Healthcare Partner, Managed Care Consulting

This is a fully remote position, open to applicants in United States.

📋 Description

• The ideal Partner, Managed Care Advisory will have the chance to significantly enhance revenue and strategically reposition healthcare clients.

• This leader will assist organizations in identifying and securing millions in potential revenue through comprehensive managed care solutions, such as commercial rate benchmarking and payer price transparency analytics.

• The position requires navigating complex contract negotiations, particularly with challenging payers, and formulating strategies that can transform a client's financial performance.

• The impact of this leader will go beyond immediate financial gains, potentially aiding distressed healthcare organizations in improving their margins and market positioning by tackling critical managed care contract challenges.

• The Partner, Managed Care Consulting is a senior leadership role within the Guidehouse Healthcare Practice, concentrating on leading and driving growth for the Healthcare sector.

• This partner will be tasked with developing a book of business and overseeing ongoing project delivery, solution development, and team management across multiple concurrent client engagements within our managed care vertical.

• This role is vital for the success of the overall practice growth strategy and will entail originating, closing, and managing client relationships, leading consulting teams, and ensuring the delivery of high-quality revenue cycle strategies and programs.

• The leader must be both strategic and operational, possessing extensive knowledge and experience regarding the workings of health systems.

• They must effectively develop and implement the vision for Managed Care services, including driving consulting projects that outline transformative initiatives aimed at cost containment, revenue enhancement, and executing initiatives across the firm for impactful results.

• Linking these initiatives to metrics and KPIs to demonstrate both revenue increases and cost containment success is essential for this role.

• They must be experts in selling and delivering advisory services that assist healthcare organizations in optimizing performance, enhancing efficiency, and ensuring compliance with industry regulations.

• This role is crucial in shaping and driving consulting opportunities throughout the entire managed care life cycle.

• This Partner will play a significant role in expanding the Managed Care practice, helping to develop and mentor consultants in innovative methods to enhance performance improvement and drive impactful transformation initiatives leveraging the Guidehouse platform.

⛳️ Requirements

• Previous executive consulting or industry leadership experience with Medicaid or Medicare/Medicare Advantage (STARS and quality), accountable care organizations, or patient-centered medical homes is highly desirable.

• 15+ years of professional experience in a combination of the following areas:

• 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 prediction and adjustment methods, as well as performance-based procurement, quality, and total cost measures of care for Federal, State, and health plans participating in the Affordable Care Act, Medicaid, and Medicare programs.

• Excellent problem-solving and interpersonal skills.

• Proven analytical skills that lead to innovative, holistic, value-based strategic solutions.

• Demonstrated ability to lead and supervise staff in a collaborative and matrixed team environment to meet budget and timeline objectives.

• Capability to sell consulting services and build strong client relationships at the executive level, evidenced by persuading boards and C-suites of Government Health State Agencies, Health Plan, and Payer organizations to take action.

• A bachelor's degree from an accredited institution is required.

• Proven leadership in achieving outcomes in healthcare consulting focused on strategy and transformation projects.

• Excellent verbal and written communication skills, including the ability to persuade senior management.

• Knowledge of Medicaid managed care operational program elements, including MMIS, eligibility and enrollment, capitation payments, quality performance, and care coordination.

• Willingness to travel up to 50% as required by the job.

🏝️ 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 Insurance

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability Insurance

• 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