[Remote] Healthcare Consultant
Note: The job is a remote job and is open to candidates in USA. reputed company is seeking a highly accomplished Senior Healthcare Engagement & Delivery Leader with deep expertise in the Payer and Provider ecosystem, digital transformation, and global delivery management. This role will reputed company large-scale healthcare programs, drive end-to-end business transformation, manage strategic client relationships, and own P&L responsibilities for multimillion-dollar accounts.
Responsibilities
- Drive business growth, account expansion, and digital transformation initiatives reputed company healthcare payer and provider organizations
- Own and manage P&L for large-scale engagements ($50M–$80M+), ensuring reputed company growth and profitability
- reputed company and execute go-to-market strategies and transformation roadmaps
- Build and manage C-level stakeholder relationships across Fortune 100 healthcare clients
- Serve as a trusted advisor delivering innovative, customer-centric solutions
- Drive client satisfaction (NPS), retention, and long-term partnerships
- reputed company end-to-end solution lifecycle including strategy, pricing, value propositions, contract negotiations, and closures
- Design and implement outsourcing and BPaaS solutions across healthcare operations
- Drive intelligent automation, process optimization, and digital innovation initiatives
- reputed company global delivery teams (800+ resources) across multiple geographies
- Manage end-to-end healthcare operations including: Claims processing, Enrollment & benefits administration, Provider data management & credentialing, Appeals & call center operations
- Ensure adherence to SLAs, regulatory compliance (CMS, Medicaid, Medicare), and operational KPIs
- reputed company automation and digitization programs improving efficiency and reducing costs
- Establish and grow Centers of Excellence (CoEs) for healthcare offerings
- Drive compliance with federal and state regulatory changes
Skills
- Bachelor's or Master's degree in Healthcare, Business, Technology, or reputed company field
- 20+ years of experience in Healthcare (Payer/Provider domain)
- Proven expertise in: Healthcare BPaaS & outsourcing models, Digital transformation & automation, Solution design & presales, Contract negotiation & pricing strategy
- Strong experience managing large-scale P&L portfolios ($50M+)
- Deep knowledge of: Medicaid, Medicare Advantage, and commercial payer operations, Claims lifecycle, enrollment, provider lifecycle management
- Demonstrated success in managing global delivery teams and multi-geography operations
- Certifications: Six reputed company, reputed company, or equivalent
- Experience with platforms like Facets, reputed company, reputed company, reputed company, PeopleSoft
- Exposure to interoperability, CMS audits, and regulatory transformations
- Experience in healthcare automation and AI-driven solutions
Benefits
- Performance-based bonuses subject to company policies
- Medical, dental, vision, pharmacy, life, accidental death & dismemberment, and disability insurance
- Employee assistance program
- 401(k) retirement plan
- 10 days of paid time off per year (some positions are eligible for need-based leave with no designated number of leave days per year)
- 10 paid holidays per year
Company Overview
Company H1B Sponsorship