Consulting Manager

Job Summary

Consulting Manager role in a global organization responsible for driving complex payer focused consulting engagements guiding teams to deliver measurable business outcomes and partnering with client stakeholders in a hybrid day shift work model without travel requirements. The role demands 12 to 15 years of experience in payer domain driven consulting.

Responsibilities

• Lead end to end payer focused consulting engagements by translating client strategic priorities into clear project scopes and outcomes that advance healthcare affordability and access for members through data informed decisions.
• Drive structured consulting methodologies for payer clients by defining hypotheses designing analyses and synthesizing findings into actionable recommendations that optimize claims operations provider networks and member experience.
• Oversee development of payer specific business cases by quantifying financial impact operational benefits and risk mitigation strategies that support client investment decisions and align with regulatory and compliance expectations.
• Provide day to day guidance to project teams in a hybrid work environment by coordinating tasks aligning deliverables and managing timelines to ensure consistent high quality outputs for payer stakeholders.
• Coordinate stakeholder engagement with payer executives and managers by facilitating workshops requirements sessions and review meetings that clarify objectives and build shared understanding of solution roadmaps.
• Analyze payer data sets and performance metrics by identifying trends variances and root causes that inform recommendations on utilization management quality programs and cost containment initiatives.
• Develop clear consulting deliverables for payer projects by creating presentations reports and dashboards that communicate complex concepts in an accessible manner and support informed client decision making.
• Collaborate with internal cross functional teams by integrating expertise from technology data operations and compliance to design holistic solutions that strengthen payer capabilities and member outcomes.
• Monitor engagement progress and risks by tracking milestones dependencies and issues while implementing corrective actions that keep payer projects on schedule and within agreed scope.
• Support practice development activities by contributing payer related thought leadership reusable assets and methodologies that enhance the consulting portfolio and improve consistency of client delivery.
• Mentor junior consulting staff by sharing payer domain knowledge consulting techniques and professional practices that build a strong talent pipeline and increase overall team effectiveness.
• Guide clients on adoption of digital and analytic solutions tailored to payer operations by outlining implementation approaches that reduce manual effort improve accuracy and support more personalized member services.
• Align consulting work with the company purpose by advancing innovative payer solutions that promote sustainable healthcare systems better population health outcomes and increased transparency for members.
  
  

• Bring 12 to 15 years of progressive consulting experience with a strong focus on payer organizations covering health plans managed care entities or similar insurance providers supported by consistent client facing delivery.
• Demonstrate deep understanding of payer business processes including benefits design claims adjudication enrollment billing provider contracting and member services with proven experience improving performance in these areas.
• Apply working knowledge of regulatory and compliance considerations for payer operations such as healthcare policies and quality programs to ensure recommendations are practical and conform to industry expectations.
• Use strong analytical and problem solving skills to interpret complex payer data design meaningful metrics and generate insights that drive operational efficiency and quality improvements.
• Communicate effectively through structured storytelling clear documentation and confident presentation abilities that enable productive discussions with payer executives and operational teams.
• Operate comfortably in a hybrid working model by managing collaboration across onsite and remote team members and using digital tools to maintain project momentum and high engagement.
• Exhibit solid consulting fundamentals including stakeholder management project planning issue resolution and benefit realization tracking that consistently lead to successful payer engagements.