Director, Managed Care

Job not on LinkedIn

🔥 38 minutes ago

🌽 Illinois, Virginia – Remote

🌽 Illinois – Remote ⚔️ Virginia – Remote

💵 $179k - $298k / year

⏰ Full Time

🔴 Lead

👔 Director

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Guidehouse

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2018

🏥 Healthcare

🎖️ Defense

📦 Logistics

💰 Grant on 2023-02

Healthcare • Defense • Logistics

Guidehouse is a global consultancy offering advisory, digital, and managed services across commercial and public sectors. It is purpose-built to support industries such as national security, financial services, healthcare, energy, and infrastructure. Guidehouse collaborates with leaders to navigate complexity and drives transformational changes that impact the future. Their expertise spans data analytics, digital technologies, risk management, and more, with a strong emphasis on sustainability and innovation.

📋 Description

• Manage the full managed care contracting cycle, including analytics, strategy preparation, negotiations, and post-contract implementation • Develop and execute managed care solutions, including commercial rate benchmarking, payer price transparency analytics, and contract negotiations • Bring new clients to the firm with a partner-level revenue target of $8 million or higher • Provide strategic insights to C-suite executives to transform revenue and market positioning • Lead business development of advisory pursuits within the territory/market • Lead advisory and delivery teams on high-impact transformation engagements • Build a book of business through senior client relationship management, finding, closing, and delivering managed care growth initiatives • Manage consulting experts and advisory personnel across key accounts • Drive contract growth and identify, originate, and capture new opportunities for revenue cycle programs • Manage transaction sizes from $500K to multi-million-dollar annual deals, including multi-year managed services • Support Next Gen Payer-Provider healthcare horizontal joint initiatives • Cross-sell Guidehouse services to broaden accounts and marketplace exposure • Evolve managed care deal constructs, teaming opportunities, and portfolio strategy • Manage and expand relationships with CEOs, CFOs, CTOs, and other senior executives • Advise clients on operational best practices, industry trends, market developments, and technology innovations • Collaborate across Guidehouse to maximize client value • Own and build internal and external business and industry relationships • Coach consultants on executive relationship development and managed care sales • Oversee sales and delivery, originate opportunities, and close entry-point projects to expand revenue-cycle engagements

🎯 Requirements

• 10+ years of professional experience in healthcare management, strategy, consulting, or related areas • Previous executive consulting or industry leadership with Medicaid, Medicare/Medicare Advantage, accountable care organization, or patient-centered medical home experience highly desirable • Experience in ACO leadership, managed care, health plan or payer leadership, executive-level contract management, IT/data management, quality management, client-facing healthcare consulting, or health policy analysis and health economics research • Knowledge of risk prediction and adjustment methods, performance-based procurement, and quality and total cost measures of care • Superb problem-solving and interpersonal skills • Demonstrated analytical skills and ability to develop innovative, holistic, value-based strategic solutions • Ability to lead and supervise staff in collaborative, matrixed team environments and achieve budget and timeline goals • Ability to sell consulting and build strong executive-level client relationships • Bachelor's degree from an accredited school required • Demonstrated leadership achieving outcomes in healthcare consulting strategy and transformation projects • Proficiency in MS Office Suite, including Word, Excel, PowerPoint, and MS Project • Proven verbal and written communication skills • Knowledge of Medicaid managed care operational program elements, including MMIS, eligibility and enrollment, capitation payments, quality performance, and care coordination • Ability to travel up to 50% • Deep managed care, payer strategy, healthcare negotiation, benchmarking, pricing, contract review, analytics, and transformation experience • Experience with CDM optimization, revenue rebalancing, managed care benchmarking, price transparency, strategic pricing, and automated analytics platforms • Understanding of EBITDA improvement, turnarounds, technology innovation, operating model redesign, financial performance, and healthcare foundational processes • Experience partnering with healthcare systems, hospitals, physician organizations, and multi-site healthcare entities

🏖️ 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 • Flexible benefits package • Flexible work arrangements