Job Description

Description: Position will primarily provide Healthcare Practice Consulting, Strategy, Business Plan Road-mapping, Business Process Optimization/Transformation services to our Healthcare clients, which will include, but not limited to the following: 1) Bring industry perspective, 2) provide advice on business problems, 3) lead business consulting/business process optimization initiatives, 4) Gather high level requirement & scope, translate strategy into design and build, 5) bring Value Innovation and Thought Leadership to our clients. Responsibilities: Consultants serve to develop analysis from the simple to complex as determined by the client and project scope. Consultants will soon manage a section of work for a project from the design to the integration of the work and client interface. The consultant will then begin to manage the whole project to managing SBU relationships and then manage company relationships:

1. Perform complete analyses within the scope of the project from the simple to the complex.
2. Structure methodologies, analyze, summarize the findings, and apply the findings to the project.
3. Manage a section of work from simple to complex. Understand the scope of the total project. Design an approach. Determine the resources needed to complete the project. Select methodology and complete the work. Develop the recommendations, integrate with the project and manage the client interface.
4. Managing a project includes managing the executive relationship, organize the team, structure the work plan, complete the work, introduce the work to the client and develop the implications for the client.
5. Manages relationships by building a development strategy and deepen trust-based relationships. Drive the business impact of the project or more than one project.
6. Manages company relationships by becoming the trusted advisor to the CEO and the Board. Improve total company performance. Lead multiple engagements for the client over time.

Qualifications: Strong Healthcare Payer Business understanding with deeper understanding of at least one or more of these areas. Membership, Enrollment & Billing, Provider Demographics/Network Management/Contracts/Pricing or Claims, Customer Service Pharmacy and Healthcare Management (clinical and outcome based).

• 10+ years of healthcare strategy consulting experience with payer, provider or services organizations
• Superior consulting and analytic skills are a must
• 8+ years healthcare payer background with extensive health management program knowledge and experience, operating comfortably with the business, IT and management, and accepted as an advisor at these levels
• 5+ year experience leading/managing or participating in large internal projects/programs or consulting engagements
• Ability to leverage existing relationships, and networking to build relationships within the industry in order to generate resources and opportunities for Client and the Center of Excellence.
• Business process optimization/transformation experience.
• Deep expertise and experience of payer operations including claims, customer service, eligibility and billing, underwriting, etc.
• The candidate should be able to translate complex ideas, concepts, and business requirements into potential solutions that bring business value to our clients. Brings a strong track record of delivering solutions that transform the fundamentals of a business
• Superior written and oral communications skills
• Ability to travel up to 75% TEPHRA

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