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Director: Payer Strategy & Program Design

Role overview

Qualifications

  • Minimum of 7-10 years of relevant work experience with in-house experience inside a Medicare Advantage health plan
  • Strong Medicare Advantage subject matter expertise, including STARS, risk adjustment, and performance management
  • Excellent written and verbal communication skills
  • Strong consulting aptitude

Responsibilities

  • Serve as a trusted thought partner to clients and internal teams while delivering value from engagement kickoff through delivery
  • Manage multiple projects, including project teams, deliverables, and timelines
  • Lead go-to-market and business strategy work for health plans in a rapidly changing Medicare Advantage environment
  • Build, deepen, and strengthen the value we deliver to clients and our relationships with them

Key facts

Other skills

  • Strategic Planning
  • Communication
  • Leadership
  • Mentorship

About the company

ATI Advisory logo

ATI Advisory

Management Consulting

ATI Advisory is a healthcare research and advisory services firm dedicated to system reform that improves health outcomes and makes care easier for everyone. ATI guides public and private leaders in developing scalable solutions. Its nationally recognized experts apply the highest standards in research and advisory services along with deep expertise to generate new ideas, solve hard problems, and reduce uncertainty in a rapidly changing healthcare landscape. For more information, visit www.atiadvisory.com. We do this is by working with public and private leaders scaling healthcare innovations that reduce costs and improve outcomes. Staff have a mix of government, private sector, and nonprofit experience. Three major business areas at ATI: --Medicare Innovation Practice works with organizations to scale innovations in population health, value-based care and Medicare Advantage. --Medicare-Medicaid Integration and LTSS Innovations works with policy and business leaders to improve and increase care delivery and program integration for vulnerable populations. --Prescription Drug Reimbursement Practice Group focuses on managing the economic incentives in our prescription drug system in a manner that aligns best with value and outcomes.

Company details

Company typeStartup
IndustryManagement Consulting
Company size11 - 50

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Job description

ATI Advisory is a healthcare research and advisory services firm changing how businesses, communities, and public programs serve complex populations. We deliver insight backed by original research and provide practical solutions for our clients and the families they serve. Our team includes nationally recognized experts across Medicare, Medicaid, long-term care, and provider delivery, and we bring an influential voice to efforts transforming health care.

For more information, visit www.atiadvisory.com.

 

 

ATI is at an exciting juncture in our growth, and we’re seeking a Director to join our Payer Strategy & Program Design team. The ideal candidate is a managed care expert who has worked inside a health plan and can serve as a strategic, business-minded thought partner to our clients. This person pairs deep Medicare Advantage knowledge with real operational experience and understands not only what plans want to do strategically, but how those decisions get operationalized across the organization. 

What You’ll Do

Lead Client Engagements 

  • Serve as a trusted thought partner to clients and internal teams while delivering value to clients from engagement kickoff through delivery.
  • Manage multiple projects, including project teams, deliverables, and timelines.
  • Manage, mentor, and support the professional development of junior team members. 

Provide Deep Expertise 

  • Lead go-to-market and business strategy work for health plans, including scenario planning, strategic planning, and growth strategy in a rapidly changing Medicare Advantage environment.
  • Translate coverage and strategic decisions into practical operational paths, weighing the trade-offs and downstream effects across functions such as STARS, risk adjustment, performance management, benefits, and claims.
  • Lead technical assistance and analyses for health plans on issues related to Medicare and Medicaid policy, organizational performance, and growth strategy. 

Business Development and Client Relationships 

  • Build, deepen, and strengthen the value we deliver to clients and our relationships with them, thinking holistically across each client's portfolio.
  • Contribute to business development through project scoping calls and proposal writing, and by developing new client relationships and cultivating existing ones. 

 

What We’re Looking For

  • Minimum of 7-10 years of relevant work experience, with required in-house experience inside a Medicare Advantage health plan.  
  • Strong Medicare Advantage subject matter expertise, including a working command of STARS, risk adjustment, and performance management, and how these functions flow through to plan revenue and interact with benefit design. 
  • Demonstrated ability to bridge plan strategy and operations 
  • Excellent written and verbal communication skills  
  • Strong consulting aptitude, including the ability to lead a dynamic portfolio of projects and clients 

 

Preferred Experience

  • Experience with or exposure to care management is a strong plus, particularly in the SNP space, including the intersection of care management, health risk assessments, risk adjustment, and STARS care-gap closure. 
  • Experience at a regional or smaller health plan is a plus, alongside or in addition to large national plan experience. 
  • MBA preferred. Other relevant graduate degrees (MPH, MPA, MPP) will be considered. 

 

Why ATI

At ATI Advisory, you’ll have the chance to do meaningful work that shapes the future of healthcare. You’ll be part of a collaborative team of nationally recognized experts, work on high-impact projects, and develop skills that advance your career while making a difference in people’s lives.

 

How to Apply

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ATI Advisory is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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