Senior Consultant, Healthcare Revenue Integrity & CDI
Revenue Integrity & CDI - Senior Consultant
Altarum Institute is seeking a Revenue Integrity Senior Consultant within our Business Advisory Services (BAS) group in Ann Arbor, MI or Washington, DC offices. This position plays a critical role in supporting the development of comprehensive business strategies for our healthcare clients. The current portfolio of projects includes federal and non-federal healthcare engagements, providing strategic and support services within payer relations, revenue cycle management, and clinical documentation improvement, applying industry expertise and best practices.
This position will support consulting engagements providing expert technical knowledge and analysis of clinical systems and operation environment, high-level functional systems analysis, design, integration, documentation and implementation advice on complex problems. The position requires subject matter expertise of clinical documentation and/or utilization review. Additional experience with managed care payers and strategies, the ability to oversee development of deliverables and strong consulting skills, interacting with executive clients, and leadership of team members. The ideal candidate will be an accomplished, talented, collaborative, highly ambitious and motivated individual with a strong work ethic and desire to make a difference.
This position will be based within the BAS group and be heavily focused on traditional healthcare consulting – improving margins and operations for key Altarum clients in the federal and commercial market spaces.
Primary responsibilities include:
- Providing subject matter expertise in payer reimbursement models and claims adjudication to project tasks, ensuring quality assurance and data validity, to generate client data and report deliverables.
- Facilitating clinical documentation improvement initiatives and training to support appropriate reimbursement for the level of service rendered to all patients with a APR DRG based payer
- Demonstrating knowledge of APR DRG payer issues, documentation opportunities, clinical documentation requirements, and referral policies and procedures
- Preparing and presenting project deliverables and findings to senior project stakeholders and practice area leadership as required, through the use of graphs, tables, and other strategic information to summarize analyses and results.
- Contributing to an innovative and team-oriented work environment with individual accountability and ownership to the success of the practice.
- Committing to knowledge development and continuing to educate and share knowledge with clients and team members.
- Building collaborative methods to develop and share internal reports with peers.
- Bachelor’s degree required in Nursing, Healthcare Administration or a related clinical field.
- Minimum of 3+ years of Healthcare consulting experience for Hospitals and/or large Physician groups.
- Certifications in coding preferred, but not required.
- Experience in Revenue Cycle (e.g., patient access, billing, payment posting, self-pay and bad debt policy, denial management, revenue integrity, and charge capture).
- Capability to succeed in a dynamic environment and produce multiple deliverables within tight timeframes.
- Willingness to effectively build relationships throughout an organization and communicate with team members virtually and in-person.
- Must be able to receive a U.S. Security Clearance (sole U.S. citizenship required).
Travel up to 50%, as needed.
Altarum Institute is a nonprofit systems research and consulting organization that has been servicing government and private sector clients since 1946. Combining the analytical rigor of a research institution with the business agility of a consulting firm, the Institute is uniquely positioned to deliver practical, systems-based health and healthcare solutions to its clients. Altarum’s nonprofit status ensures that the public interest is always preeminent in our work. Our dedication to social responsibility is evident in all that we do, serving the public good with integrity and enabling others to do the same.
Altarum's dynamic work environment emphasizes integrity, personal commitment, and teamwork. In addition to the meaningful and challenging work, Altarum offers an outstanding benefits program that includes paid time off, tuition reimbursement, 401k (5% employer contribution), a flexible work environment, and much more. We invite you to explore exciting and rewarding career opportunities with us.
Altarum Institute is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to, among other things, race, color, religion, sex, sexual orientation, gender identity, national origin, age, status as a protected veteran, or disability
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