Description & Requirements The Senior Consultant role supports value-based care (VBC) advisory engagements by bringing a clinical (RN) perspective to care model transformation, population health strategy, and financial performance improvement. This role bridges clinical operations and strategic advisory to improve quality outcomes, reduce total cost of care, and position organizations for success in alternative payment models.
What You Will Do: - Develop and deliver executive-level insights and recommendations linking clinical transformation to financial outcomes and organizational strategy
- Translate clinical workflows into financial and operational improvement opportunities (e.g., LOS reduction, readmissions, avoidable ED utilization, total cost of care)
- Advise clients on VBC readiness and performance optimization for CMS models (e.g., TEAM, CJR-X, MSSP, etc.)
- Research and stay up to date on evidence based best practices around risk stratification, care coordination, and transition-of-care protocols to improve patient outcomes and resource utilization
- Perform performance assessments to include financial, operational and clinical benchmarks and economic analysis
- Partner with analytics teams to interpret population health data, quality metrics, and utilization trends, and translate insights into actionable interventions
- Advise clients on the development of care management infrastructure, including staffing models, workflows, documentation practices, and enabling technologies
- Identify and advance strategies for risk adjustment (HCC capture), quality performance, and coding accuracy within clinical workflows
- Facilitate clinical stakeholder engagement (physicians, nursing, care managers) to drive adoption of new care models and performance improvement initiatives
- Support client delivery and business development, including proposal development, thought leadership, and subject matter expertise in population health and VBC transformation
- Learn and develop new technical knowledge specific to our consulting practice and the clients we serve across the value-based care practice
- Work both individually and in a team environment
- Establish and maintain relationships with the healthcare practitioners in other service lines within the firm to maintain an understanding of all the firm's service offerings and coordinate practice development efforts accordingly
Minimum Qualifications: - Bachelor's degree in nursing from an accredited university
- 2+ years in Care Management or Population Health consulting
Preferred Qualifications: - Care Management and/or Population Health experience
- Familiar with total cost of care and/or episodic payment models
- Experience advising healthcare providers regarding Medicare alternative payment models
- Familiarity with MIPS and/or HQR reporting requirements
- CCM, or equivalent certification
- Experience with Tableau or Power BI
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