Principal Consultant – Medicare Provider Network Strategy

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

📋 Description

• Assist in spearheading both short-term and long-term initiatives related to the strategy of the Medicare Advantage provider network.

• Oversee and lead significant, intricate, and strategic network initiatives from their inception through to completion.

• Conduct analysis of Medicare network data utilizing both internal and external data sources.

• Facilitate the prioritization of divisional initiatives and monitor progress towards established goals.

• Aid the leadership team in implementing the business plan, strategies, analytics, and data requirements for the division.

• Collaborate with divisional leadership on strategies and business plans for strategic network initiatives.

• Identify and present trends and insights related to the network.

• Engage with all levels of cross-functional management, including senior divisional leadership.

• Work closely with corporate leadership.

• Drive outcomes across departments within a matrixed environment.

⛳️ Requirements

• Bachelor’s degree along with 6 years of experience in healthcare, health insurance, or a strategic consulting environment OR a Bachelor’s degree with 5 years of consulting experience involving strategic planning, business development, and financial management operations OR 8 years of experience in strategic planning, market research, network management, or product development within the healthcare sector.

• Proven experience in leading and developing strategy with a knack for building strong relationships with individuals and teams.

• Capacity to thrive in a fast-paced, rapidly changing organization while managing multiple complex priorities.

• Ability to work directly with corporate leadership.

• Skilled at driving results by collaborating across departments in a matrixed environment.

• Strong interpersonal skills, including proficiency in presentation, and both written and verbal communication.

• Experience in business analytics and information synthesis.

• Understanding of strategic planning techniques and industry trends.

• Demonstrated analytical, program management, and problem-solving capabilities.

• An advanced degree such as a Juris Doctor, MBA, or MHA is preferred.

• Experience in the health insurance or healthcare industry supporting Medicare Advantage is preferred.

• In-depth knowledge of Medicare Advantage provider networks, key performance indicators, trends, and financial acumen is preferred.

• Familiarity with Medicare Stars, Medicare Risk Adjustment, Medicare Finance, and various Medicare Plan types is preferred.

• Exceptional executive-level communication, presentation, and writing skills are preferred.

• Experience in analyzing and providing solutions for complex conceptual and operational challenges is preferred.

• A strong aptitude for analytical thinking both upstream and downstream, information seeking, willingness to learn, and attention to detail is preferred.

• Must be able to work remotely within the continental United States, excluding California, New York, Alaska, and Hawaii.

🏝️ Benefits

• Tailored development plans and opportunities for professional growth.

• Comprehensive health and wellness benefits.

• 401(k) savings plan.

• Pension plan.

• Paid time off.

• Paid parental leave.

• Disability insurance.

• Supplemental life insurance.

• Employee assistance program.

• Paid holidays.

• Tuition reimbursement.

• Annual incentive bonus plan.

• Additional incentives.

• Commitment to equal opportunity employment.

• A drug-free and smoke-free workplace.