Managing Director, Payer Government Programs Compliance & Operations Consulting

Ankura is a team of excellence founded on innovation and growth.

Ankura’s Disputes and Economics Healthcare practice is seeking an experienced Managing Director for our payer government programs compliance & operations consulting services.

This exciting position will focus on driving value to clients through compliance, disputes, and investigations and advisory services. The position has tremendous growth potential with one of the leading professional services firms in the United States. The healthcare group is the largest industry group within Ankura. This position is remote with a preference of the ability to travel to one of our large office locations (New York, D.C. Chicago) to work with key leaders and team members.

Key Components of the Role will Include:

Technical Expertise: Previous or current consulting experience at a public accounting firm or large to mid-size consulting firm in the payer and government programs (Medicare Advantage and Part D, ACA, Medicaid, etc.) with experience working in a transformative environment to properly align people/process/technology to improve compliance, financial and operational performance.  Specific expertise in PACE program operations and Medicare Advantage Special Need Programs (ISNP, CSNP, DSNP) Model of Care (MOC) and operations.  Knowledge of chronic care management and other clinical topics are also important.

A strong working knowledge of laws, regulations and industry trends impacting compliance (Medicare, Medicaid, ACA, government programs) and operations at health plans and their strategic business partners.

Strategic Thought Leadership: Actively engaged in industry groups and events providing executive experience in “innovation thought leadership” for payers, providers, and their counsel and strategic partners is important for this position. Demonstrated ability to translate complex regulatory requirements into actionable strategies and present findings to C-suite executives.

Client Service Experience: A proven track record in delivering large/complex compliance and advisory projects is essential. This individual has executive experience in communicating effectively with boards of directors; client executives; governmental authorities; and industry professionals at all working levels. Includes directing multi-disciplinary teams and managing large-scale compliance remediation projects for national health plans.

Growth: You will be part of a group that is pursuing internal and external growth opportunities. A proven track record in driving sustainable financial and operational results at a consulting firm is preferred. This includes driving go-to-market or sales in the payer sector.

Talent Development: Experience coaching and mentoring talent to help our team grow professionally (regardless of position). Participating in recruiting new talent will also be expected.  Experienced in mentoring senior consultants and fostering cross-functional collaboration to achieve enterprise goals.

Collaborative Influence: As previously noted, Ankura’s largest industry focus is healthcare. Collaborating with consulting professionals across all lines of business within the firm is a core expectation for this position (i.e. Financial Services, Strategy and Performance, Health Economics, Data Analytics including AI, and other transaction services). Brings expertise in integrating payer operations with clinical delivery systems to optimize performance and compliance.

Other Expectations Include:

• Participate in healthcare or compliance industry groups and conference events
• Executing quality service delivery and identifying additional value-added services
• Managing multiple, large engagements, evaluating work quality and performance, including qualitative and quantitative tasks
• Providing best-in-class experience for our clients
• Complying with the firm’s expectations around risk management standards as it pertains to client service delivery including timely billing and collections
• Participating in developing new business, developing relationships, qualifying leads, and scoping opportunities in a highly collaborative manner

Qualifications

• 4-year degree in business, health administration, or other related field required or equivalent experience
• 10 years or more of experience at a Director/Senior Management level --- OR a combination of industry experience, public accounting, and health care compliance consulting required
• Background in revenue development and network expansion is a plus, with demonstrated success in building meaningful business relationships over time

Ankura’s Compliance, Disputes and Economics Healthcare and Life Sciences Practice is a recognized leader in healthcare compliance, investigations, and litigation support. Ankura’s Healthcare team combines unparalleled compliance, clinical, operational, and technical experience with the financial, economic, analytical expertise that healthcare and life sciences clients and their legal counsel rely upon to successfully navigate complex matters.

Ankura is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability. Equal Employment Opportunity Posters, if you have a disability and believe you need a reasonable accommodation to search for a job opening, submit an online application, or participate in an interview/assessment, please email [email protected] or call toll-free +1.312-583-2122. This email and phone number are created exclusively to assist disabled job seekers whose disability prevents them from being able to apply online. Only messages left for this purpose will be returned. Messages left for other purposes, such as following up on an application or technical issues unrelated to a disability, will not receive a response.