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Senior Consultant/Program Lead

Remote: 
Full Remote
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Offer summary

Qualifications:

8+ years of consulting experience in a healthcare organization, preferably with payer experience., Bachelor’s Degree required; Advanced Degree (MBA/MHA) preferred., Strong understanding of Health Plan Core Admin operations and healthcare technology., Experience in building financial models and defining future state business processes..

Key responsabilities:

  • Run consulting engagements focused on health plan operational assessments and future state operating models.
  • Create operational and technology blueprints to recommend cost savings initiatives.
  • Provide expertise in core admin operations to maximize performance and drive efficiencies.
  • Collaborate with engagement leadership and assist the Sales team in consultative selling efforts.

UST HealthProof logo
UST HealthProof SME https://www.usthealthproof.com/
501 - 1000 Employees
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Job description

Role Description

Senior Consultant/Program Lead

Consultant II

Who We Are

UST HealthProof is a trusted partner for health plans, offering an integrated ecosystem for health plan operations. Our BPaaS solutions manage complex admin tasks, allowing our customers to prioritize members’ well-being. With our commitment to simplicity, honesty, and leadership, we navigate challenges with our customers to achieve affordable health care for all.

We have a strong global presence and a dedicated workforce of over 4000 people spread across the world.

Our brand is built on the strong foundation of simplicity, integrity, people-centricity, and leadership. We stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

You Are

As a Senior Consultant, you possess strong understanding and working knowledge of Health Plan Core Admin operations (i.e. Enrollment and Billing, Claims, Provider and Contracts, Disbursements) and healthcare technology. You will contribute to defining strategic and tactical plans to help streamline and maximize Health Plans operational capabilities using industry leading platforms, innovative solutions and best practices. As a member of the Advisory team, you will run advisory engagements focused on strategic and technology assessments of Health Plan operations and play a crucial role in providing Health Plans recommendations for improved operational efficiency, and stakeholder experience.

The Opportunity

  • Run consulting engagements, including health plan operational assessments, current state information discovery activities and defining future state operating model/technology ecosystem, assuming responsibility for contract deliverables and project resourcing
  • Create operational and technology blueprints, build business case to reduce total cost of ownership for Health Plan Core Administration platforms and operations by recommending and implementing cost savings initiatives
  • Provide core admin cross-functional expertise and best practices to help maximize health plan core admin platform and operations performance, driving efficiencies, and operational administrative cost structure
  • Work collaboratively with engagement leadership and be fully responsible for the engagement work product and performance.
  • Plan the detailed execution approach of advisory projects and engagements.
  • Directly assist the Sales leadership team on pursuits, build collateral and contribute thought leadership to drive consultative selling.
  • Participate in strategic planning, building reusable assets and scaling practice operations

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What You Need

  • 8+ years’ experience consulting in a healthcare organization; Payer experience preferred
  • Bachelor’s Degree Required; Advanced Degree Preferred – MBA/MHA
  • Expertise in government sponsored plans, employer group medical health and health plan operations
  • Experience in building configurable financial models and utilizing them to build business cases as part of recommendations
  • Experience defining future state business processes
  • Ability to travel within the continental US – 75% travel Required


  • Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. UST HealthProof provides a reasonable range of compensation for roles that may be hired in various U.S. markets as set forth below.

    Role Location: Remote

    Compensation Range: $109,000-$145,000

    Benefits

    Full-time, regular employees accrue up to 16 days of paid vacation per year, receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year), 10 paid holidays, and are eligible for paid bereavement leave. They are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance, as well as the following Company-paid benefits: basic life insurance, accidental death and disability insurance, and short- and long-term disability benefits. Regular employees may purchase additional voluntary short-term disability benefits, and participate in a Health Savings Account (HSA) as well as a Flexible Spending Account (FSA) for healthcare, dependent child care, and/or commuting expenses. Certain regular employees may have the potential for quarterly incentive-based bonuses and or commissions depending on role. Benefits offerings vary in Puerto Rico.

    Part-time employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) Retirement Plan with employer matching.

    Full-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year) and are eligible to participate in the Company’s 401(k) program with employer matching. They and their dependents residing in the US are eligible for medical, dental, and vision insurance.

    Part-time temporary employees receive 6 days of paid sick leave each year (pro-rated for new hires throughout the year).

    All US employees who work in a state or locality with more generous paid sick leave benefits than specified here will receive the benefit of those sick leave laws.

    What We Believe

    At UST HealthProof, we envision a bold future for American healthcare. Our values are the bedrock beliefs our organization holds dear. They not only define what our brand stands for but also serve as a compass guiding every action and decision.

    Guiding Principles

    These principles illuminate the path of ‘how’ we operate. They detail actions and behaviors we much embody to honor our values and achieve our goals.

    • Simplicity

    Simplifying complexity underlines everything we do—this approach is what makes us unique. We come with an open mind and straightforward approach, cutting our way to the core with measurable and actionable insights.

    • Integrity

    Integrity is our currency to build relationships. We believe in being open and honest. It is only natural when we have nothing to hide. It demonstrates that we are here to do the right thing, no matter who is watching.

    • People-Centricity

    Everything that we do reflects our deep bonds with peers and customers. These aren't mere transactions, but transformational ties. They shape our culture and decisions, affirming that our true value lies in the lives we touch and impact.

    • Leadership

    Taking ownership is about taking initiative, being in-charge and driving things to completion. It’s a brave choice to ‘own’ all aspects of our work, ensuring we take full responsibility for everything we handle.

    Mission

    A future possible only when health plans are free from administrative burdens so they can truly focus on what matters more – their members’ well-being.

    Equal Employment Opportunity Statement

    UST HealthProof is an Equal Opportunity Employer.

    All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other applicable characteristics protected by law. We will consider qualified applicants with arrest or conviction records in accordance with state and local laws and “fair chance” ordinances.

    UST HealthProof reserves the right to periodically redefine your roles and responsibilities based on the requirements of the organization and/or your performance.

    #Healthproof

    #CB

    Skills

    Healthcare,Consulting,Business Consulting

    Required profile

    Experience

    Spoken language(s):
    English
    Check out the description to know which languages are mandatory.

    Other Skills

    • Strategic Planning
    • Consulting
    • Collaboration
    • Communication
    • Leadership

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