Remote Healthcare Claims Analytics Senior Consultant

Guidehouse; Arlington (VA); Hybride; USD 98 000 - 163 000; Plein temps

Avantages offerts par ce poste

Medical, Rx, Dental & Vision

Sick Time & Holidays

Bonus eligible

Parental Leave

401(k) Plan

Life Insurance

HSA & FSAs

Disability Insurance

Student Loan PayDown

Tuition Reimbursement

Skills Development

Employee Referrals

Events & Outreach

Mobility Stipend

Hybrid onsite in Tysons

Résumé du poste

Guidehouse is seeking Consultants with healthcare claims data experience to validate, load, process and analyze claims across payer types. You'll support audits to reduce improper payments and identify fraud patterns, building dashboards to visualize trends and communicating policy implications.

The role is remote with preference for DMV-area onsite 2–3 days/week in Tysons, requiring ability to obtain Public Trust clearance and delivering high-quality analytics.

Qualifications

• Bachelor’s degree required.
• 3+ years of professional experience with datasets to derive insights and 1+ year collaborating with stakeholders.
• Technical coding proficiency (SQL, Python, R) and experience building dashboards.
• Exposure to healthcare data analytics and claims data.
• Strong attention to detail and ability to deliver high-quality deliverables.
• Interest in state health agencies, Medicare/Medicaid, VA, and healthcare reform.
• Ability to obtain a Public Trust Clearance.

Responsabilités

• Demonstrate working knowledge of claims datasets and reimbursement concepts.
• Assist in gathering and interpreting business and technical requirements for claims audits.
• Conduct data-driven and qualitative research for policy evaluation and anomaly detection.
• Build dashboards and reports to visualize claims trends and audit findings.
• Research industry coding rules and contribute to reimbursement policy discussions.
• Document findings and support recommendations and follow-up actions.
• Contribute to analytics identifying payment trends, errors and risks.
• Stay informed on state healthcare reform efforts and policy changes.
• Translate research insights into analytics tool requirements.
• Respond to inquiries related to claims edits and policy interpretation.
• Collaborate with internal and external stakeholders to support project delivery.
• Support project management activities and client interactions.

Connaissances

SQL

Python

R

Dashboards

Data visualization

Attention to detail

Stakeholder collaboration

Healthcare analytics

Formation

Bachelor's degree

Outils

Power BI

Tableau

SQL Server

Description du poste

Guidehouse is seeking Consultants with healthcare claims data experience to validate, load, process and analyze claims across payer types. You'll support audits to reduce improper payments and identify fraud patterns, building dashboards to visualize trends and communicating policy implications.

The role is remote with preference for DMV-area onsite 2–3 days/week in Tysons, requiring ability to obtain Public Trust clearance and delivering high-quality analytics.