Healthcare/Dental RCM Analytics & Solutions Consultant (Hybrid day one)

Own the bridge between data and revenue for healthcare and dental clients. Mine client claims and RCM data to surface measurable opportunities, map those gaps to our solutions portfolio, build concise Power BI visuals, and drive customer conversations that convert to projects and ARR. You combine payer-domain fluency, hands-on analytics, and consultative sales.

• Opportunity discovery: Profile client datasets (837/835, claim status, AR aging, denial codes, write-offs, fee schedules) to quantify leakage, denial drivers, and throughput constraints.
• Analytics & visualization: Build Power BI models and dashboards; define measures (DAX) for KPIs like first-pass yield, denial rate, days in AR, net collection rate, clean-claim rate, no-response aging, and payment variance.
• Data engineering light: Use Databricks for ingest, wrangling, and reproducible notebooks; join EDI, PMS, and clearinghouse feeds; write performant SQL/PySpark.
• Solution mapping: Translate findings into solution architectures and proposals using our portfolio (e.g., eligibility/coverage detection, coding/charge capture, denial prevention, work queue automation, underpayment analytics).
• Client-facing delivery: Run executive readouts and working sessions; articulate problem, quantified impact, recommended solution, and ROI.
• Commercial support: Partner with Sales on scoping, SoWs, success criteria, pricing inputs, and timelines; contribute to RFPs and POVs.
• Closed-loop impact: Define baselines, track post-deployment results, and iterate dashboards to show realized savings and lift.
• Enablement: Create reusable templates, metrics definitions, and playbooks for common payer or procedure patterns in dental and medical.
• Governance & compliance: Handle PHI securely; follow HIPAA and internal data-access controls.

• 4–7 years in healthcare or dental RCM/claims analytics or solutions consulting.
• Working knowledge of dental CDT and payer rules; familiarity with CARC/RARC codes, 835 remits, 837P/D institutional/professional claims; understanding of COB, bundling, frequency limitations, and medical-dental crossovers.
• Strong Power BI skills: data modeling, star schema, DAX, row-level security, and deployment pipelines.
• Hands-on Databricks: SQL and PySpark notebooks, Delta tables, job scheduling, basic optimization.
• Proficient SQL; capable with Python for data prep and KPI calculations.
• Proven record of customer-facing discovery, storytelling with data, and deal support in a quota-carrying environment.
• Ability to self-direct, prioritize, and move from raw files to an executive-level narrative without hand-holding.
• Clear written and verbal communication tailored to exec, ops, and technical audiences.
• Familiarity with HIPAA, BAAs, and PHI handling.

• Experience with practice management systems and clearinghouses common in dental and ambulatory (e.g., Dentrix, Eaglesoft, Open Dental; Availity, Change Healthcare).
• Knowledge of payer contracting, fee schedule analysis, and underpayment detection.
• Exposure to automation tooling (RPA, rules engines) and claim editing.
• Azure experience beyond Databricks (Data Factory, ADLS, Purview).
• Basic statistics for sampling, A/B, and confidence intervals.

• Qualified opportunities sourced from analytics: X per quarter with quantified value.
• Conversion rate from insights deck to signed SoW/PO: ≥ Y%.
• Realized impact for clients: days in AR reduction, denial rate reduction, net collections lift against baselines.
• Time-to-insight: ≤ 10 business days from data receipt to executive readout.
• Dashboard adoption: monthly active viewers and stakeholder satisfaction.