Healthcare Partner, Managed Care Consulting

Role Overview

• Drive revenue enhancement, risk mitigation, and strategic repositioning for healthcare clients, with a focus on improving revenue and margins
• Manage the full managed care contracting cycle, including analytics, strategy preparation, negotiations, and post-contract implementation
• Develop and execute comprehensive managed care solutions, including commercial rate benchmarking, payer price transparency analytics, and contract negotiations
• Bring new clients to the table, with a partner-level revenue target of $8 million or higher
• Provide strategic insights across the healthcare ecosystem, including working with C-suite executives to transform revenue and market positioning
• Lead business development of advisory pursuits within the territory/market. Activities include originating new consulting opportunities, driving assessments in the front end, current v. future state performance, expanding and extending current advisory engagements, relationship-based selling to new clients, leading RFP responses, and representing the firm at business development-related conferences
• Lead advisory and delivery teams on high-impact revenue cycle transformation client engagements within territory/market. Activities include: client relationship management, consulting delivery execution, project financial management, risk/quality management, and client satisfaction management
• Build a book of business through senior client relationship management by finding, closing and delivering Managed Care growth initiatives
• Manage teams consisting of consulting experts and advisory personnel to cover key accounts
• Responsible for contract growth, and uncovering and assisting in originating and capturing new opportunities that land and expand revenue cycle programs with clients
• Manage transaction deals sizes ranging from $500K to multi-million dollars annually with pull through to managed services that are multi year

Requirements

• Previous executive consulting or industry leadership with Medicaid OR Medicare/Medicare Advantage (STARS and quality), accountable care organization, or patient centered medical home highly desirable
• 10+ years professional experience in a combination of the following: ACO leadership Managed care Health Plan or Payer leadership Health Plan executive level contract management IT/Data management Quality management Client-facing healthcare consulting role Health policy analysis and health economics research. Risk predication and adjustment methods, and performance based procurement, Quality and total cost measures of care for Federal, State, and health plans who participate in the Affordable Care Act, Medicaid, and Medicare programs.
• Superb problem-solving and interpersonal skills
• Demonstrated use of analytical skills that found innovative, holistic, value based strategic solutions
• Demonstrated ability to lead and supervise staff in a collaborative and matrixed team environment to achieve budget and timeline goals
• Ability to sell consulting and building strong client relationships at the executive level, demonstrated by persuading boards and C-suites of Government Health State Agencies, Health Plan and Payor organizations to action
• Bachelors degree from accredited school required
• Demonstrated leadership achieving outcomes in healthcare consulting focused strategy and transformation projects
• Proficiency in MS Office Suite – Word, Excel, PowerPoint, MS Project
• 15+ years of work experience in healthcare management and/or strategy, or equivalent consulting experience.
• 3+ years of work experience with payor in Medicare or Medicare Operations strategy or operations leadership, or financial strategy /ops or contracting strategy is highly preferred
• Proven verbal and written communication skills, including the ability to persuade senior management or
• Knowledge of Medicaid managed care operational program elements including MMIS, eligibility and enrollment, captivation payments, quality performance and care coordination.
• Travel up to 50% as the job requires

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