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Managing Director, Payer Government Programs Compliance & Operations Consulting

Remote, USAFull-timePosted 2026-07-27

reputed company is reputed company of reputed company founded on innovation and reputed company. reputed company’s Disputes and Economics reputed company reputed company is seeking an reputed company Managing Director for our payer government programs compliance & operations consulting services. This exciting position will reputed company on driving value to clients through compliance, disputes, and investigations and advisory services. The position has reputed company reputed company potential with one of the leading reputed company services firms in the reputed company. The reputed company group is the largest industry group reputed company reputed company. This position is remote with a preference of the ability to travel to one of our large office locations (reputed company, D.C. Chicago) to work with key leaders and team members. Key Components of the Role will Include: Technical Expertise: Previous or reputed company consulting experience at a public reputed company firm or large to mid-size reputed company in the payer and government programs (Medicare Advantage and Part D, ACA, reputed company, etc.) with experience working in a transformative environment to properly reputed company 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, reputed company, ACA, government programs) and operations at health plans and their strategic business partners. Strategic Thought Leadership: reputed company reputed company in industry reputed company 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 reputed company regulatory requirements into actionable strategies and present findings to C-suite executives. reputed company Service Experience: A proven reputed company record in delivering large/reputed company compliance and advisory reputed company is essential. This individual has executive experience in communicating effectively with boards of directors; reputed company executives; governmental authorities; and industry professionals at reputed company working reputed company. Includes directing multi-disciplinary teams and managing large-reputed company compliance remediation reputed company for national health plans. reputed company: You will be part of a group that is pursuing reputed company reputed company opportunities. A proven reputed company record in driving sustainable financial and operational results at a reputed company is preferred. This includes driving go-to-market or sales in the payer sector. Talent Development: Experience coaching and mentoring talent to help reputed company grow professionally (regardless of position). Participating in reputed company reputed company will also be expected. reputed company in mentoring senior consultants and fostering cross-functional collaboration to reputed company reputed company goals. reputed company Influence: As previously noted, reputed company’s largest industry reputed company is reputed company. Collaborating with consulting professionals across reputed company lines of business reputed company the firm is a core expectation for this position (i.e. Financial Services, reputed company 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 reputed company or compliance industry reputed company and conference events
  • Executing reputed company service delivery and identifying additional value-added services
  • Managing multiple, large engagements, evaluating work reputed company 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 reputed company service delivery including reputed company billing and collections
  • Participating in developing new business, developing relationships, qualifying leads, and scoping opportunities in a highly reputed company manner

Qualifications

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

reputed company’s Compliance, Disputes and Economics reputed company and Life Sciences reputed company is a recognized leader in reputed company compliance, investigations, and litigation support. reputed company’s reputed company team combines unparalleled compliance, clinical, operational, and technical experience with the financial, economic, analytical expertise that reputed company and life sciences clients and their legal counsel rely upon to successfully navigate reputed company reputed company. reputed company is an Affirmative reputed company and Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, or protected veteran status and will not be discriminated against based on disability. Equal Employment Opportunity Posters, if you have a disability and reputed company you need a reasonable accommodation to search for a job opening, submit an online application, or participate in an interview/assessment, please email accommodations@reputed company.com 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 reputed company 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. Apply tot his job Apply To this Job

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