Senior Manager, Healthcare - Payer Core Operations and PBM
Focuses on assisting those organizations that are responsible for the delivery, funding and payment management of health care and medical related services. Clients include hospitals, academic medical centers, health systems, home health agencies, long term care, outpatient facilities, ambulatory surgery centers, practitioners and physician groups as well as health plans, other health insurance companies, and pharmacy benefit managers. Also drives integration with government agencies.
Work you’ll do
Senior Managers are expected to contribute to the firm's growth and development in a variety of ways, including:
•Engagement Management: Lead engagement planning and budgeting; mobilize and manage engagement teams; define deliverable structure and content; facilitate buy-in of proposed solutions from top management levels at the client; direct on-time, quality delivery of work products; manage engagement economics; manage engagement risk
•Client Management: Manage day to day interactions with executive clients and sponsors
•Business Development: Develop and maintain contact with top decision makers at key clients; organize and lead pursuit teams; participate and lead aspects of the proposal development process; contribute to the development of proposal pricing strategies
•Practice Development & Eminence: Develop practical solutions and methodologies; develop "thought-ware" and "point-of-view" documents; participate in public speaking events; get published in industry periodicals
•People Development: Perform role of counselor and coach; provide input and guidance into the staffing process; actively participate in staff recruitment and retention activities; provide leadership and support for delivery teams and staff in local offices
Our Operations Transformation team focuses on transforming our clients’ core business operations. We advise, design, implement, and deploy solutions focused on “heart of the business” issues in specific sectors including Health Care, Banking & Securities, Insurance, and Energy & Resources. The type of work we provide to our clients includes Operations Excellence, Payment & Care Model Innovation and Emerging Business Models.
Our clients seek a fresh perspective on how to create a flexible, innovative business model supported by a strong operations foundation. Professionals will use their deep sector knowledge and technical business operations consulting experience to take a more strategic view of our clients’ priorities, helping them to prepare for growth, embrace the digital agenda and maximize operational efficiency.
•Bachelor’s degree from accredited university with strong undergraduate academic record. MBA and/or Advanced degree in clinical sciences preferred (PharmD, RN, MSN, MD)
•Minimum of 8+ years of professional experience in Health Plans industry, or a mix of a few years’ industry experience and functioning as a Senior Manager or higher in a Consulting environment.
•Require business and clinical operations experience and subject matter expertise on Core Operations, Pharmacy Benefits Management, Value Based Care, Population Health Management, Care Management, and Analytics; Clinical and HP
- Knowledge and experience with Pharmacy Benefit Management industry (5+ years’ experience in pharmacy benefit industry facing role)
- Pharmacy Benefit and Formulary Implementation, Pharmacy Claim Adjudication, Pharmacy Benefit Operations, Specialty Pharmacy Benefits, Home Delivery Pharmacy
- Pharmacy benefit, formulary, network design and management, Drug benefit pricing, utilization management program operations, Medicare Part D operations
• Demonstrates consistent career progression with increasing levels of responsibility; performed above expectations in professional roles
•Ability to work independently; lead teams focused on specific work streams of large projects.
•Strong oral and written communication skills, presentation skills and MS Visio, PowerPoint, Excel and PowerPoint proficiency
•Willingness and ability to travel 80%
•Advanced degree in clinical sciences or MBA from a top tier program
•Superior critical thinking, analytical and problem-solving skills
•Exceptional interpersonal, team-building and communication skills
•Outstanding integrity, initiative, creativity, and passion
•Ability to work in an ambiguous environment
•Strong problem solving and troubleshooting skills with the ability to exercise mature judgment.
•Live within commuting distance to one of Deloitte’s consulting offices
How you’ll grow
At Deloitte, our professional development plan focuses on helping people at every level of their career to identify and use their strengths to do their best work every day. From entry-level employees to senior leaders, we believe there’s always room to learn. We offer opportunities to help sharpen skills in addition to hands-on experience in the global, fast-changing business world. From on-the-job learning experiences to formal development programs at Deloitte University, our professionals have a variety of opportunities to continue to grow throughout their career. Explore Deloitte University, The Leadership Center.
At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits. Learn more about what working at Deloitte can mean for you.
Our positive and supportive culture encourages our people to do their best work every day. We celebrate individuals by recognizing their uniqueness and offering them the flexibility to make daily choices that can help them to be healthy, centered, confident, and aware. We offer well-being programs and are continuously looking for new ways to maintain a culture where our people excel and lead healthy, happy lives. Learn more about Life at Deloitte.
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As used in this posting, “Deloitte” means Deloitte Consulting LLP, a subsidiary of Deloitte LLP. Please see www.deloitte.com/us/about for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. Certain services may not be available to attest clients under the rules and regulations of public accounting.
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