South Dakota Mitchell Jobs

Job Information

Navigant Consulting Inc Managing Consultant - Healthcare - Value Transformation State Medicaid Programs - Remote Location in MITCHELL, South Dakota

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:

  • Clinically Integrated Networks: Market analysis, organizational design, network development, physician alignment.

  • 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 a Managing Consultant with prior healthcare State 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

  • Clinical Managed Care Strategy (Post-Acute Care, Service Lines, Care Continuum)

  • New Revenue Models (specifically focused on State Governemnt clients 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)

  • Accountable for client relationships and managing day-to-day program work with a focus on the payer and health plan strategy and operations.

  • Participate in leading internal team and external client meetings.With state sponsored health plans (Medicaid/Medicare/CHIP).

  • Present results and updates to Navigant leadership and clients, and manage projects on time, within budget and set objectives.

  • Manage internal multi-workstream project teams to deploy the right expertise to meet objectives.

  • Oversee senior consultants and consultants to achieve deliverables.

  • 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.

Required:

  • 5+ years of previous work experience in a healthcare management consulting firm and/or a combination of industry and/or government/consulting experience.

  • Bachelor's Degree. MBA/MHA/MBA or healthcare related studies are preferable.

  • Experience working directly with State Government clients, conducting research, analyses and presenting insights

  • Deep knowledge of State Medicaid/Medicare programs

  • Experience working in and /or buidling value-based payment arrangements such as Medicare Advantage/Managed Care, risk contracting, shared savings arrangements, bundled payment initiatives, STARS programs, reimbursement, managed care programs and/or risk adjustment consulting.

Preferred:

  • Ability to implement industry best practices and create an effective story line to present to State 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.

  • Superior written and oral communication skills.

  • Excellent quantitative analysis, project management, research, and core consulting skills.

  • 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.

  • Consulting experience is a plus.

  • Frequently communicates with clients and coworkers and must be able to share information effectively

  • Strong conceptual, as well as quantitative and qualitative analytical skills

  • Work as a member of a team as well as be a self-motivator with ability to work independently

  • Flexibility and responsiveness in managing multiple projects in sometimes high-pressure situations simultaneously

  • Able to travel via airplane with minimal assistance to client sites across the US and potentially internationally

  • Usually remains stationary for the majority of the day

  • Regularly uses close visual acuity and operates computer equipment to prepare and analyze and transmit data

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.

DirectEmployers