Guidehouse · 2 weeks ago
Healthcare Technology Consulting - Revenue Cycle Architect
District of Columbia, United States
Full-time
Hybrid
Senior Level
$130K/yr - $216K/yr
5+ years expGuidehouse is a leading healthcare technology consulting firm that seeks a Revenue Cycle Architect to enhance technology outcomes for healthcare clients. The role involves leading the architecture and optimization of revenue cycle operations, overseeing data migration, and ensuring effective communication with executive leadership.
AdviceConsultingManagement Consulting
Responsibilities
Revenue Cycle Domain Architecture Lead enterprise architecture across Patient Access, Revenue Integrity, Charge Services, Billing, Claims, PFS, HIM, and Financial Clearance
Translate revenue cycle operational requirements into system design, build standards, and workflow architecture
Define encounter models, charge logic pathways, claims and remittance flows, and cross-functional handoffs between clinical operations and revenue operations
Serve as the domain authority for RevElate’s account structure, workflow logic, reconciliation models, and operational implications
Provide Subject-matter Leadership On RevElate—including Account structure modeling Charge event logic Claim creation and submission rules Workqueues and staff workflows Conversion considerations (pre- and post-go-live) Translate legacy workflows into RevElate equivalents, identifying operational and financial risks
Oversee The Revenue Cycle Components Of Data Migration, Including Encounter conversion Charge, payment, and adjustment data mapping Aged A/R strategy (what to convert vs. close out) Reconciliation models and validation rules Guide the financial integrity review cycles and defect remediation workflows
Design Comprehensive Revenue Cycle Test Plans That Reflect End-to-end operational flows Charge capture accuracy Payer-specific rules and CRD/accelerated edits Claims logic and denial scenario testing Reimbursement modeling, underpayment triggers, and audit checkpoints Partner with testing leadership to ensure scenarios cover complex payer mixes (Medicaid, Medicare, commercial, workers comp)
Oversee Design And Alignment Across All Revenue Cycle-related Interfaces X12/EDI (837/835, 270/271, 278, attachments, secondary claims) Eligibility/authorization workflows Payer-specific nuance (Medicaid state rules, coverage carve-outs, program-specific edits) Ensure integration design supports real-time revenue cycle operations and financial performance
Lead The Revenue Cycle Planning For Cutover Including Encounter/account preparation Freeze logic for claims and charge processing Transitional workflows (split claims, shadow claims, manual reconciliation) Charge capture and clinical documentation dependencies Ensure stability in day 1–90 revenue operations and defect triage
While not responsible for cloud design, must clearly understand how OCI impacts revenue cycle through: Environment provisioning and refresh cycles Integration latency and message throughput RevElate performance behaviors on OCI Downtime workflows and revenue cycle contingency planning EDI and clearinghouse connectivity pathways DR/BCP implications for billing, claims, authorizations, and front-end operations
Collaborate with clinical, technical, integration, data migration, and operational leads to ensure cohesive, end-to-end design
Mentor analysts and builders working across revenue cycle domains
Establish governance standards and reusable patterns for the EHR CoE
Serve as a trusted advisor to CFOs, VPs of Revenue Cycle, PFS Directors, Clinical/Operational Leadership, and CIO/CTO partners
Communicate revenue cycle impacts and design decisions clearly, including risks and mitigation options
Qualification
Required
Bachelors degree
5+ years of Oracle Health revenue cycle experience, spanning multiple domains
Experience with RevElate—workflow logic, build, account structure, and operational impacts
Expertise in: Revenue cycle architecture and future-state design
EDI/claim workflows and payer rules
Financial testing and reimbursement modeling
Data migration (financial/encounter data)
Cutover planning for revenue cycle operations
Strong understanding of how OCI hosting affects revenue cycle performance
Ability to lead teams in complex, multi-vendor implementations
Strong grounding in hospital and ambulatory revenue cycle operations
Preferred
Experience with large-scale EHR modernization
Background with AMCs, IDNs, multi-hospital networks, or state agencies
Familiarity with CRD, coverage rules engines, authorization workflows, and Medicaid-specific requirements
Prior consulting experience
Benefits
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
Company
Guidehouse
Guidehouse offers consulting services for public and commercial markets with expertise in management, technology, and risk consulting.
10001+ employees
H1B Sponsorship
Guidehouse has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (25)
2024 (20)
2023 (29)
2022 (49)
2021 (50)
2020 (59)
Funding
Current Stage
Late StageTotal Funding
$0.75MKey Investors
Mission Daybreak
2023-11-06Acquired
2023-02-16Grant· $0.75M
Leadership Team
Scott McIntyre
Chairman and CEO
Alicia Harkness
Partner
Recent News
Washington Technology
2026-01-09
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2025-11-20
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