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Risk Based Payer /Provider Consulting Expert at Guidehouse

Risk Based Payer /Provider Consulting Expert

Guidehouse Carson City, NV (Onsite) Full-Time
**Job Family** **:**

Strategy & Transformation Consulting

**Travel Required** **:**

Up to 50%

**Clearance Required** **:**


**What You Will Do** **:**

Incredible opportunity to work with an exceptional Healthcare Consulting firm to reshape the go-forward strategy for health systems, AMCs and Provider organization as they deliver to the demands to reform and brace for industry disrupters. You will thread these models into integrated strategy project teams. He or she identifies, pursues and owns critical relationships with key clients. They drive new opportunities, innovative strategic based solutions and increase value to the healthcare client and revenue to Guidehouse. He/she is responsible for being an expert at healthcare provider strategic modeling and large-scale business transformations for health systems to succeed under risk-based payment. You are clearly capable of selling its value within the larger horizontal programs. All with an eye toward superior client satisfaction!

+ Demands a healthcare Business strategist and practice builder able to craft a disciplined but flexible large-scale business transformations for health systems to succeed under risk-based payment that catalyzes and set direction for stronger disciplined business strategy

+ You will use your strong network with Health providers to continually build C-suite, Board, and other client relationships strategically to strengthen the firm's value and secure new work

+ You will manage and mentor large teams of Guidehouse consultants and client leaders/ executives (for health systems, physician groups, and other care delivery providers) to ensure content and achieve results.

+ You will be an action-oriented, results -oriented, "take charge" resource capable of developing a strong business case for client action and the ability to develop and design strategies and capability building expertise for firm and client including: particularly Medicare Advantage Strategies but also enterprise/growth, M&A, ambulatory, service line, clinical, physician alignment, and payor strategy.

+ Lead at drafting client deliverables, including synthesizing the strategic, financial and operational implications of your analyses.

+ Assist where necessary with data acquisition, integration and analysis to support a wide range of payer and provider analytics including financial analysis, clinical and operational benchmarking

+ Be required to work on projects in **one or more of the following areas:**

+ Development of alternative value based care models (ACOs, CINS, Bundled Payments)

+ Accountable care organization operations including process improvement, Lean, 6 sigma skills in a payer or provider environment

+ Product design and development (e.g., Exchange products, Medicare Advantage, consumer directed health plans)

+ Medical management design and operations (e.g., utilization review, medical management, case management)

+ Financial / managed care contract payment and contract terms

**What You Will Need** **:**

+ A Bachelor's Degree from an accredited university. A Master's degree in management, health policy and administration or other quantitative degree is a significant plus.

+ 10+ years of previous work experience in a Healthcare consulting firm and or a combination of industry and consulting experience.

+ 6+ yrs. strategy and operations lead experience in commercial managed care market with demonstrated financial and analytical skills to realign health entities investment portfolio. Identifying and reprioritizing the portfolio to invest in the right service lines and businesses to optimize revenue, growth or other strategic imperatives.

+ 3+Yrs. of executive consulting experience influencing CSUITE healthcare client on strategic decisions inclusive of selling, designing and implementing programs that deliver results

+ Expert level skill in: Medicare Advantage (payer or provider: quality, HEDIS, strategy, compliance), Physician Strategy, Physician Operations, Payer Operations, Contract Strategy (for Provider and Payer), Managed Care strategy or operations, Payer Strategy, Medicaid Managed Care, affordability of care, physician alignment, and/or healthcare economics

+ Project and or Program Management experience in complex, multi-work stream, matrixed environments delivery to timeline, scope and budget.

+ Excellent quantitative analysis skills with strong proficiency not to just understand the foundational data, compliance and financial data but to leverage it to solve industry issues and drive results cohesively.

+ Structured approach to model solutions and manage teams' work.

+ Previous experience in selling strategy-based solutions to health Systems, providers and academic clients.

+ Working knowledge of Word, Excel, PowerPoint, and Access as well as the ability to conduct research.

+ The ability to work overtime as necessary

+ The ability to travel as necessary (including significantly)

**What** **Would Be Nice To Have:**

+ Superior written and oral communication skills

+ Additional qualifications include efficiency, flexibility, creative problem solving skills, a high level of motivation and excellent organizational skills. Candidates must be able to work independently, and within team structure

+ Previous experience in selling strategy-based solutions to health Systems, providers and academic clients. Minimum of 3 yrs. + experience in this capacity with a track record of driving new client revenues of $2MThe annual salary range for this position is $143,200.00-$314,900.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

**What We Offer** **:**

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

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 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

**About Guidehouse**

Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.

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

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at
or via email at [ Email address blocked ] - Click here to apply to Risk Based Payer /Provider Consulting Expert . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

_Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee._

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