Guidehouse
Healthcare Technology Consulting - Revenue Cycle Management (RCM) Functional Lea
Guidehouse, Washington, District of Columbia, us, 20022
Healthcare Technology Consulting - Revenue Cycle Management (RCM) Functional Lead
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Job Family
Technology Consulting
Travel Required
Up to 50%
Clearance Required
None
Guidehouse’s Health IT Solutions team works with clients to measurably improve their technology outcomes through a mix of IT strategies, improvement in IT operations, and adoption of technology initiatives. By leveraging a deep understanding of health system IT operational best practices supported by data, Guidehouse propels IT operational improvement and technology adoption across departments and service lines at client organizations.
What You Will Do The Technical Healthcare Revenue Cycle Lead will oversee the design, configuration, validation, and deployment of an ERP solution across the entirety of a health system for a public client. This role requires deep expertise in public sector healthcare billing, including long‑term care, behavioral health, and pharmacy operations. The Lead will serve as the primary liaison between the Revenue Cycle Advisory Council, client health teams, and stakeholders, ensuring that the solution meets the client's complex financial, regulatory, and operational requirements.
Key Responsibilities
Revenue Cycle Design and Configuration
Lead the functional design and configuration of ERP solutions, ensuring alignment with client billing workflows, including long‑stay inpatient billing, trust account management, and pharmacy claims
Develop and validate workflows for interim monthly billing, Medicare Part D, Medicaid eligibility, and resident trust accounts
Oversee the upload and validation of the Charge Description Master (CDM), ensuring CPT/HCPCS code alignment with procedures and services
Collaborate with the Patient Accounting and Practice Management teams to configure registration, scheduling, and eligibility workflows
Design and validate EMRN/MRN strategies to support cross‑agency patient identity management
Ensure compliance with federal and state clients, CMS and HFMA MAP standards for billing, reimbursement, and financial reporting
State‑Specific Revenue Cycle Requirements
Translate client‑specific billing needs into system requirements, including:
Long‑term care billing cycles and interim claims
Resident trust account workflows, including deposits, withdrawals, and reconciliation
Federal/state community services billing, including vendor‑submitted claims and EIM system integration.
Service authorization workflows and capacity management for behavioral health services
Integrations for financial tracking and reporting
Collaborate with state finance and compliance teams to ensure accurate grant and funding reports for state and federal programs.
Testing and Validation
Lead parallel revenue cycle testing, reconciling results with legacy MEDITECH systems
Validate charge capture, claims generation, eligibility verification, and electronic remittance advice (ERA) posting
Ensure readiness for day‑one revenue cycle operations, including cash flow continuity and billing compliance
Collaborate with Testing Lead and Data Migration Lead to validate financial data accuracy and integrity
Stakeholder Engagement and Governance
Serve as the primary point of contact for revenue cycle stakeholders, including the Revenue Cycle Advisory Council, billing teams, HIM, and finance leadership
Participate in Change Control Board (CCB) and Steering Committee meetings to evaluate financial impacts of scope changes
Provide executive‑level reporting on revenue cycle readiness, risk posture, and performance metrics
Facilitate workshops and design sessions with state agencies to gather requirements and validate workflows
What You Will Need
Bachelor's Degree
Minimum 5 years of leadership experience in healthcare revenue cycle operations roles
Proven experience implementing Oracle Health RevElate in public sector or complex payer environments.
Deep understanding of State and Federal billing requirements, including long‑stay inpatient billing, trust accounts, and behavioral health reimbursement
Experience with HFMA MAP standards and other industry-recognized revenue cycle frameworks
Familiarity with Medicaid, Medicare Part D, and state‑specific billing systems
Strong knowledge of CDM management, charge capture workflows, and denial prevention strategies
Excellent communication, stakeholder engagement, and documentation skills
What Would Be Nice To Have
HFMA certification or equivalent credential
Experience with federal/state EHR implementation projects
Familiarity with Oracle Health Data Intelligence (formerly HealtheIntent) for financial analytics and reporting
Experience managing revenue cycle transformation in multi‑entity, multi‑payer environments
The annual salary range for this position is $130,000.00–$216,000.00. 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
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 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. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process. If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
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Get AI-powered advice on this job and more exclusive features.
Job Family
Technology Consulting
Travel Required
Up to 50%
Clearance Required
None
Guidehouse’s Health IT Solutions team works with clients to measurably improve their technology outcomes through a mix of IT strategies, improvement in IT operations, and adoption of technology initiatives. By leveraging a deep understanding of health system IT operational best practices supported by data, Guidehouse propels IT operational improvement and technology adoption across departments and service lines at client organizations.
What You Will Do The Technical Healthcare Revenue Cycle Lead will oversee the design, configuration, validation, and deployment of an ERP solution across the entirety of a health system for a public client. This role requires deep expertise in public sector healthcare billing, including long‑term care, behavioral health, and pharmacy operations. The Lead will serve as the primary liaison between the Revenue Cycle Advisory Council, client health teams, and stakeholders, ensuring that the solution meets the client's complex financial, regulatory, and operational requirements.
Key Responsibilities
Revenue Cycle Design and Configuration
Lead the functional design and configuration of ERP solutions, ensuring alignment with client billing workflows, including long‑stay inpatient billing, trust account management, and pharmacy claims
Develop and validate workflows for interim monthly billing, Medicare Part D, Medicaid eligibility, and resident trust accounts
Oversee the upload and validation of the Charge Description Master (CDM), ensuring CPT/HCPCS code alignment with procedures and services
Collaborate with the Patient Accounting and Practice Management teams to configure registration, scheduling, and eligibility workflows
Design and validate EMRN/MRN strategies to support cross‑agency patient identity management
Ensure compliance with federal and state clients, CMS and HFMA MAP standards for billing, reimbursement, and financial reporting
State‑Specific Revenue Cycle Requirements
Translate client‑specific billing needs into system requirements, including:
Long‑term care billing cycles and interim claims
Resident trust account workflows, including deposits, withdrawals, and reconciliation
Federal/state community services billing, including vendor‑submitted claims and EIM system integration.
Service authorization workflows and capacity management for behavioral health services
Integrations for financial tracking and reporting
Collaborate with state finance and compliance teams to ensure accurate grant and funding reports for state and federal programs.
Testing and Validation
Lead parallel revenue cycle testing, reconciling results with legacy MEDITECH systems
Validate charge capture, claims generation, eligibility verification, and electronic remittance advice (ERA) posting
Ensure readiness for day‑one revenue cycle operations, including cash flow continuity and billing compliance
Collaborate with Testing Lead and Data Migration Lead to validate financial data accuracy and integrity
Stakeholder Engagement and Governance
Serve as the primary point of contact for revenue cycle stakeholders, including the Revenue Cycle Advisory Council, billing teams, HIM, and finance leadership
Participate in Change Control Board (CCB) and Steering Committee meetings to evaluate financial impacts of scope changes
Provide executive‑level reporting on revenue cycle readiness, risk posture, and performance metrics
Facilitate workshops and design sessions with state agencies to gather requirements and validate workflows
What You Will Need
Bachelor's Degree
Minimum 5 years of leadership experience in healthcare revenue cycle operations roles
Proven experience implementing Oracle Health RevElate in public sector or complex payer environments.
Deep understanding of State and Federal billing requirements, including long‑stay inpatient billing, trust accounts, and behavioral health reimbursement
Experience with HFMA MAP standards and other industry-recognized revenue cycle frameworks
Familiarity with Medicaid, Medicare Part D, and state‑specific billing systems
Strong knowledge of CDM management, charge capture workflows, and denial prevention strategies
Excellent communication, stakeholder engagement, and documentation skills
What Would Be Nice To Have
HFMA certification or equivalent credential
Experience with federal/state EHR implementation projects
Familiarity with Oracle Health Data Intelligence (formerly HealtheIntent) for financial analytics and reporting
Experience managing revenue cycle transformation in multi‑entity, multi‑payer environments
The annual salary range for this position is $130,000.00–$216,000.00. 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
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 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. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process. If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
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