Associate Director - Healthcare Value Transformation Actuarial Services - Multiple Locations

Navigant Consulting Denver , CO 80208

Posted 1 week ago

Practice Information

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.

Responsibilities

This job can be based in any of the following locations: Chicago, IL; Atlanta, GA; Denver, CO; Indianapolis, IN; Washington, DC; Minneapolis, MN; Seattle, WA

You will play a key role in Navigant's Value Transformation practice. Leveraging your healthcare industry expertise, specifically in the areas of in the areas of payment/reimbursement methodologies and strategy, managed care, and actuarial science. You will provide leadership in Navigant's Healthcare Actuary or Actuarial Analysis service line. You will be focused on overseeing the leadership of engagements within the Value Transformation practice, overseeing the analytics, modeling and financial assessments of these programs. Your clients will expect accurate, understandable, holistic presentations with actionable solutions.

You will oversee goals, objectives and plans for client engagements to optimize their programs, while working closely with Navigant staff and leadership to evolve strategic recommendations regarding our Actuarial service offerings. You will manage and coach team members to achieve their highest potential for Navigant and its clients. You will have a proven ability to oversee engagements and drive positive results for our clients through timely and accurate completion of deliverables.

Specific Responsibilities:

  • Contributes to the overall content of engagement deliverables as well as the project implementation plans; leveraging his/her knowledge of: actuarial analytics (including methodologies, model development and modifications), industry reporting and research and client presentation oversight (reports, findings, exhibits and other materials).

  • Accountability for the execution of consulting projects to ensure timely and quality implementation of program deliverables, insuring metrics are achieved. Insure appropriate: communication, scope adjustment /documentation and client relationships are made as the project progresses.

  • Will help grow and develop Navigant's actuarial team and solutions internally in a way that fosters career development, fiscal responsibility and culture/brand. You will have the opportunity to recruit, retain, train and guide staff to meet the needs of our project/product/documentation work and our people.

  • Responsible for maintaining strong client relationships, and assisting in proposal development, managing and writing responses to RFPs, account management and publications/presentations aimed at winning state actuarial program projects.

  • Typical project areas include (but not limited to) actuarially sound capitation rate-setting, determining and measuring managed care plan effectiveness, risk-adjustment methods, medical cost trend management, and forecasting.

Qualifications

  • 8-10 years of successive, progressive responsibility within healthcare with a focus on healthcare actuarial consulting for public and/or commercial healthcare payers and/or providers.

  • Credentialed ASA or FSA, plus experience with certifications of actuarially sound capitation rates for Medicaid programs and/or commercial payers Credentialed Group and Health FSA preferred.

  • Knowledge of innovative payment approaches for healthcare providers, including hospitals, physicians, nursing facilities and other long-term care providers

  • 5-10 years with supervisory and/or project management experience managing multi-million dollar budgets. P&L management experience a plus.

  • Experience and credibility interacting with state officials at the executive and program levels, c-level provider and plan executives, and a strong network within the industry.

  • Excellent written, verbal and presentation skills.

  • A strong team leader and mentor with a track record of developing mid-level and junior staff.

  • Ability to travel 50-75%

Mental/Physical Requirements

  • 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

EEO/C&B Statement

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.

About Navigant

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.


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Associate Director - Healthcare Value Transformation Actuarial Services - Multiple Locations

Navigant Consulting