Senior Consultant, Member Experience
Core
Senior Consultant bridging health plans and healthcare providers to improve the end-to-end patient and member journey, driving quality metrics and operational performance.
Role type
Senior Consultant (Healthcare Operations & Quality Improvement)
Builds
Cross-entity partnerships between payers and providers to enhance care experiences and quality outcomes.
Domain
Healthcare (Payer-Provider relations, Quality Improvement, Regulatory Compliance)
Deliverable
client delivery
Required skills
Healthcare operations expertise, Continuous improvement methodologies (PDSA), Executive facilitation & coaching, Data interpretation (CAHPS, HEDIS, Star Ratings), Stakeholder management
Preferred skills
Dual payer/provider experience, Value-based care models, Medicare Advantage/Medicaid expertise
Technologies
Microsoft Office (PowerPoint, Excel, Word)
Responsibilities
Bridge health plans and provider networks to align on quality goals; Drive operational improvement initiatives using PDSA cycles; Facilitate virtual and onsite workshops and coaching sessions; Analyze performance metrics (CAHPS, HEDIS, HOS, Star Ratings) to identify gaps; Manage end-to-end client engagements and timelines.
Seniority
Senior, hands-on IC
