Director State Healthcare Payment and Program innovation Par

at Guidehouse in Dover, Delaware, United States

Job Description


Guidehouse is a leading global provider of consulting services to the public sector and commercial markets, with broad capabilities in management, technology, and risk consulting. By combining our public and private sector expertise, we help clients address their most complex challenges and navigate significant regulatory pressures focusing on transformational change, business resiliency, and technology-driven innovation. Across a range of advisory, consulting, outsourcing, and digital services, we create scalable, innovative solutions that help our clients outwit complexity and position them for future growth and success. The company has more than 12,000 professionals in over 50 locations globally. Guidehouse is a Veritas Capital portfolio company, led by seasoned professionals with proven and diverse expertise in traditional and emerging technologies, markets, and agenda-setting issues driving national and global economies. For more information, please visit


The Director of State Payment and Program innovation applies cutting-edge policy, finance, economics and quantitative methods to assist clients in developing and implementing market-based payment and reimbursement models across the spectrum of healthcare and human service programs. They will partner with our payment teams to leverage analyses and utilize economic modeling to provide better insights into how to maintain quality, improve health outcomes and reduce costs, as well as to properly deploy constrained resources. Further, with the increased need to look across payers to understand the implications of state physician and payer reimbursement on the health system infrastructure, this individual should have experience in all-payer designs and ability to consider aligned payment models. This person will function as an account executive to bridge client relations and technical delivery on projects with emphasis on payment reform. This person will use their industry and policy expertise in the public and private sector to improve stated health outcomes and cost of care. This person will provide guidance on market, value-based arrangements, cross-stakeholder and community-level analysis including economic impact of poor health, population health, value assessment, quantification of patient-centered preferences and digital health.The position provides an extraordinary opportunity for a highly motivated individual interested in promoting equity and efficiency, cost containment, improved access, and improved quality of care across the healthcare delivery spectrum This position will primarily be responsible for:

+ Client relations and directing client deliverables for assigned accounts

+ Familiar with and involved in the evaluation, assessment and improvement of fee-for-service payment models with demonstrated experience with (APR-DRGs, EAPGs, grouper software, PPEs, payment models for special population and programs such as school based providers, HCBS waiver populations, etc.).

+ Leads client and Guidehouse teams to develop the Medical Economics analyses and functions required for successful implement “Total Cost of Care Model”, including monitoring and evaluating outcomes and performance

+ Partners with states to design and develop cost of care and quality benchmarks to use in policy and goal development, to promote transparency

+ Leverages deep industry and strategy expertise to create a compelling case for change for State Agencies

+ Responsible for developing and building strong client relationships/management with executive/state decision makers (Health and social service Directors, State representatives, State Treasurers/CFO/Controllers and other state program leaders) to help them achieve their goals and set the stage to deliver transformative strategy Treasurers/CFO/Controllers and other state program leaders) to help them achieve their goals and set the stage to deliver transformative strategy

+ Will be the thought-leader as well as a leader that drives best practice, structure. superior health economic deliverables and sustainable results to the state entities. You will develop a strong business case for client action and lead the effort to secure revenue for the firm.

+ You are responsible to be a proactive business leader that creatively works with partners, clients and resources at Guidehouse to find new solutions that create repeatable value and revenue stream to the practice


Basic Qualifications

+ Masters in Public Health or related field from an accredited university, or comparable industry experience

+ Sound understanding of relevant healthcare data and policies

+ 10+yrs. experience in health economics or public health is required.

+ 10 + yrs. of demonstrated ability to develop creative approaches and solutions necessary to resolve complex problems within Medicaid, Medicare, Duals, Social Determinant programs to get expected outcomes

+ Demonstrated data management skills, and familiarity with diverse analytical methodologies.

+ Strong candidates will be forward-thinking and will have demonstrated they are capable and have been accountable in leading multiple client engagements simultaneously to timeline, scope and budget.

+ 5+ yrs. of success with states, demonstrating a strong network, ability to build and retain pipeline and client base.

Preferred Skills

+ Excellent listening, verbal, written, and presentation skills

+ Executive Consulting Experience at the State Director and leadership level

+ Strong leadership skills

+ Advanced modeling techniques applied in healthcare and life science context

+ Proficient in Microsoft Office Suite programs

Additional Requirements

The successful candidate must not be subject to employment restrictions from a former employer (such as a non-compete) that would prevent the candidate from performing the job responsibilities as described. The salary range for this consultant role is $95,000 -$150,000 but may vary based on experience and location Applicants must be currently authorized to work in the United States for any employer. No sponsorship is available for this position. Due to our contractual requirements, to be eligible for this role, you must be fully COVID-19 vaccinated at time of hire.


About Guidehouse Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee. Rewards and Benefits Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and
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Job Posting: JC226652569

Posted On: Oct 20, 2022

Updated On: Dec 09, 2022

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