Healthcare Innovations Functional Consultant/SME

GDIT is searching for a dynamic healthcare administration and policy Sr. Advisor to join our growing Federal Health team. You will support an exciting new program focused vulnerability risk assessments for the Centers for Medicare & Medicaid Services. The role will allow you to utilize in-depth knowledge of Medicare, Medicaid and Managed Care policies, systems, payment structures, risk adjustments processes, including claims and data analyses. You will conduct high-level research and analyses to identify opportunities for advancement and improvement in healthcare regulations and payment guidelines with a focus on developing recommendations for efficiencies, innovation, and strategies to reduce or prevent future risk.

Responsibilities:

• Conduct advanced research, analysis, and investigative activities to assess program risk related to Medicare and/or Medicaid managed care policy, payments, and regulatory requirements.
• Lead a team dedicated to the assessment of complex requirements, processes, systems, and guidelines to identify opportunities for innovation, efficiencies, and improvements.
• Lead a team of research analysts in completing a comprehensive assessment of risk, documenting and presenting findings to senior executives and our customers.
• Work collaboratively with a team of data, clinical, and research analysts to efficiently assess complex guidelines and accurately prioritize risk based upon quantitative and qualitative findings.
• Synthesize complex policy and regulatory guidance to develop recommendations, both written and verbal, to present to senior leadership.

Required Skills:

• Bachelor's degree or Master's degree in Healthcare Policy, Healthcare Administration or related field, or equivalent experience.
• Minimum of 10 years conducting systems, regulatory or policy research related to Medicare and/or Medicaid.
• Significant in-depth experience with Centers for Medicare and Medicaid programs, coupled with a deep customer intimacy
• Experience documenting and presenting complex studies and analyses to a wide audience including senior Agency leadership

Desired Skills:

• Medicare Advantage or Medicaid Managed Care experience is preferred.
• Ability to conceptualize, solve problems and draw conclusions
• Highly organized, ability to multi-task and meet deadlines
• Strong inter-personal and communications skills, both written and oral
• Proficient in computer skills, e.g. Microsoft Office-Word, Excel

Work Requirements