Advisory - Consultant - Healthcare Regulatory

Risk Management | Regulatory & Legal Support
Same job available in 28 locations

Position Summary

Deloitte’s Risk & Financial Advisory provides you an opportunity to gain valuable hands-on experience working alongside leading professionals across diverse industries while building your professional skills in a variety of project experiences.  Our Deloitte Risk & Financial Advisory practice helps organizations effectively navigate business risks and opportunities—from strategic, reputation, and financial risks to operational, cyber, and regulatory risks—to gain competitive advantage. We apply our experience in ongoing business operations and corporate lifecycle events to help clients become stronger and more resilient. Our market-leading team’s help clients embrace complexity to accelerate performance, disrupt through innovation, and lead in their industries.

Work you’ll do

As a Consultant in our Regulatory Healthcare Practice, you will have the opportunity to work on multiple projects leveraging your education and prior work experience to help our clients more confidently make decisions to drive performance.  You will help our clients embrace change, grow their business, accelerate performance, and navigate periods of crisis or controversy and emerge resilient.

Projects may be aligned to the following areas and include:

  • Operational Improvement:   For business process that include significant regulatory requirements, you will improve efficiency and business outcomes by leverage process improvement, technology innovation and operating model evolution.
  • Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory and contractual requirements while also determining that payments are appropriate for the type and level of care provided.
  • Strategic Risk: Helping clients to embrace their most significant regulatory risks, by enabling senior health care executives to plan for, spot, assess, manage, and respond to those risks to either avoid harm or to embrace risks as opportunity.
  • Regulatory Response:  Supporting clients with their most pressing regulatory and operational challenges.  Helping them to identify, remediate, monitor, and manage enterprise risks and create value through implementing a compliant, resilient enterprise.  Includes helping clients manage and respond to internal and external investigations, regulatory concerns  and other business controversy.

Qualifications


Required:

  • BS/BA Degree required in business, finance, accounting or other related subject
  • 1+ years of experience working with health plans, healthcare providers, or other healthcare sector companies (e.g. Pharmacy & Life Sciences); or relevant consulting experience
  • Experience with healthcare payer or provider operations

·       Experience with federal and state regulatory requirements, regulatory compliance, and billing requirements

  • Experience with medical related data sets, including medical services documentation and claims data

·       Experience designing, implementing and operating risk management and compliance activities

·       Experience participating in risk, quality and compliance transformational programs

·       Experience leveraging data and analytics to enhance risk management, quality and compliance

  • Proficiency in verbal and written communication skills essential to interacting with clients and teams including presentation skills (MS Power Point, MS Visio)
  • Practical experience in project management fundamentals, and ability to meet deadlines
  • Advanced proficiency with tools like Excel, Access, SQL, and Tableau
  • Ability to work independently and manage multiple projects/assignments/responsibilities in a fast-paced environment
  • Excellent problem-solving skills with a demonstrated ability to identify issues, resolve them quickly and know when to rely on internal resources to assist
  • Ability to travel up to 40%

Preferred/Appreciated:

·       Leading the development of proposals, marketing content, and thought leadership as a key contributor to developing new business

  • Master's degree in healthcare administration or related field, preferred
  • Any healthcare certification such as RHIA, CMM, AAHAM, CPHRM, CPHIMS, FACHE, preferred

·       Experience with application security controls, risk and compliance

  • Experience in quality measurement, quality improvement, and value-based payment models
  • Proven applicable CPT and ICD-10 coding experience; APR-DRG, MS-DRG and HCC assignment; coding certification and CCDS preferred
  • Prior EHR implementation experience including CDM Management, Charge Capture, HIM/Coding, and Clinical Documentation (e.g. Epic, Cerner); other clinical application experience and certifications desired

·       Other revenue cycle experience including conducting charge capture and coding reviews for compliance with billing and coding regulatory requirements

·       Experience in program and/or project management for technology implementations using third party software

·       Knowledge of process excellence (Six Sigma, LEAN, Design Excellence), certifications preferred

·       Experience training, educating and coaching



Our people and culture

Our diverse, equitable, and inclusive culture empowers our people to be who they are, contribute their unique perspectives, and make a difference individually and collectively. It enables us to leverage different ideas and perspectives, and bring more creativity and innovation to help solve our client most complex challenges. This makes Deloitte one of the most rewarding places to work. Learn more about our inclusive culture.

Professional development

From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to build new skills, take on leadership opportunities and connect and grow through mentorship. From on-the-job learning experiences to formal development programs, our professionals have a variety of opportunities to continue to grow throughout their career. Learn more about our commitment to developing our people.


As used in this posting, "Deloitte Advisory" means Deloitte & Touche LLP, which provides audit and enterprise risk services; Deloitte Financial Advisory Services LLP, which provides forensic, dispute, and other consulting services; and its affiliate, Deloitte Transactions and Business Analytics LLP, which provides a wide range of advisory and analytics services. Deloitte Transactions and Business Analytics LLP is not a certified public accounting firm. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. These entities are separate subsidiaries of Deloitte LLP.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.

Requisition code: 51224

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