Associate Director Reimbursement and Policy Consultant

at Guidehouse in Dover, Delaware, United States

Job Description


Guidehouse is a leading global provider of consulting services to the public and commercial markets with broad capabilities in management, technology, and risk consulting. We help clients address their toughest challenges and navigate significant regulatory pressures with a focus 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 prepare our clients for future growth and success. The company has more than 10,000 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 Associate Director, Payer Provider Consulting will be a member of our Healthcare Public/payer practice and part of a team responsible for solving complex and strategic issues faced by commercial and public health, including Medicaid managed care. The Associate Director will lead a team of Consultants working on multiple assignments at any given time and receive exposure to a broad range of healthcare projects, including: healthcare managed care models, financial /risk modeling, and actuarial analytic support. The Associate Director will work on a variety of project teams within Guidehouse, providing mentorship to Guidehouse Consultants, and working with senior executives both within the company and with clients to achieve deliverables. Responsibilities include: • Participate in actuarial analytics (including methodologies, model development and modifications), industry reporting and research, and data analysis. • Lead consultants in developing project approach, strategies, and work plans. • Typical project areas include (but not limited to) actuarially sound capitation rate-setting, determining and measuring managed care plan effectiveness, risk-adjustment methods, medical cost trend management, and forecasting. • Supply detailed, quantitative analysis; build Excel models; and prepare operational and financial projections. • Supply data and/or quantitative information that develops project findings and recommendations. • Prepare project materials and reports. • Prepare client-ready deliverables and present complex findings to non-technical audiences. • Work with the larger teams and take lead on presentation of final deliverables that go to client sponsors. • Assist in design and implementation of recommended solutions. • Work with several project teams, Guidehouse Associate Directors, and Executives. • Effectively communicate with Guidehouse management and client staff. • Learn about Guidehouse’s breadth of solutions and identify those that reflect personal and professional interests.


Required: • A Bachelor’s degree in computer science, mathematics, statistics, actuarial science or business administration, with an emphasis in data analysis, data grouping and large data sets • 10+ years of applicable professional experience (e.g. health plan or state managed care data analysis and/or healthcare consulting experience) • Experience using SQL, SAS, or other third generation programming language (R, STATA, Python) is preferred • Experience developing analytical models and structuring methodologies • Excellent quantitative analysis skills and strong data analytics background (financial modeling/planning skills a Plus) • Demonstrated management of smaller work streams or deliverables • Proficiency with excel, including experience in formatting, formulas, pivot tables, etc. • Ability to travel post COVID_ 25% Preferred Skills • A team player that fosters a culture of collaboration and team-oriented process. • Excellent verbal and written communication skills. • Strategic and conceptual thinker and planner • Detailed oriented with strong analytical skills. • Experience in value-based payment arrangements such as Medicare Advantage/Managed Care, risk contracting, shared savings arrangements, and/or post-acute care consulting. • Significant knowledge of the healthcare industry • Understanding of data warehousing and ETL techniques • Certification(s) in a programming languages or other areas related to data analytics. • Proven track record of solving complex problems and completing challenging projects • Additional qualifications include efficiency, flexibility, innovative problem-solving skills, a high level of motivation, and excellent organizational skills.

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.

+ This position is open to candidate virtually from EST, CST, PST time zones as well as AZ, UT.

+ Due to our contractual requirements and an Executive Order from the White House, every federal government employee and onsite federal contractor will be asked to attest to their vaccination status. In the interest of health and safety during the continued unprecedented COVID-19 pandemic, anyone who does not attest to being fully vaccinated will be required to follow CDC guidelines which may include (subject to specific contractual requirements): wearing a mask on the job no matter their geographic location, physically distancing from all other employees and visitors, complying to any screening testing requirements. This requirement will apply to Guidehouse employees who work onsite for the federal government.


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 a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace. Benefits include: Medical, Rx, Dental & Vision Insurance Personal and Family Sick Time & Company Paid Holidays Parental Leave and Adoption Assistance 401(k) Retirement Plan Basic Life & Supplemental Life Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts Short-Term & Long-Term Disability Tuition Reimbursement, Personal Development & Learning Opportunities Skills Development & Certifications Employee Referral Program Corporate Sponsored Events & Community Outreach Emergency B
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Job Posting: JC189084307

Posted On: Aug 01, 2021

Updated On: Nov 12, 2021