Consulting Director

Role Description

Who We Are:

Founded in 2016, we’ve become a trusted and valued partner for health plans and providers. We offer a modern integrated ecosystem of healthcare operations, processes, and products, with inherent scalability, efficiency, and predictable outcomes. Our BPaaS delivery solutions work behind the scenes to manage our customers’ complex admin operations, giving them elbow room to focus on their members’ needs and well-being.

Bending cost curves, guaranteeing outcomes, finding paths through roadblocks – that’s our way of life. Our customers count on us to safely navigate them through deadlocks. We have a strong global presence and a dedicated workforce of 4000+ people spread across the world.

Our brand is built on strong foundations of simplicity, honesty, and leadership, and we stay inspired in our goal to unburden healthcare and ensure it reaches all, equitably and effectively.

You Are

Consulting Director will focus on leading advisory engagements focused on strategic and technology assessments for Health Plan operations and play a crucial role in providing Health Plans advisory and recommendations to enhance operational efficiency, reduce cost to operate and improve stakeholder experience.

You have experience building deep relationships with customer stakeholders at all levels for business opportunities or problems. You listen to the customers and understand ‘what is being said' and ‘what is not being said’, identify opportunities to improve build improvement and actionable plans for change, and partnerships with key ecosystem vendors. You excel at deal sensing, deal solutioning, deal narrative, deal closing and deal executions and follow through constantly on all deals – large and small.

The Opportunity

• Lead advisory engagements to conduct current state assessments to define future state roadmap to lead Core Administration and operations transformation to modern, scalable platforms that support digital capabilities and enhance operational efficiency
• Leverage technology experience, tools and assets to define business and technology blueprint that optimizes core administrative functions and claims operations, ultimately improving efficiency, compliance, and business outcomes
• Conduct operational financial assessment to determine opportunities for cost takeout and build business case to position business services that help reduce administrative costs, maximize platform capabilities and improve operational efficiencies
• Find opportunities to recommend automation tools and AI-driven processes to streamline administrative tasks, reduce manual errors, and improve overall efficiency
• Developing and implementing strategies for integrating new technologies into existing health insurance systems to streamline operations and improve client experiences.
• Provide strategic leadership for extensive interrelated programs of work to ensure that we are enabling change and delivering benefits in line with overall business strategic aims.
• Apply extensive business and technological mastery to conceive and bring innovative ideas to fruition. Ensure constant learning on the business domain of current focus areas.
  
  

What You Need

• At least 8 years of relevant experience in a Consulting Leadership role in Health Plan practice or a Health plan with in-depth Health plan or Healthcare sector knowledge
• Demonstrable positive movement in the relationship maturity with leadership at C-suite level and below.
• Domain / Industry Knowledge: Experience conceptualizing new holistic solutions that lead to large highly complex deals and act as differentiators in positioning Healthproof with the customer
• Technology Concepts: Experience in creating an optimal technology road map, identifying technology skill sets to be built or bought over the next 2 to 3 years, selecting the right infrastructure and technology platform. Must have an extremely sound sense of what technology means, and what/how certain technologies are used.
• Profitability Management: Experience performing outcome-based pricing, crating cost benefit model using ROI, internal rate of return, and other management concepts. Development and compliance to financial plans and budget
• Pricing & Licensing Models: Experience creating complex estimates including third party commercial inputs and large complex deals and obtain approval from relevant stakeholders (leadership, legal etc.
• Solution Structuring: Experience reviewing and validating solutions in proposals and architect solutions for large / transformational deals. Engage / disengage with stakeholders so that program benefits are maximized
• Team Management: always focusing on performance and outcomes, by harnessing teamwork and collaboration. Good at delegating tasks and managing team members’ contributions appropriately
  
  

Compensation can differ depending on factors including but not limited to the specific location, role, skill set, education, and level of experience. As required by applicable law, 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 US

Compensation Range: 170-200K

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, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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

#Healthproof

Skills

Healthcare,Consulting,Business Process