Associate Director - Healthcare Value Transformation - Payer - Remote Location - Dover - 19904
2898 W Denneys Rd
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Navigant Consulting, Inc. (NYSE: NCI) is a specialized, global professional services firm that helps clients take control of their future. Navigant's professionals apply deep industry knowledge, substantive technical expertise, and an enterprising approach to help clients build, manage and/or protect their business interests. With a focus on markets and clients facing transformational change and significant regulatory or legal pressures, the Firm primarily serves clients in the healthcare, energy and financial services industries. Across a range of advisory, consulting, outsourcing, and technology/analytics services, Navigant's practitioners bring sharp insight that pinpoints opportunities and delivers powerful results. More information about Navigant can be found at navigant.com.
The healthcare industry is undergoing a generational shift from Fee For Service (curve 1) to Pay For Value (curve 2) payment and delivery models. Our Value Transformation (VT) practice is responsible for helping payers and providers develop go-to-market strategies and operational plans to **transform** their business, payment and delivery models to create high **value** , more sustainable, affordable and high quality services. Our team has an integrated platform of services to help our clients achieve their goals, including:
+ **Payment Transformation:** Develop payment and funds flow distribution models that incentivize and reward high quality of care.
+ **Total Medical Expense Management (TME):** Implementation of care delivery models that manage care across the continuum.
Our experience includes:
+ Work in over 90 markets nationally provides us tremendous national experience and local market insight to value based care models
+ Experience with over 20 ACOs, including Pioneer ACOs and MSSPs, including managing the start-up for 6 MSSPs
+ Facilitated over 25 commercial payer/provider ACO contracts/partnerships centered on shared savings, shared risk and performance based payment
+ Assists over 150 hospitals with CMS bundling applications, implementation and performance measurement
+ Development of numerous CIN's, including several regional / statewide organizations across multiple health systems
+ Utilize our NextGeneration analytic toolkit, with over 1B claims, to provide a wide array of analytics, modeling and reporting services for leading payers and providers to budget and manage margin and total medical cost trend Assists several large providers and payers, including Medicaid agencies, with the design and implementation planning of new payment and delivery models (e.g., ACOs, medical homes, etc.)
Our clients rely on our team for an integrated solution that drives improved performance and competitive advantages in their markets, in a way that enables senior executives to manage their business to new provider sponsored risk models. See How Far Impact Can Reach.
We are currently seeking an Associate Director with prior healthcare Payer strategy consulting experience or a blend of relevant healthcare payer industry and consulting experience. The successful candidate will:
+ Take a multidisciplinary approach to addressing projects in one or more of the practice's following focus areas:
+ Enterprise Strategy for Payers
+ Clinical Managed Care Strategy (Post-Acute Care, Service Lines, Care Continuum)
+ Heavy emphasis in strateegy to maximize scores in Medicare advantage
+ New Revenue Models (Managed Care, Payor and Pricing Strategy)
+ Development of alternative value based care models
+ Accountable care organization operations including process improvement, Lean Six Sigma skills in a payer environment
+ Medical management design and operations (e.g., utilization review, medical management, Medicare Advantage, case management)
+ M&A pre-deal feasibility, due diligence, pre-close, and post-close strategic and financial planning in a payer environment
+ Accountable for client relationships and managing day-to-day program work with a focus on the payer and health plan strategy and operations.
+ Facilitate/ or lead internal team and external client meetings.With health plans, provider sponsored plans and/or payer clients.
+ Regularly present results and updates to clients, and manage client expectations in line with budget and project objectives.
+ Manage internal multi-workstream project teams to deploy the right expertise to meet objectives.
+ Oversee various levels of consultants to achieve deliverable..
+ Assist where necessary with data acquisition, integration and analysis to support a wide range of provider and payer analytics including financial analysis, clinical and operational benchmarking to direct decisions for payer clients.
+ Structure analysis methodology and direct junior staff on analysis execution and crafting impactful client solutions.
+ Lead the creation of \"client ready\" deliverables, including synthesizing the strategic, financial and operational implications of the team's analyses.
+ Develop teams and individuals through coaching, feedback, and apprenticeship.
+ Directly support business development and sales activities.
+ Recognize add-on work opportunities at existing clients and suggest course of action.
+ 8+ years of previous work experience in a healthcare management consulting firm and/or a combination of industry and consulting experience.
+ Bachelor's Degree. MBA/MHA/healthcare related studies are preferable.
+ Experience putting together strategic models - (expert knowledge to the Payer Industry very important)
+ Ability to implement industry best practices and create an effective story line to present to payer clients (as well as provider).
+ Experience delegating to and directing others in the effective execution of a project plan.
+ Experience managing the quality of a team's work product and producing \"client ready\" deliverables in the health payer area including managed care, STARS- quality programs, Medicare Advantage operations, medical management, contract negotiations, risk adjustment and /or reimbursement processes.
+ Experience leading team meetings and keeping team informed of relevant developments.
+ Experience in value-based payment arrangements such as Medicare Advantage/Managed Care, risk contracting, shared savings arrangements, STARS programs, reimbursement, managed care programs and/or risk adjustment consulting.
+ Solid proficiency in Word, Excel, PowerPoint, and Access. SAS and SPSS knowledge is a plus.
+ The ability and willingness to travel and work overtime whenever necessary.
+ Additional qualifications include efficiency, flexibility, innovative problem solving skills, a high level of motivation, and excellent organizational skills. Must be able to work well independently and within team structures.
+ Frequently communicates with clients and coworkers and must be able to share information effectively
+ Strong conceptual, as well as quantitative and qualitative analytical skills
+ Flexibility and responsiveness in managing multiple projects in sometimes high-pressure situations simultaneously
+ Self-motivator with ability to work independently
+ Plan, direct, and coordinate work activities of others
+ Frequently travels by airplane, train or car as necessary to perform work at another location
The company offers competitive compensation packages including an incentive compensation plan, comprehensive medical/dental/life insurance, 401(k) and employee stock purchase plans.
**_Navigant does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Navigant and Navigant will not be obligated to pay a placement fee._**
**Navigant** is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.
Navigant will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. Associated topics: hematopathology, laboratory, medical laboratory science, molecular, pathology, surgical technologist, technician ii, technician iv, technologist, toxicology
* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.