Guidehouse
Healthcare
HealthcarePaymentIntegrityAssociateDirector
Neural analysis suggests this role is
optimal for Director candidates.
“Healthcare Payment Integrity Associate Director at Guidehouse. Skills: Clinical documentation, Coding, Reimbursement, Payment integrity. Lead transformation engagements. Own delivery quality”
What You'll Achieve.
Measurable improvement opportunities; Monitor value realization
Industry & Context.
Root-cause analysis
Up to 25% travel, Ability to Obtain Public Trust clearance, US citizenship required
What They're Looking For.
Must Have
10+ years healthcare consulting, 10+ years industry leadership, Ability to obtain Public Trust clearance
Nice to Have
Master of Health Administration preferred, MBA preferred, MPH preferred, Other relevant advanced degree preferred, AAPC coding credentials, AHIMA coding credentials, Experience with healthcare technology, Experience with classification systems, Experience with clinical documentation solutions, Experience with coding solution environments, Experience with analytics-enabled transformation, Experience with AI-supported transformation, Experience across payer advisory, Experience with health information vendors, Experience with professional associations, Experience supporting reimbursement operations, Experience supporting payment operations, Knowledge of revenue cycle, Knowledge of DRG validation, Knowledge of audit/compliance, Knowledge of utilization improvement, Knowledge of quality improvement, Knowledge of risk adjustment, Knowledge of fraud, waste, and abuse, Knowledge of payment-integrity concepts, Experience designing education programs, Experience with thought leadership, Experience with market-facing content
What You'll Do.
Lead transformation engagements
Own executive communications
Own integrated storylines
Translate subject-matter depth
Advise senior stakeholders
Assess current-state workflows
Assess documentation practices
Assess coding operations
Define target-state processes
Define measurable improvement opportunities
Apply payer-provider expertise
Connect reimbursement mechanics
Connect classification systems
Connect payment policy
Connect risk adjustment
Connect incentive structures
Guide analytics-enabled transformation
Use revenue cycle data
Prioritize interventions
Monitor value realization
Design sustainable improvements
Develop executive-ready deliverables
Develop decision materials
Build high-performing teams
Mentor high-performing teams
Drive business development
Drive practice growth
Shape solution offerings
Develop reusable assets
Bring thought leadership
How You'll Work.
Team & Collaboration
Cross-functional engagements; Client stakeholders; Clinical leaders; Operational leaders; IT leaders; Compliance leaders; Finance leaders
Communication Scope
Executive communications; Executive presentations
Process & Methodology
Workplans, Staffing, Budgets
Full Job Description
**_Job Family_ :** Strategy & Transformation Consulting ** _Travel Required_ :** Up to 25% **_Clearance Required_ :** Ability to Obtain Public Trust _**What You Will Do:**_ * Lead multiple concurrent transformation engagements for federal health clients, owning delivery quality, workplans, staffing, budgets, executive communications, and integrated storylines across workstreams. * Serve as a senior SME in clinical documentation integrity, coding, revenue integrity, reimbursement, payment policy, and payment integrity, translating subject-matter depth into practical transformation roadmaps and operating model decisions. * Advise senior client stakeholders on the intersection of documentation, coding, claims/payment accuracy, quality measurement, utilization, denials, compliance, and financial performance. * Assess current-state workflows, documentation practices, coding operations, and performance drivers; identify root causes; and define target-state processes, governance, controls, and measurable improvement opportunities. * Apply payer-provider expertise to federal health environments, connecting reimbursement mechanics, classification systems, payment policy, risk adjustment, and incentive structures to operational and clinical outcomes. * Guide analytics-enabled transformation by using claims, revenue cycle, coding, and operational data to generate insights, size opportunities, prioritize interventions, and monitor value realization. * Partner with clinical, operational, IT, compliance, and finance leaders to design sustainable improvements in documentation quality, coding accuracy, audit readiness, provider education, and workflow efficiency. * Develop executive-ready deliverables, workshops, and decision materials that clearly communicate the “so what” for C-suite, program, and operational leadership. * Build and mentor high-performing teams through apprenticeship-style coaching, including upskilling staff in clinical documentation, coding, reimbursement, anal
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