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Healthcare Payment Integrity Associate Director

June 4, 2026

Job Family:Strategy & Transformation Consulting Travel Required:Up to 25% Clearance Required:Ability to Obtain Public TrustWhat You Will Do:<ul><li>Lead multiple concurrent transformation engagements for federal health clients, owning delivery quality, workplans, staffing, budgets, executive communications, and integrated storylines across workstreams.</li><li>Serve as a senior SME in clinical documentation integrity, coding, revenue integrity, reimbursement, payment policy, and payment integrity, translating subject-matter depth into practical transformation roadmaps and operating model decisions.</li><li>Advise senior client stakeholders on the intersection of documentation, coding, claims/payment accuracy, quality measurement, utilization, denials, compliance, and financial performance.</li><li>Assess current-state workflows, documentation practices, coding operations, and performance drivers; identify root causes; and define target-state processes, governance, controls, and measurable improvement opportunities.</li><li>Apply payer-provider expertise to federal health environments, connecting reimbursement mechanics, classification systems, payment policy, risk adjustment, and incentive structures to operational and clinical outcomes.</li><li>Guide analytics-enabled transformation by using claims, revenue cycle, coding, and operational data to generate insights, size opportunities, prioritize interventions, and monitor value realization.</li><li>Partner with clinical, operational, IT, compliance, and finance leaders to design sustainable improvements in documentation quality, coding accuracy, audit readiness, provider education, and workflow efficiency.</li><li>Develop executive-ready deliverables, workshops, and decision materials that clearly communicate the “so what” for C-suite, program, and operational leadership.</li><li>Build and mentor high-performing teams through apprenticeship-style coaching, including upskilling staff in clinical documentation, coding, reimbursement, analytics, and client relationship management.</li><li>Drive business development and practice growth by shaping solution offerings, supporting proposals, developing reusable assets, and bringing thought leadership in CDI, coding optimization, payment integrity, and healthcare data strategy.</li></ul>What You Will Need:<ul><li>Bachelor’s degree required; Master of Health Administration, MBA, MPH, or other relevant advanced degree strongly preferred.</li><li>10+ years of healthcare consulting and/or industry leadership experience spanning payer, provider, revenue cycle, health information, reimbursement, or federal health transformation environments.</li><li>Deep expertise in clinical documentation, coding, reimbursement/payment policy, revenue integrity, payment integrity, and/or healthcare performance improvement.</li><li>Demonstrated success leading complex, cross-functional engagements with accountability for client outcomes, delivery quality, team leadership, and executive stakeholder management.</li><li>Strong payer-provider lens, including understanding of claims/payment operations, documentation and coding impacts, reimbursement methodologies, and policy-driven operational change.</li><li>Experience translating data into action, including opportunity sizing, root-cause analysis, performance measurement, dashboarding, and executive synthesis.</li><li>Ability to educate and influence diverse stakeholders, including clinicians, coding teams, operations leaders, finance executives, and government clients.</li><li>Ability to obtain a Public Trust clearance (i.e. US citizenship required).</li><li>Willingness to travel as needed (up to 25%).</li></ul>What Would Be Nice To Have:<ul><li>AAPC and/or AHIMA coding credentials (e.g., CPC, CCS, RHIA, RHIT, CDIP, CCDS) and demonstrated credibility in documentation and coding education.</li><li>Experience with healthcare technology, classification systems, or clinical documentation/coding solution environments, including analytics-enabled or AI-supported transformation.</li><li>Experience across payer advisory, health information/coding vendors, professional associations, or consulting environments supporting reimbursement and payment operations.</li><li>Knowledge of revenue cycle, DRG validation, audit/compliance, utilization or quality improvement, risk adjustment, and fraud, waste, and abuse or payment-integrity concepts.</li><li>Experience designing education programs, thought leadership, or market-facing content for coding, documentation, reimbursement, or health information audiences.</li></ul>The annual salary range for this position is $149,000.00-$248,000.00. 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:<ul><li>Medical, Rx, Dental & Vision Insurance</li><li>Personal and Family Sick Time & Company Paid Holidays</li><li>Position may be eligible for a discretionary variable incentive bonus</li><li>Parental Leave and Adoption Assistance</li><li>401(k) Retirement Plan</li><li>Basic Life & Supplemental Life</li><li>Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts</li><li>Short-Term & Long-Term Disability</li><li>Student Loan PayDown</li><li>Tuition Reimbursement, Personal Development & Learning Opportunities</li><li>Skills Development & Certifications</li><li>Employee Referral Program</li><li>Corporate Sponsored Events & Community Outreach</li><li>Emergency Back-Up Childcare Program</li><li>Mobility Stipend</li></ul>About GuidehouseGuidehouse 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 1-571-633-1711 or via email at <a href="mailto:RecruitingAccommodation@guidehouse.com" target="_blank" rel="noopener noreferrer">RecruitingAccommodation@guidehouse.com</a>. 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 <a href="mailto:guidehouse@myworkday.com" target="_blank" rel="noopener noreferrer">guidehouse@myworkday.com</a>. 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 <a href="mailto:recruiting@guidehouse.com" target="_blank" rel="noopener noreferrer">recruiting@guidehouse.com</a>. 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.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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