Consultant | Healthcare Performance Improvement

About the position

The Consultant in Healthcare Performance Improvement at Forvis Mazars will support clients in the Pharmacy and Clinic Services sector, focusing on compliance, program optimization, and financial performance. This role involves conducting financial assessments, providing operational assistance, and ensuring adherence to regulatory requirements while delivering high-quality client experiences.

Responsibilities

• Assist with Financial/Reimbursement assessments to determine reimbursement opportunities for provider-based departments and Rural Health clinics.
• Conduct financial analysis and modeling of new regulatory changes and impacts.
• Prepare PowerPoint presentation reports for clients.
• Develop provider-based strategy, gap assessments, and transition advisory processes.
• Provide guidance on operational assistance related to split-billing and chargemaster requirements.
• Ensure compliance with CMS Provider-Based Clinic regulations and Federal and State regulations.
• Assist with transitions to Rural Health Clinic (RHC) and develop policy and procedure documentation.
• Prepare Medicare RHC cost reporting schedules and calculate RHC visits and FTEs for productivity.
• Advise clients on 340B and pharmacy operations, including policy development and network expansion.
• Conduct compliance reviews and independent reviews, with HRSA audit experience being a plus.
• Communicate and present to all levels of client organizations, including C-suite and management.

Requirements

• Bachelor's degree in Business, Accounting, Finance, Health Services Administration, or a related field.
• 2 years or more of experience in the healthcare industry, specifically in consulting or hospital settings.
• Significant experience in advanced Excel, IT platforms, and healthcare.
• Strong technical skills with spreadsheets, databases, and automated audit work paper systems.
• Experience with project management.

Nice-to-haves

• Experience in healthcare provider-based billing and compliance submission to Medicare.
• Knowledge of Medicare/Medicaid Hospital cost reporting.
• Operational knowledge in provider-based physician practices or RHCs.
• Experience with EPIC and data visualization tools like Tableau or Power BI.

Benefits

• Competitive salary
• Opportunities for professional development
• Flexible work arrangements
• Health insurance options
• Retirement savings plan