Healthcare Claims Analytics Managing Consultant

Management Consulting Position

We are seeking experienced managers with subject matter expertise in healthcare claims data, including knowledge of validating, loading, processing, and analyzing healthcare claims data, preferably a variety of claims (Medicare, Medicaid, VA, Commercial). The role will lead strategy, analytics, and audit initiatives aimed at reducing improper payments, identifying fraud and anomalies, and determining payment trends that inform policy and drive cost savings. The successful candidate will :

• Serve as a strategic leader and thought partner in claims analytics, payment integrity, and reimbursement policy.
• Lead assessments of business and technical requirements for claims audits, post-payment analysis, and payment integrity strategies.
• Interpret complex healthcare data to identify anomalies, trends, and policy gaps.
• Translate insights into actionable business requirements and policy recommendations.
• Stay current on state-level healthcare transformation efforts and industry coding standards.
• Oversee the development of dashboards, reports, and analytics tools to support improper payment reduction.
• Apply general coding skills to build scalable solutions and support team members in technical execution.
• Direct in-depth data modeling, scenario analysis, claims analytics, or health system performance to inform strategic decisions.
• Provide hands-on training and mentorship to junior consultants and analysts.
• Facilitate knowledge transfer, promote continuous improvement, and enhance audit readiness across teams.
• Foster a collaborative culture that encourages innovation and career growth.
• Manage complex client engagements from inception to completion, ensuring high-quality outcomes.
• Lead business development efforts, including proposal creation and relationship management.
• Support internal strategy initiatives, including offering development and community engagement.

What You Will Need :

What Would Be Nice To Have :

The annual salary range for this position is $113,000.00-$188,000.00. 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.

Benefits include :

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 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.

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