Healthcare Partner, Managed Care Consulting
Guidehouse · Remote · United States · 11d ago
Job Family:
Strategy & Transformation Consulting
Travel Required:
Clearance Required:
What You Will Do:
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.
Primarily the responsibilities for this role include:
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.
Activities include originating new consulting opportunities, driving assessments in the front end, current v. future state performance, expanding and extending current advisory engagements, relationship-based selling to new clients, leading RFP responses, and representing the firm at business development-related conferences
Lead advisory and delivery teams on high-impact revenue cycle transformation client engagements within territory/market.
Activities include: client relationship management, consulting delivery execution, project financial management, risk/quality management, and client satisfaction management
Build a book of business through senior client relationship management by finding, closing and delivering Managed Care growth initiatives
Manage teams consisting of consulting experts and advisory personnel to cover key accounts
Responsible for contract growth, and uncovering and assisting in originating and capturing new opportunities that land and expand revenue cycle programs with clients
Manage transaction deals sizes ranging from $500K to multi-million dollars annually with pull through to managed services that are multi year
This role will also support the Next Gen Payer-Provider healthcare horizontal joint initiatives between the managed care and the payer practice
Key to this role will be able to cross sell other guide house services to broaden accounts and exposure in the marketplace parentheses (e.g. access performance excellence, strategy digital etc)/
Provide expertise and deep experience in Managed Care to evolve deal constructs, teaming opportunities, and portfolio evolution
Lead client management and growth in Managed Care by leveraging design, development, and implementation skills to advise and guide clients to best options
Interface, manage, and expand relationships with client CEOs, CFOs, CTOs and other senior executives to demonstrate how solutions set the strategy for enhancing operational efficiency, financial health, and patient care quality.
Own and build critical business and industry relationships, both internally and externally
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
What You Will Need:
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
15+ 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.
Risk predication and adjustment methods, and performance-based procurement,
Quality and total cost measures of care for Federal, State, and health plans who participate in the Affordable Care Act, Medicaid, and Medicare programs.
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 building strong client relationships at the executive level, demonstrated by persuading boards and C-suites of Government Health State Agencies, Health Plan and Payor organizations to action
Bachelor's degree from accredited school required
Demonstrated leadership achieving outcomes in healthcare consulting focused strategy and transformation projects
Proven verbal and written communication skills, including the ability to persuade senior management or Knowledge of Medicaid managed care operational program elements including MMIS, eligibility and enrollment, captivation payments, quality performance and care coordination
Travel up to 50% as the job requires
What Be Nice to Have:
Sales and Commercial Excellence
Demonstrated experience in selling Managed Care contracts for projects that support large hospital systems and physician organizations, as well as community hospitals, academic medical centers, and mid to large-size regional healthcare providers.
Deep experience originating front end deals and getting new logos by positioning best practices, industry trends and leveraging existing relationships and developing new ones
A consulting sales leader that is constantly scouring for new opportunities, leveraging their experience and relationships in the managed care space to sell assessments and shape consulting deals for the entire Managed Care life cycle (strategy, technology, operations, etc)
A demonstrated sales record of consistent achievement of $8-10 million+ annually within Healthcare Managed Care Advisory and skills, relationships and market knowledge to build a book of business quickly
Player/Coach that drives all client facing and business development activities for selling advisory and positioning digital and managed services end to end projects.
Leverages strategy, financial and operational knowledge to serve as a consulting leader to sell advisory to healthcare executives using learned experiences and best practices, the latest industry trends, regulation changes, and market movements to compel them to act.
Utilize proper sales operations discipline (e.g. pipeline analytics, offering collaterals, tracking scorecards) to performance manage the team
Can coach strategy consultants on best practices for developing and growing executive client relationships
Can create a high-energy environment among the consulting team that drives enthusiasm, optimism, and a relentless focus on solving client problems, winning deals, and achieving performance metrics
Can originate opportunities, oversee sales and delivery, and engage in closing entry point projects to position land and expand opportunities across the revenue cycle continuum.
Managed Care Domain Knowledge
Deep payer strategy and advisory experience in the drivers that can enhance optimizing operations, financial health, and patient outcomes while navigating complex regulatory environments
A deep experience developing and executing negotiation strategies for provider and payer healthcare clients to improve their financial posture from both a revenue enhancement and cost containment perspective
Deep experience in either industry and/or consulting driving optimization work, including analytics around benchmarking to help inform fact-based negotiation strategy and positions
Negotiation experience from strategy through execution in the healthcare ecosystem internally and externally including partners to make improvements
Experience in CDM optimization, revenue rebalancing, managed care benchmarking, price transparency, strategic pricing, managed care strategy, contract language review and automated analytics platform for benchmarking type services will be crucial.
A deep understanding across the healthcare system environment to lay out roadmaps for broad transformations and restructuring work to sell discrete projects that satisfy strategic goals
An expert in areas such as EBITDA improvement, turnarounds, tech innovation, operating model redesign, financial performance, and foundational processes in a healthcare system.
Deep understanding of industry trends towards greater price transparency and the technology enabled solutions to support an evolving marketplace as well as other analytical advancements that impact clients
Deep strategic consulting in large scale transformations that impact operational performance and implement technology transformations and strategic planning
Experience partnering with healthcare systems, hospitals, physician organizations, and multi-site healthcare entities, reinforced by a deep knowledge of key players in the market
Ability to tailor solutions that address the unique challenges of the healthcare industry driving performance and patient outcomes
Delivery Excellence
Track record of advising clients on payer revenue and contract yield leading practices, clinical operations, technology strategy, and innovative care, leveraging deep industry insights to drive performance improvement to ensure its proper delivery.
Demonstrated experience in developing strategic roadmaps and ensuring consulting teams deliver the plans to drive financial and operational performance improvements that help organizations streamline processes, reduce costs, and enhance efficiency.
The ideal candidate will come with a reputation for selling and delivering Managed Care transformations that made an everlasting impact to healthcare clients and can be replicated Deep experience in creating compelling deliverables and work products that clients have used to drive performance improvement initiatives with impact.
Ideal candidates will have a record of relationship building, selling and delivering roadmaps of work, strong employee and team satisfaction metrics, focusing on an employee experience focused management approach
Ability to manage multiple pursuits and overseeing and coaching teams on internal operations and methodologies for effective programs.
Proven ability to sell and deliver across the entire Guidehouse portfolio
Focused on Managed Care and ensuring projects are delivered on time and on budget
Can leverage delivery insights into addressing problems before they happen and looking for cross-sell opportunities
Client Management
Has C-Level relationships and can build others with senior executives at healthcare entities, including Partners, to serve with excellence and quality
Develops account planning programs for proper client coverage to go deep and wide (expand the “pipe and pie”) in serving clients holistically
Brings clients new ideas based on the market, industry and technology trends proactively to keep them ahead of achieving their goals
Bring strong provider and payer market relationships with senior executives and be able to gain traction rapidly on selling new business
Ideal candidates will lead with empathy and have an extensive set of relationships, capabilities, and approaches to bring firm offerings to client needs in an authentic, mission-driven, and client service-focused manner
Track record of building and expanding client partnerships through the development and delivery of new advisory services solutions
Ability to build new processes and solutions to improve client satisfaction, service quality and market penetration
Scale & Execution
Experience selling a roadmap of managed care services that start with consulting and advisory to position larger deals across the Guidehouse portfolio
Demonstrated experience selling and delivering large, concurrent consulting projects that made impact and delivered results to replicate at other healthcare organizations.
Track record of consistent achievement of building and growing a book of business of $8-$10 million annually within healthcare Managed Care
Disciplined operator who performance-manages their consulting team with rigor and discipline and develops best practices and processes for constant improvement
A KPI-driven leader that monitors the health of the business and takes proactive action for improvements and innovation
Culture Fit & Leadership
A strategic thought leader, expert in Managed Care advisory, driven to improve financial and operational improvement in healthcare.
Personable, humble, confident and experienced proactive leader able to function in a matrix
Charismatic visionary with high EQ, high IQ, and low ego
A strong leader and communicator able to guide and mentor their team to successful outcomes
A resilient consulting expert who has the proven experience to work through client opportunities and issues to get results, improve ways of working, and deliver quality results
Demonstrated experience grooming the following generations of leadership
Proven experience building and transforming teams, driving service and quality excellence
Ability to articulate mature hiring and management philosophies as well as leading best practice methodology development to improve overall consulting performance.
Ability to navigate and lead through ambiguity
Highly credible, leadership polish, and winning instincts
Collaborative team player that works well to best serve clients and Guidehouse across the firm
Personal characteristics
The ideal candidate must possess strong people skills and the ability to function effectively in a matrix management environment. They should be adaptable, capable of working across different organizational structures, and not rigidly hierarchical. The leader must have excellent interpersonal abilities who can lead and develop team members. They must have high emotional intelligence who can collaborate effectively. Some important details include:
Strategically minded, operationally inclined, and action-oriented
Market facing deal maker and delivery/operational leader
A team builder with executive presence
Charismatic visionary with low ego/high EQ
Resilient, roll-up-the-sleeves ‘doer’ that ‘gets things done’
Innovative out-of-the-box critical thinker
Natural collaborator that reaches across the firm to maximize impact
Driven to improve revenue cycle management performance
Provide and create a high-energy environment among the healthcare team that drives enthusiasm, optimism, and a relentless pursuit of solving client problems, winning deals, and achieving targeted metrics
Inspired by strong teamwork and collaboration and working with great people
Other
Preference will be given to candidates living near a Guidehouse office
Master’s degree in business, healthcare, or related field strongly preferred;
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 Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.
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