Deloitte Manager, Healthcare Payer Core Admin, Govt Program, PBM in San Francisco, California
Manager, Healthcare - Core Operations, PBM Government Programs
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. Also drives integration with government agencies.
Work you ll do
Deloitte is seeking Managers who areprofessionals withdeep industry experience andstrong records of academic and professional achievement who have the capacity and desire for continuous development and growth. Deloitte professionals must also be capable of working and communicating with people at all levels of an organization.
Managers provide clinical knowledge to teams,lead multiple project work-streams, small engagement teams or components of large, complex engagements.
Typical project responsibilities of a Manager could include:
Develop the detailed, quantitative analysis work associated with developing meaningful insights to address Health Plan clients biggest challenges
Participate in setting engagement objectives and scope
Develop work plans for components of engagements, coordinate activities between work streams and identify changes in scope
Design deliverable content to precisely reflect the engagement contract and client needs
Strive to improve deliverable quality through verification and validation of results
Participate in the development and presentation of proposals for business development activities
Deloitte Managers typically work with a project team dedicated to a single client, taking direction from the project leader. They work side by side with Principals/Partners /Directors and other Consultants at all levels, often with exposure to clients C-level executives, organizational leaders and team members. Managers will lead work streams of client projects and contribute to the overall engagement delivery. Project teams work onsite with the client team, typically necessitating travel three to four nights a week.
Core Business Operations
Our team focuses on transforming our clients core business operations. We advise, design, implement, and deploy solutions focused on heart of the business issues in specific sectors including Health Care, Banking & Securities, Insurance, and Energy & Resources. The type of work we provide to our clients includes Operations Excellence, Payment & Care Model Innovation and Emerging Business Models.
Our clients seek a fresh perspective on how to create a flexible, innovative business model supported by a strong operations foundation. Professionals will use their deep sector knowledge and technical business operations consulting experience to take a more strategic view of our clients priorities, helping them to prepare for growth, embrace the digital agenda and maximize operational efficiency.
Bachelor s degree from accredited university with strong undergraduate academic record. MBA and/or Advanced degree in clinical sciences preferred (RN, MSN, MD)
Minimum of 6 years of professional experience in Health Plans industry, or a mix of a few years industry experience and functioning as a Manager or higher in a Consulting environment.
Knowledge and experience implementing operational platforms supporting Enrollment, Membership, Billing, Reporting, Claims adjudication
Knowledge and experience with Pharmacy Benefit Management industry (3 years experience in pharmacy benefit industry facing role)
Pharmacy Benefit and Formulary Implementation, Pharmacy Claim Adjudication, Pharmacy Benefit Operations, Specialty Pharmacy Benefits, Home Delivery Pharmacy
Pharmacy benefit, formulary, network design and management, Drug benefit pricing, utilization management program operations, Medicare Part D operations
Demonstrates consistent career progression with increasing levels of responsibility; performed above expectations in professional roles
Ability to work independently; lead teams focused on specific work streams of large projects.
Strong oral and written communication skills, presentation skills and MS Visio, PowerPoint, Excel and PowerPoint proficiency
Willingness and ability to travel 80 %
Advanced degree in clinical sciences or MBA from a top tier program
Superior critical thinking, analytical and problem-solving skills
Exceptional interpersonal, team-building and communication skills
Outstanding integrity, initiative, creativity, and passion
Ability to work in an ambiguous environment
Strong problem solving and troubleshooting skills with the ability to exercise mature judgment.
Live within commuting distance to one of Deloitte 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 https://zoomforth.com/s/deloitte/du#home
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 http://www2.deloitte.com/us/en/pages/careers/articles/life-at-deloitte-benefits-and-rewards.html
Deloitte s culture
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. 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. 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. Learn more about Deloitte s impact on the world. at http://www2.deloitte.com/us/en/pages/about-deloitte/articles/deloitte-corporate-citizenship.html
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. Check out recruiting tips from Deloitte professionals. at http://www2.deloitte.com/us/en/pages/careers/topics/recruiting-tips.html
Category: Management Consulting
As used in this document, Deloitte means Deloitte LLP and its subsidiaries. Please see www.deloitte.com/us/about 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.