Job Description
Role Description
The desired Partner, Managed Care Advisory will have the opportunity to drive significant revenue enhancement and strategic repositioning for healthcare clients. This leader will be responsible for helping organizations identify and capture millions in potential revenue through comprehensive managed care solutions, including commercial rate benchmarking and payer price transparency analytics. The role involves navigating complex contract negotiations, particularly with challenging payers, and developing strategies that can transform a client's financial performance. This leader’s impact will extend beyond immediate financial gains, potentially helping distressed healthcare organizations improve their margin and market positioning by addressing critical managed care contract challenges.
The Partner, Managed Care Consulting is a senior leadership position within the Guidehouse Healthcare Practice, specifically focused on leading and driving growth for the Healthcare sector. This partner will be responsible for bringing and developing a book of business and have an oversight of ongoing project delivery solution development and management of teams across multiple concurrent client engagements across our managed care vertical. This role is critical to the success of the overall practice growth strategy, and will have responsibility for originating, closing, and managing clients, leading consulting teams, and ensuring the delivery of high-quality revenue cycle strategies and programs. This leader must be both strategic and operational, possessing deep knowledge and experience on how health systems work. They must successfully develop and execute against the vision for Managed Care services, including driving consulting projects that outline transformative initiatives to contain costs, enhance revenues, and lay out initiatives for execution across the firm for impact. Tying these initiatives to metrics and KPIs to show both revenue increases and cost containment success is crucial to the role. They must be experts in selling and delivering advisory work that assists healthcare organizations in optimizing performance, enhancing efficiency and ensuring compliance within industry regulations. This role is key in shaping and driving consulting opportunities across the entire managed care life cycle. This Partner will be key in helping build out the Managed Care practice, helping develop and mentor consultants in new methods to enhance performance improvement and drive impactful transformation initiatives leveraging the Guidehouse platform.
- The ideal candidate will co-lead the managed care practice that has the strong analytical staff, benchmarking and price transparency processes, as well as the reputation in the managed care place to advance the practice and work alongside highly experienced industry leaders to make meaningful change for clients served across 150+ markets.
- 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.
- Lead advisory and delivery teams on high-impact revenue cycle transformation client engagements within territory/market.
- Build a book of business through senior client relationship management by finding, closing and delivering Managed Care growth initiatives.
- Manage transaction deals sizes ranging from $500K to multi-million dollars annually with pull through to managed services that are multi-year.
- Support the Next Gen Payer-Provider healthcare horizontal joint initiatives between the managed care and the payer practice.
- Provide expertise and deep experience in Managed Care to evolve deal constructs, teaming opportunities, and portfolio evolution.
- Interface, manage, and expand relationships with client CEOs, CFOs, CTOs and other senior executives.
- Advise clients based on knowledge of operations best practices, industry trends, market happenings, and the newest technology innovations.
- Team and collaborate across the firm to drive maximum value for clients.
- Qualifications
- 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.
- 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 build strong client relationships at the executive level.
- Bachelor's 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.
- Knowledge of Medicaid managed care operational program elements.
- Travel up to 50% as the job requires.
- Requirements
- Sales and Commercial Excellence.
- Demonstrated experience in selling Managed Care contracts for projects that support large hospital systems and physician organizations.
- Deep experience originating front end deals and getting new logos by positioning best practices, industry trends and leveraging existing relationships.
- A consulting sales leader that is constantly scouring for new opportunities.
- A demonstrated sales record of consistent achievement of $8-10 million+ annually within Healthcare Managed Care Advisory.
- Player/Coach that drives all client facing and business development activities.
- Leverages strategy, financial and operational knowledge to serve as a consulting leader.
- Utilize proper sales operations discipline.
- Can coach strategy consultants on best practices for developing and growing executive client relationships.
- Can create a high-energy environment among the consulting team.
- Can originate opportunities, oversee sales and delivery, and engage in closing entry point projects.
- 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.
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