(Core Business Operations Ã Core Industry Solutions Ã Emerging Industry Solutions Ã Health Plan Core Admin & Care Mgmt)
Are you an experienced professional with health plan and core administration experience? Do you have a penchant for detail with leadership experience? Do you encourage creative and innovative thinking from team members while helping them to bring their ideas and career plans to fruition? As a Digital Health Plan Manager, you will help clients set up, manage, and operate their most complex programs, assess and implement core administration solutions, and design and derive transformative approaches for health plan systems and processes.
The team â Health Care
The Health Care team 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 (PBMs).
Health plans face a number of unique environmental pressures that affect the way they will conduct business today and in the future â among them a need for increased privacy and security, an intense focus on risk management, access to capital, efforts to consolidate and streamline IT functions, the launch of new consumer-driven business models, managing chronic diseases through medical management practices, maximizing e-business-driven platforms, implementing health plan-specific customer relationship management tools, and complying with increasing financial and transactional legislation. Our health care professionals can help clients address these and other challenges in today's complex health care environment.
About our Digital Health Plan practice
Our Digital Health Plan practice sits within Core Industry Solutions under Core Business Operations, which supports design, implementation, and operation of âheart of the businessâ transactional systems and core operations. Core Industry Solutions encompasses industry vertical, sector specific solutions that leverage distinct technologies to drive operational change and automate the core our clientâs business. We incorporate expertise from across the firm to leverage common approaches, best practices, and strategic investments to scale these solutions according to industry strategy. Professionals focus on key client issues that are at the core of the business by integrating our industry expertise with deep technical and operational transformation capabilities.
The Digital Health Plan practice is focused on accelerated transformation of âheart of the businessâ operations for health plans through industry technology solutions. Practitioners focus on digital enablement across the health plan value chain, working with health care leaders and organizations to tailor a successful approach for transforming core administration operations and design solutions that meet our their financial, operational, and performance improvement goals. We connect with industry solutions players in the market, incubate new solutions in collaboration with clients and strategic alliances, and scale industry solutions using package and in-house products.
Work youâll do
Managers are professionals with strong records of academic and professional achievement who have the capacity and desire for continuous development and growth. Deloitte Consulting professionals must also be capable of working and communicating with people at all levels of an organization. Responsibilities typical of a manager on one of our Digital Health Plan projects could include:
Provide expertise in core administration platforms and health plan functions to clients
Assess a clientâs current core administration capabilities, define desired future state, identify gaps, and propose potential solutions
Analyze available core administration platforms and provide recommended options based on a clientâs business and technical needs
Lead project management activities throughout the implementation of a third-party core administration vendor platform
Oversee conversion efforts to migrate core business data (e.g., providers, members, claims) from a clientâs legacy system to a new platform
Partner with business areas to identify impacts, define requirements, design new processes, and implement changes needed for future activities
Assist client with the identification, prioritization, coordination, and resolution of issues among various business areas and third-party vendors that impact production and quality of system implementation efforts
Participate in setting engagement objectives and scope
Build and source internal team structure and composition to deliver engagements
Assume accountability for on-time delivery of contracted activities and deliverables
Manage delivery, work plans, and activities for multiple components of an engagement across work streams
Lead teams to assess, design, and implement solutions to achieve clientâs strategic objectives and business issues
Conduct client interviews and facilitate client meetings
Develop process flows depicting pain points in the business process
Conduct detailed analyses to draw conclusions, and develop pertinent and insightful recommendations
Design and manage deliverable content to reflect the engagement contract
Present findings and recommendations to client leadership
Develop and maintain trusted relationships with client counterparts
Provide client sponsors with regular updates
Identify and mitigate risks throughout the project life-cycle
Lead and manage identification and prioritization of issues
Own budgeting and forecasting of team member time and expenses for projects
Foster a trusting and safe environment with an emphasis on problem solving and continuous improvement
Perform role of counselor and coach
Mentor and develop junior staff
Actively participate in staff recruitment and retention activities
Provide leadership for delivery teams and staff in local offices
Set work/life balance expectation on engagements through flexibility and predictability initiatives
Provide input and guidance into the staffing process
Provide real-time feedback to project team members and participate in the performance review process
Provide guidance to junior practitioners as they manage large, confidential, and complex data sets
Eminence and firm activities:
Develop points of view in health care
Publish white papers and present opinion at industry conferences
Lead practice development activities within the firm
Lead and support recruitment activities
Organize local office events to build firm culture
Bachelorâs degree in computer science or relevant field from an accredited college or university
Minimum of 8+ years of professional experience within the health care industry, specifically focused on health insurance core administration functions and platforms
Experience with delivering large technology programs, establishing high performing teams, and selling client projects
Experience in one or more of the following types of projects within health plans: core administration platform implementation / migration, operational and/or IT solution design, operational and/or IT impact assessment, system evaluation and selection, application rationalization
Demonstrated understanding of the health insurance business (Commercial (Employer and Individual), Medicare, Medicaid, Federal Employee Program, HealthCare Exchanges), with expertise in three or more of the following functional areas: membership and enrollment, billing, claims and claim payables, products and benefits, provider services, provider networks, provider reimbursement methodologies, authorizations, utilization management, care management, customer service
Understanding of the health care industry, including market landscape, regulatory environment, and industry trends
Experience, training, and/or certification in Epic Tapestry core administration platform
Proficient in Microsoft Office (PowerPoint, Excel, Word)
Proven critical thinking, analytical, and problem-solving skills on business and technical constructs
SDLC management experience in waterfall, agile, and/or scaled agile
Strong leadership and management skills
Strong work ethic; comfortable working in a fast-paced environment
Ability to travel 80%+ (While 80%+ of travel is a requirement of the role, due to COVID-19, non-essential travel has been suspended until further notice.)
Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.
Advanced degree in business, technology, or health care related field from a top tier program
Management consulting experience in a health care related field
Experience working on provider data migration initiatives
Experience configuring benefits, providers, contracts, and/or other health plan functions
Exceptional interpersonal, team-building, and communication skills
Ability to build consensus and foster change in ambiguous settings
Commitment to personal and professional growth
Sense of responsibility to self, team, and client
Outstanding integrity, initiative, creativity, and passion
Record of consistent career progression with increasing levels of responsibility
Proactive and open to learning new technologies
How youâll 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 thereâs always room to learn. We offer opportunities to help sharpen skills in addition to hands-on experience in the global, fast-changing business world.Â 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.Â Explore Deloitte University, The Leadership Center.
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.Â Learn more about Life at Deloitte.
Deloitte is led by a purpose: to make an impact that matters. This purpose defines who we are and extends to relationships with our clients, our people and our communities.Â We believe that business has the power to inspire and transform. We focus on education, giving, skill-based volunteerism, and leadership to help drive positive social impact in our communities.Â Learn more about Deloitteâs impact on the world.
We want job seekers exploring opportunities at Deloitte to feel prepared and confident. To help you with your interview, we suggest that you do your research: know some background about the organization and the business area youâre applying to. Check out recruiting tips from Deloitte professionals.
Internal Number: 12093335
About Deloitte Consulting
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. At Deloitte, we know that great people make a great organization. We value our people and offer employees a broad range of benefits.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. Deloitte is led by a purpose: to make an impact that matters. This purpose... defines who we are and extends to relationships with our clients, our people and our communities. We believe that business has the power to inspire and transform. We focus on education, giving, skill-based volunteerism, and leadership to help drive positive social impact in our communities. We want job seekers exploring opportunities at Deloitte to feel prepared and confident. To help you with your interview, we suggest that you do your research: know some background about the organization and the business area you’re applying to.