Consulting Healthcare Manager - Managed Care - Strategic Pricing

Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.

Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.

Joining the Huron team means you’ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.

Join our team as the expert you are now and create your future.

At Huron, Managers are pivotal in driving success by leveraging their expertise to manage projects and lead teams. They forge lasting client partnerships, collaborating to solve business challenges and align results with client goals. Managers mentor junior staff, fostering a culture of respect, unity, and personal achievement.

Specializing in areas of expertise while gaining broad exposure, Managers benefit from career growth opportunities and personalized professional development. Every colleague's growth contributes to the organization's success. If you're passionate about leading impactful projects and nurturing talent, Huron offers a rewarding path forward. Create your future at Huron.

As the Healthcare Consulting Manager in Managed Care, focused on Strategic Pricing , you will:   

• Manage complex multi-workstream projects and oversee junior team members. 

• Analyze data to implement performance improvement and organizational change. 

• Collaborate with team members and clients to align with business objectives. 

• Communicate effectively with project teams and stakeholders. 

• Lead and develop team members through training, supervision, coaching, and feedback. 

• Partner with Revenue Cycle, clinical documentation and coding, charge capture, and other Huron capabilities and businesses to ensure holistic and high-quality solutions. 

• Establish, maintain and monitor performance of outside vendors supporting CDM and pricing activities as well as other capabilities across Huron. 

• Manage the distribution CPT and HCPCS updates with high level of accuracy to a variety of our hospital, medial group and health system clients. 

• Proficiently address coding professionals of upcoming CPT/HCPCS changes based on changing regulations and/or guidance (e.g., from CMS, AMA, etc.) 

• Lead and/or participate in the design, development, and enhancement of core tools and utilities to support business needs. 

• Create and maintain structured processes for recurring updates and maintenance of core tools to ensure accuracy, relevance, and alignment with changing industry standards. 

• Develop tools and methodologies to assess market pricing factors and develop appropriate pricing levels in a defensible, strategic manner. 

• Develop and implement structured plans and tools for regular CDM review and maintenance, aiming to spot discrepancies, identify charging opportunities, and proactively address risks linked to outdated CDMs and related dictionaries. 

• Become a thought leader on changes in healthcare broadly as well as payor policy changes/updates and coding guidelines that have a direct or indirect impact to the CDM and strategic pricing. 

• Ensure Huron’s offerings related to CDM, and pricing-related changes/ recommendations adhere to federal, state, and local regulations. 

Requirements:    

• Bachelor’s degree required 

• 6 + years project leadership and workplan management experience with a focus on strategic pricing, chargemaster management, and related modeling skills. 

• 3 + years managing chargemaster consolidation and updating, preferably for both hospital (facility/institutional) and physician/professional services. 

• Strong and current working knowledge of Physician and Hospital coding and billing rules and related regulations is required, as stated above) 

• Experience in developing and managing methodologies to strategically set standard prices for procedural charges to support accurate charging and charge capture and optimal reimbursement revenue. 

• Experience reviewing and interpreting health insurance payer agreements to evaluate contractual limitations on chargemaster revisions and payment arrangements tied to standard charges (e.g., charge-sensitive reimbursement.) 

• The ability to travel based on client, enterprise, or project needs is an essential function of this role. While travel requirements may vary based on business need, the current average travel in the Healthcare practice is less than 50%, annually. 

• Proficiency in Microsoft Office (Word, PowerPoint, Excel) 

• US Work Authorization required 

Preferences:   

• Master’s degree in one of the following fields: Healthcare Management, Healthcare Administration, Business Administration (MBA), Medical Economics, Health Economics, or a closely related graduate credential 

• Coding certification (e.g., AAPC) 

• Experience with using database technologies to support the manipulation of large data sets (e.g., relational databases queried using SQL) and/or experience using business intelligence visualization tools (e.g., Microsoft PowerBI or Amazon QuickSight) 

• Experience in a matrixed organization or cross-functional team environment  

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The estimated base salary range for this job is $140,000 - $200,000.  The range represents a good faith estimate of the range that Huron reasonably expects to pay for this job at the time of the job posting. The actual salary paid to an individual will vary based on multiple factors, including but not limited to specific skills or certifications, years of experience, market changes, and required travel. This job is also eligible to participate in Huron’s annual incentive compensation program, which reflects Huron’s pay for performance philosophy.  Inclusive of annual incentive compensation opportunity, the total estimated compensation range for this job is $161,000 - $250,000. The job is also eligible to participate in Huron’s benefit plans which include medical, dental and vision coverage and other wellness programs. The salary range information provided is in accordance with applicable state and local laws regarding salary transparency that are currently in effect and may be implemented in the future.

Position Level

Manager

Country

United States of America