Healthcare is a transforming industry due to legislative and regulatory demands, technology challenges, and societal trends. Our growing Health Industries Advisory practice provides management, technology and risk consulting services to help healthcare institutions around the world to anticipate and address their most complex business challenges. Our practitionars are supported by a dedicated health research unit, which is managed by a physician partner and provides our clients with cutting-edge intelligence, perspective, and analysis on issues transforming the health industry. Our professionals have deep health industry expertise and include physicians, nurses, system specialists, health policy analysts, actuaries, financial advisors, and data analysts. The Healthcare Advisory practice is aligned across: Healthcare Provider, Healthcare Payers, and Pharmaceutical and Life Science.
Our Operations consultants help clients realize competitive advantage from operations. This high performing team translates business strategy into operations strategy and transforms operations to drive both growth and profitability. Specific areas of focus include global footprint and network design, product innovation and development, sales and operations planning, procurement and sourcing, manufacturing operations, service operations, logistics, and capital programs.
Position/Program Requirements
Knowledge Preferred:
Demonstrates proven thorough knowledge and understanding of, and success with contributing or managing specific workstreams of client engagements that involve, the following areas:
- Transaction lifecycles of Financial, Healthcare, Federal and Product and Services products
- Financial operations, including the financial close, planning and forecasting processes
- Operations and administration of Financial, Healthcare, Federal , Product and Services businesses
- Data and systems interactions including IT tools and technology
- Documentation and the identification of key controls within the transaction lifecycle
- Statutory Reporting, GAAP or IFRS requirements
Skills Preferred:
Demonstrates proven thorough abilities and success with utilizing tools and techniques to contribute to the delivery of financial effectiveness strategies for global, financial service clients
Demonstrates proven extensive abilities and success with working collaboratively and independently to address client needs by:
- Actively participating in client discussions and meetings
- Communicating a broad range of offered consulting services
- Managing engagements
- Preparing concise, accurate documents, including utilizing PC applications including Microsoft Word, Excel, PowerPoint and Project to write and deliver proposals to prospective clients
- Maintaining project economics while maintaining flexibility for unanticipated issues
Demonstrates proven thorough abilities and success as a team leader by:
- Creating a positive environment
- Monitoring workloads of the team while meeting client expectations
- Respecting the work-life quality of team members
- Providing candid, meaningful feedback in a timely manner
- Keeping leadership informed of progress and issues
- Answering questions and providing direction to less experienced staff
- Developing, writing, presenting and facilitating discussions on strategy to all levels of industry audiences, clients and internal staff and management
Minimum Years of Experience Necessary:
3 years of relevant experience in Financial, Healthcare, Federal or Products and Services Industries
Minimum Degree(s) and Certification(s) Required:
Bachelor's Degree
Additional Information
This role will be in our Health Industries Advisory Payer Practice, with a focus on Medicare.
Preferred Skills/Knowledge:
Selected individuals will have demonstrated thorough knowledge of and direct experience with the following:
Government Programs: Medicare Advantage, Medicaid, TriCare,enrollment, claims, billing and payments (provide and health plan), regulatory compliance and remediation
Operations/Administration/PMO: process improvement, sustainable cost reduction, health reform, ICD-10, membership, medical claims, billing, capitation, data analytics, project/program management, technology assessment/planning/implementation
Clinical Management: Care, disease, utilization management, healthcare analytics, coding
Product Management: market strategy and competitive intelligence, product development, sales channel development and management
Preferred Skills:
- Proven ability to work independently and lead small teams on specific projects
- Demonstrated thorough presentation skills, both verbal and written, utilizing technologies such as MS PowerPoint, MS Word, MS Excel, MS Visio, MS Access
- Proven ability to utilize creative problem solving skills and contribute to innovative solutions when working on client-related healthcare projects - Thorough knowledge of CMS regulations, regulatory environment and Health Plan operations process for Medicare products (enrollment, member services, product, claims, billing, capitation)
- Demonstrated experience coaching junior staff
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