyze billing rules, charge routing logic, and system integrations
• Partner with IT and configuration teams to resolve technical issues affecting claim generation and processing

Data Analysis & Reporting

• Analyze financial, clinical, and operational data to identify trends and improvement opportunities
• Develop dashboards, reports, and executive summaries using tools such as SQL, Power BI, Tableau, or similar
• Track key performance indicators (KPIs) across revenue cycle functions
• Perform data validation, quality checks, and root cause analysis

Claims & Denial Management

• Investigate claim edits, rejections, and denials
• Conduct root cause analysis related to coding, documentation, system configuration, or payer rules
• Recommend and implement corrective actions to improve first-pass payment rates

Compliance & Auditing

• Perform chart-to-bill audits ensuring accurate coding and documentation
• Ensure compliance with CPT, ICD-10, HCPCS, NCCI edits, and federal regulations (e.g., CMS, TRICARE, DHA)
• Support audit readiness and regulatory reporting requirements

Communication & Stakeholder Engagement

• Develop and deliver clear, concise communication products (presentations, reports, newsletters, briefings)
• Translate complex technical and operational information into stakeholder-friendly messaging
• Support leadership briefings, program updates, and change management communications
• Coordinate across teams to ensure consistent messaging and alignment

Change Management & Process Improvement

• Support implementation of system and workflow changes across the organization
• Develop communication and training materials to drive adoption
• Identify and implement process improvements to enhance performance and compliance

What You Will Need:

• Must be able to OBTAIN and MAINTAIN a Federal or DoD "PUBLIC TRUST"
• Bachelor's degree; four (4) additional years of professional experience may be used in lieu of a degree.
• THREE (3) or more years of professional experience in revenue cycle management, healthcare consulting, or other relevant field

What Would Be Nice To Have:

• Bachelor's degree in Healthcare Administration, Business, Communications, Information Systems, or related field
• Experience with EHR systems (Oracle Health/Cerner, Epic, or similar), preferably MHS GENESIS
• Strong understanding of healthcare billing, coding (CPT, ICD-10, HCPCS), and revenue cycle operations
• Experience analyzing data and developing reports or dashboards
• Excellent written and verbal communication skills
• Strong organizational skills with ability to manage multiple priorities
• Experience supporting Federal healthcare agencies (DoD, DHA, VA, or similar)
• Familiarity with Military Health System (MHS) operations
• Certifications such as PMP, CAPM, CPC, CCS, RHIT, or RHIA
• Experience with analytics tools (SQL, Power BI, Tableau, Python)
• Experience in large-scale healthcare transformation or EHR implementation programs
• Knowledge of healthcare data systems, reporting platforms, and interoperability

The annual salary range for this position is $61,000.00-$101,000.00. 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