Senior Consultant - Public Health - Healthcare Review/Audit Policy

Job Family :

Management Consulting

Travel Required :

Up to 10%

Clearance Required :

Ability to Obtain Public Trust

What You Will Do:

The Healthcare Review/Audit Policy Member is responsible for monitoring federal/state policy changes and court rulings relevant to the Exchanges (e.g., changes impacting the Advanced Premium Tax Credit (APTC)/Qualified Health Plan (QHP) eligibility, and Special Enrollment Periods (SEPs), and through reviewing annual Exchange regulations, sub-regulatory guidance, and system/operations documentation; Assesses the impact of those changes on Exchange Improper Payment Measurement (EIPM) methodology, including review unit logic, scripts, and review tools, and determines where updates are required; Develops policy update deliverables and coordinates with technical, review, and data teams to accurately reflect changes.

What You Will Need:

• Bachelor’s degree

• 3-5+ years of relevant experience

• Experience working in or knowledge of the Affordable Care Act, specifically State-Based Exchanges, Federally-Facilitated Exchanges, and health insurance markets and exchanges

• Ability to oversee multiple concurrent workstreams

• Excellent communication skills (verbal and written)

• Strong stakeholder management skills and experience

What Would Be Nice To Have:

• Experience with regulatory analysis

• Ability to navigate ambiguity and provide clear guidance, direction, and structure to the team

• Flexibility and agility to respond to changing requirements in a dynamic environment

• Skills to develop training on regulatory updates and train team members on the impact of the changes

• Proficiency working with compliance team members and developers to confirm that regulatory changes are properly reflected in testing methodology and automation scripts

The annual salary range for this position is $98,000.00-$163,000.00. 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.

What We Offer :

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may be eligible for a discretionary variable incentive bonus

• Parental Leave and Adoption Assistance

• 401(k) Retirement Plan

• Basic Life & Supplemental Life

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability

• Student Loan PayDown

• Tuition Reimbursement, Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program

• Mobility Stipend

About Guidehouse

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at View phone number on click.appcast.io or via email at View email address on click.appcast.io . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or View email address on click.appcast.io . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact View email address on click.appcast.io . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.