NewHealthcare Claims Analytics Senior Consultant GuidehouseHealthcare Claims Analytics Senior ConsultantMcLean, VirginiaThis role supports the development and execution of claims analyses and audits aimed at reducing improper payments, identifying potential fraud, and uncovering patterns that inform payment policy and cost-saving strategies. 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.
Fraud AI / Data Healthcare Senior Consultant (Remote) GuidehouseFraud AI / Data Healthcare Senior Consultant (Remote)Arlington, VARemote$113,000–$188,000 / yearHands-on experience with financial crime compliance technology and data solutions, e.g., Oracle Mantas, Actimize, Fircosoft, LexisNexis Bridger, World-Check, Dow Jones, Chainalysis, Elliptic, TRM Labs, etc. 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.
Fraud AI / Data Healthcare Senior Consultant (remote) GuidehouseFraud AI / Data Healthcare Senior Consultant (remote)Tysons Corner, VirginiaRemoteHands-on experience with financial crime compliance technology and data solutions, e.g., Oracle Mantas, Actimize, Fircosoft, LexisNexis Bridger, World-Check, Dow Jones, Chainalysis, Elliptic, TRM Labs, etc. 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.
Senior Consultant, Healthcare Strategy & Transformation GuidehouseSenior Consultant, Healthcare Strategy & TransformationTysons Corner, VirginiaCandidates may bring payer strategy/transformation experience (enterprise strategy, operating model, performance improvement) and/or payer operations/payment experience (claims/payment functions, analytics, policy-informed operations), with the ability to lead workstreams and coach others. Apply commercial payer/provider expertise to federal health challenges, bringing a pragmatic perspective on how reimbursement, payment structures, and policy-driven incentives influence operations, provider behavior, and performance outcomes.
Clinical Transition Consultant (Healthcare) Gilbane Building CoClinical Transition Consultant (Healthcare)Arlington, VA$70,000–$115,000 / yearWe are dedicated to building a diverse, inclusive and authentic workplace, so if you're excited about this role but your past experience doesn't align perfectly with every qualification in the job description, we encourage you to apply anyway. You are someone who acts inclusively, showing empathy and treating others with respect and dignity in order to uphold Gilbane's core value of Caring and "People First" workplace culture.
Managing Consultant – Clinical Quality Improvement (Maryland Programs) - Healthcare Berkeley Research GroupManaging Consultant – Clinical Quality Improvement (Maryland Programs) - HealthcareBaltimore, MarylandThis role is designed for a seasoned quality professional with hands-on experience in Maryland’s unique hospital payment and quality environment, including the HSCRC Quality-Based Reimbursement (QBR), Maryland Hospital Acquired Conditions (MHAC), and Readmission Reduction Incentive Program (RRIP), and alignment with CMS programs such as Hospital Readmission Reduction Program (HRRP), Value-Based Purchasing (VBP), Hospital-Acquired Reduction Program (HACRP), and CMS Care Compare. Led by seasoned healthcare executives, operators, physicians, nurses, and other clinicians, IHS partners with organizations to drive sustainable performance improvement and long-term growth through strategic growth, operating model transformation, AI and digital enablement, clinical quality and patient care optimization, and revenue strategy—helping clients build resilient, future-ready healthcare enterprises in an increasingly complex environment.
NewHealthcare Quality Measurement Consultant, Data Analytics and Coding - Remote UnitedHealth Group IncHealthcare Quality Measurement Consultant, Data Analytics and Coding - RemoteReston, VARemote$91,700–$163,700 / yearThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Primary Responsibilities: Evaluate evidence on effectiveness for clinical measures derived from administrative or claims data, health records, electronic health records, other data sources in compliance with Centers for Medicare & Medicaid Services (CMS), the Agency for Healthcare Research and Quality, and the National Quality Forum (NQF) requirements.
Healthcare Claims Analytics Senior Consultant Guidehouse IncHealthcare Claims Analytics Senior ConsultantMcLean, VA$98,000–$163,000 / yearThis role supports the development and execution of claims analyses and audits aimed at reducing improper payments, identifying potential fraud, and uncovering patterns that inform payment policy and cost-saving strategies. 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.
Clinical Consultant (RN) - Federal Healthcare EHR Adoption Oracle CorpClinical Consultant (RN) - Federal Healthcare EHR AdoptionDC$82,500–$166,100 / yearThis role gives you the opportunity to improve that experience at scale-helping federal healthcare teams adopt EHR capabilities that strengthen workflows, support clinicians, and improve outcomes for the patients they serve. You'll bring clinical expertise and informatics experience to large-scale transformation efforts, guiding workflow adoption, change management, and adoption strategies that lead to successful and sustained use of the EHR.
Fraud AI / Data Healthcare Senior Consultant (remote) Guidehouse IncFraud AI / Data Healthcare Senior Consultant (remote)McLean, VARemote$113,000–$188,000 / yearHands-on experience with financial crime compliance technology and data solutions, e.g., Oracle Mantas, Actimize, Fircosoft, LexisNexis Bridger, World-Check, Dow Jones, Chainalysis, Elliptic, TRM Labs, etc. 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.
SEnior Consultant, Healthcare Strategy & Transformation Guidehouse IncSEnior Consultant, Healthcare Strategy & TransformationMcLean, VA$98,000–$163,000 / yearCandidates may bring payer strategy/transformation experience (enterprise strategy, operating model, performance improvement) and/or payer operations/payment experience (claims/payment functions, analytics, policy-informed operations), with the ability to lead workstreams and coach others. Apply commercial payer/provider expertise to federal health challenges, bringing a pragmatic perspective on how reimbursement, payment structures, and policy-driven incentives influence operations, provider behavior, and performance outcomes.
NewSenior Consultant, Healthcare Strategy & Transformation Guidehouse IncSenior Consultant, Healthcare Strategy & TransformationTysons, VA$98,000–$163,000 / yearCandidates may bring payer strategy/transformation experience (enterprise strategy, operating model, performance improvement) and/or payer operations/payment experience (claims/payment functions, analytics, policy-informed operations), with the ability to lead workstreams and coach others. Apply commercial payer/provider expertise to federal health challenges, bringing a pragmatic perspective on how reimbursement, payment structures, and policy-driven incentives influence operations, provider behavior, and performance outcomes.
Government Healthcare Provider Rate Setting Consultant Marsh & McLennan Companies IncGovernment Healthcare Provider Rate Setting ConsultantWashington, DC$115,200–$230,400 / yearThe Government Healthcare Financial Consultant partners with state governments to examine financial reports in order to understand emerging Medicaid health care experience as well as the financial performance of managed care organization and interacts with credentialed actuaries and financial executives to ensure Medicaid dollars are being utilized efficiently. Beyond the in-depth training provided, new employees are included on client teams immediately, providing unique opportunities to learn more while helping team members with critical workloads and making a difference to our clients.
Senior Consultant, Healthcare Business Transformation Operations | Corporate Finance FTI Consulting IncSenior Consultant, Healthcare Business Transformation Operations | Corporate FinanceWashington, DCYou will partner with Managing Directors and Senior Managing Directors to manage projects and be accountable for project scope as well as coordinating multiple work streams to deliver a successful, timely outcome for our clients. As a Senior Consultant, you will leverage your consulting background and/or industry expertise to manage the daily activities of high-performing, interdisciplinary teams to develop dynamic analytical, financial and operational solutions for our clients.
NewConsultant, Healthcare Economics & Hospital Contracting Analytics UnitedHealth Group Inc.Consultant, Healthcare Economics & Hospital Contracting AnalyticsWashington, DC$72,800–$130,000 / yearThe Senior Healthcare Economics Consultant (Network Pricing & Analytics) is responsible for supporting provider reimbursement analysis, pricing strategy support, financial modeling, and analytical reporting activities across provider network initiatives. The Manager partners closely with contracting, clinical, finance, actuarial, operations, provider relations, and executive leadership teams to evaluate pricing impacts, support provider negotiations, and drive data-informed business decisions.
NewSenior Learning Consultant ( EHR Certification Team, Healthcare, Federal)- Up to 100% travel Oracle CorpSenior Learning Consultant ( EHR Certification Team, Healthcare, Federal)- Up to 100% travelDC$71,200–$166,100 / yearOracle maintains broad salary ranges for its roles in order to account for variations in knowledge, skills, experience, market conditions and locations, as well as reflect Oracle''s differing products, industries and lines of business. Working closely with senior training professionals, this role will help analyze training effectiveness, track learner progress, and ensure training aligns with business needs.
NewHealthcare Quality Measurement Consultant, Data Analytics And Coding - Remote UnitedHealth Group Inc.Healthcare Quality Measurement Consultant, Data Analytics And Coding - RemoteReston, VARemote$91,700–$163,700 / yearPrimary Responsibilities: Evaluate evidence on effectiveness for clinical measures derived from administrative or claims data, health records, electronic health records, other data sources in compliance with Centers for Medicare & Medicaid Services (CMS), the Agency for Healthcare Research and Quality, and the National Quality Forum (NQF) requirements. Optum Serve Consulting/The Lewin Group (OSC/Lewin), a premier national health care and human services consulting and policy analysis firm, brings 50 years of experience finding answers and solving problems for leading organizations in the public, non-profit, and private sectors.
Senior Consultant, Healthcare Ipsos SASenior Consultant, HealthcareWashington, DC$110,000–$130,000 / yearTypical engagements include developing competitive assessments, market landscape analysis, product life cycle strategies for future and in line healthcare products, working with our executive leaders and assisting in designing commercialization and go-to-market models, launch strategies, and executing analytical work streams to optimize the impact of commercial programs and tactics. With over 75 different data-driven solutions, and presence in 90 markets, Ipsos brings together research, implementation, methodological, and subject-matter experts from around the world, combining thematic and technical experts to deliver top-quality research and insights.
Senior Healthcare Consultant Prometheus Federal ServicesSenior Healthcare ConsultantFairfax, VAFull timeAbility to simplify complex ideas into clear, accessible information for diverse audiences; strong writing skills and ability to develop business cases, operations manuals, presentation decks, and communications. Senior Consultants contribute to program planning and implementation, including landscape analyses, business cases, program design, implementation plans, change management plans, and communications.
: EAP Consultant or Behaviorial Healthcare COORDINATOR Integrated Resources, Inc: EAP Consultant or Behaviorial Healthcare COORDINATORColumbia, MarylandFull timeOur team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. Demonstrate flexibility in areas such as job duties and schedule to aid in better serving its members and help Magellan achieve its business and operational goals.