Senior Consultant - Public Health - Healthcare Review​/Audit Policy

Job Overview

Job Family:
Management Consulting

Travel Required:

Up to 10%

Clearance Required:

Ability to Obtain Public Trust

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). The role includes reviewing annual Exchange regulations, sub‑regulatory guidance, and system/operations documentation to assess the impact of these changes on Exchange Improper Payment Measurement (EIPM) methodology, including review unit logic, scripts, and review tools, and determining where updates are required.

The candidate will develop policy update deliverables and coordinate with technical, review, and data teams to accurately reflect changes.

• 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 work streams
• Excellent communication skills (verbal and written)
• Strong stakeholder management skills and experience

• 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 $98,000.00-$. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience, training, security clearances, licensure and certifications, and other business and organizational needs.

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package.

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 Pay Down
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back‑Up Childcare Program
• Mobility Stipend

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

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