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Deloitte Senior Manager, Healthcare - Payer Core Operations and PBM in Atlanta, Georgia

Senior Manager, Healthcare- Payer Core Operations and PBM

Health Plans

In the currentenvironment, Health Plans face more than an adjustment. They are playing a newrole in helping new populations get new kinds of care in new ways. Deloitte sHealth Plans practice understands the past and present of the health careindustryand we collaborate with clients to address complex challenges and helpthem create and shape their future.

Thefee-for-service (FFS) model as we know it today may be headed for obsolescence.In its absence, Plans face a crossroadsenhance positions through new modelsand collaborations, or risk irrelevance. The shift from volume-based tovalue-based care isn t immediate, but the end of FFS in its current form may beinevitable. This change affects everyone in the health care ecosystem.

Work you ll do

Senior Managers areexpected to contribute to the firm's growth and development in a variety ofways, including:

  • Engagement Management:Lead engagement planning and budgeting; mobilize and manage engagement teams;define deliverable structure and content; facilitate buy-in of proposedsolutions from top management levels at the client; direct on-time, qualitydelivery of work products; manage engagement economics; manage engagement risk

  • Client Management: Manageday to day interactions with executive clients and sponsors

  • Business Development:Develop and maintain contact with top decision makers at key clients; organizeand lead pursuit teams; participate and lead aspects of the proposaldevelopment process; contribute to the development of proposal pricingstrategies

  • Practice Development& Eminence: Develop practical solutions and methodologies; develop"thought-ware" and "point-of-view" documents; participatein public speaking events; get published in industry periodicals

  • People Development:Perform role of counselor and coach; provide input and guidance into thestaffing process; actively participate in staff recruitment and retentionactivities; provide leadership and support for delivery teams and staff inlocal offices

Core Business Operations

Our Core BusinessOperations team focuses on transforming our clients core business operations.We advise, design, implement, and deploy solutions focused on heart of thebusiness issues in specific sectors including Health Care, Banking &Securities, Insurance, and Energy & Resources. The type of work we provideto our clients includes Operations Excellence, Payment & Care Model Innovationand Emerging Business Models.

Our clients seek a freshperspective on how to create a flexible, innovative business model supported bya strong operations foundation. Professionals will use their deep sectorknowledge and technical business operations consulting experience to take amore strategic view of our clients priorities, helping them to prepare forgrowth, embrace the digital agenda and maximize operational efficiency.



  • Bachelor s degreefrom accredited university with strong undergraduate academic record. MBAand/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 fewyears industry experience and functioning as a Senior Manager or higher in aConsulting environment.

  • Business and clinical operations experience andsubject 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 BenefitManagement industry (5 years experience in pharmacy benefit industry facingrole)

  • Pharmacy Benefit and Formulary Implementation,Pharmacy Claim Adjudication, Pharmacy Benefit Operations, Specialty PharmacyBenefits, Home Delivery Pharmacy

  • Pharmacy benefit, formulary, network design andmanagement, Drug benefit pricing, utilization management program operations,Medicare Part D operations

  • Demonstrates consistent career progression withincreasing levels of responsibility; performed above expectations inprofessional roles

  • Ability to work independently; lead teamsfocused on specific work streams of large projects.

  • Strongoral and written communication skills, presentation skills and MS Visio,PowerPoint, Excel and PowerPoint proficiency

  • Willingness and ability to travel 80%

  • Limited sponsorship

Preferred Skills:

  • Advanced degree in clinical sciences or MBA froma top tier program

  • Superior critical thinking, analytical andproblem-solving skills

  • Exceptional interpersonal, team-building andcommunication skills

  • Outstanding integrity, initiative, creativity,and passion

  • Ability to work in an ambiguous environment

  • Strong problem solving and troubleshootingskills with the ability to exercise mature judgment.

  • Live within commuting distance to one ofDeloitte 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


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. at

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Category: Management Consulting

About Deloitte

As used in this document, Deloitte means Deloitte LLP and its subsidiaries. Please see for a detailed description of the legal structure of Deloitte LLP and its subsidiaries. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or protected veteran status, or any other legally protected basis, in accordance with applicable law.