Consultant

• 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 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.

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