Director-Payer Operations

Overview Guidehouse is a leading global provider of consulting services to the public and commercial markets with broad capabilities in management, technology, and risk consulting.

We help clients address their toughest challenges and navigate significant regulatory pressures with a focus on transformational change, business resiliency, and technology-driven innovation.

Across a range of advisory, consulting, outsourcing, and digital services, we create scalable, innovative solutions that prepare our clients for future growth and success.

The company has more than 10,000 professionals in over 50 locations globally.

Guidehouse is a Veritas Capital portfolio company, led by seasoned professionals with proven and diverse expertise in traditional and emerging technologies, markets, and agenda-setting issues driving national and global economies.

For more information, please visit: www.guidehouse.com.

Responsibilities Responsibilities: As a Director in Payer Group, you’ll lead and work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution.

• Arrange and sponsor appropriate assignments and experiences to help people realise their potential and support their long-term aspirations.

• You will identify market gaps and help lead where there are opportunities to create value propositions.

• You will identify opportunities at the Payer to scale efficiencies and guide work horizontally across environments to help the payer client and his partners be more effective including: financial transformation, performance improvement, payment systems optimization.

• You build road maps, pillars and processes for the payer that empower people and technology together to maximize value.

• Manage and take ownership for developing client relationships, vendor relationships, firm relationships that help deliver what is best for our people and stakeholders.

• Business development for the firm
– Influence/ persuade and create relationships that result in sales for the practice and add value to the firm.

• Support team to disrupt, improve and evolve ways of working when necessary • Expert-level functional knowledge of business intelligence and performance management software tools • Team leadership, including the recruitment, retention and development of top talent Qualifications REQUIRED Demonstrates considerable knowledge of, and/or success in Payer operations roles within a professional services firm or corporate environment, helping Health Plans and Payers to identify, clarify and resolve complex issues critical to their strategic and operating success.

Demonstrates Deep Knowledge Of: • Payer operations strategy (10+ Yrs.) Sales, Marketing, Benefits/Products, Clinical Management, and Core Operations for Commercial Payer and Health Plans (Enrollment, Claims, Billing, and Customer Service) • Payer Domain expertise (10+ Yrs.) Data & Analytics, Automation, Artificial Intelligence, Health Advocacy, Medical Trend Analysis, Cost Benchmarking.

• Payer industry market trends and industry-actively leads practices in order to develop insights and provide recommendations • Demonstrates proven team leader, collaborator and mentor that: guides, learns from others, is clear in direction and feedback • 10+ Yrs.

Of Consulting like skills inclusive of: designing, managing and delivering project content, conducting the analyses and defining the quality of client deliverables.

Able to develop conclusions, recommendation and client reports and presentations • Clear demonstration of developing/improving frameworks and operations best practice.

• Demonstrated ability to structure and manage larger, complex projects profitably ($2M+) • Developing and sustaining deep client relationships using networking, negotiation and persuasion skills to identify and sell potential new service opportunities • Proven track record of achieving sales quota (annual yr.

over yr.

Sales revenue $2M; managed revenue $2M) • Bachelors Degree from accredited university required; Master’s in Business, Health or IT strongly preferred.

Desired Skills • Effective Communication in knowledgeable manner in written and verbal formats • Medicaid Operations Experience a strong plus • Demonstrating strong aptitude for conducting quantitative analyses, (Excel and/or Access) and synthesizing complex data into meaningful insights.

• Strategic and creative problem solver • 5 plus years in consulting preferred Additional Requirements+ The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described.+ This position is open to candidate virtually from EST, CST, PST time zone as well as AZ, UT.

+ Due to our contractual requirements and federal orders, including an Executive Order from the White House and an emergency regulation from the Centers for Medicare & Medicaid Services (CMS), the position for which you are applying requires that you provide proof of your vaccination status.

If you are unable to receive the COVID-19 vaccine for medical reasons or because of a sincerely held religious belief, you may request an exemption from the vaccination requirement which shall be reviewed after the submission of requested documentation.

If an accommodation is granted, the conditions may include weekly testing and masking.

All Guidehouse employees also agree to follow any additional health and safety mitigation policies that may be required in the workplace.

Disclaimer About Guidehouse Guidehouse 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.

Guidehouse 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.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com .

All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies.

All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Rewards and Benefits 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 + 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 + Tuition Reimbursement, Personal Development & Learning Opportunities + Skills Development & Certifications + Employee Referral Program + Corporate Sponsored Events & Community Outreach + Emergency Back-Up Childcare Program + Position may be eligible for a discretionary variable incentive