Senior Manager - Strategy and Solutions

EXL Health is looking for a Senior Manager – Healthcare Strategy and Solutions. This is a remote role within the US.

We are seeking an innovative and data-driven Strategist to join our team. This individual will play a critical role in shaping and driving the strategic direction of payment integrity initiatives, focusing on improving outcomes, and driving new solutions. The ideal candidate will possess deep industry expertise and a forward-thinking mindset, capable of developing and executing strategies that address the challenges and opportunities within the payment integrity landscape.

Key Responsibilities:

• Develop and Implement Strategies: Lead the design and execution of strategic initiatives that enhance service delivery, payer/provider experience, and operational efficiency across the organization.

• Market Analysis and Forecasting: Conduct comprehensive analysis of payment integrity market trends, regulatory changes, and competitive positioning to inform business decisions and strategy development.

• Data-Driven Decision Making: Utilize data analytics to evaluate performance metrics and operational processes, using insights to guide strategic initiatives.

• Innovation & Optimization: Research emerging technologies, tools, and methodologies to enhance claims audits, software, and overall payment integrity functions while driving innovation and transformation through new digital health solutions and operational improvements that address payer, patient, and provider needs.
• Collaborate Across Departments: Work closely with clinical, financial, operational, and executive leadership to identify key opportunities and align strategic goals with overall organizational objectives.
• Monitor and Evaluate Programs: Continuously track the performance of implemented payment integrity programs and make data-driven decisions to improve effectiveness and accuracy.
• Contract and Vendor Management: Evaluate strategic solution fit provided by third-party vendors. Manage relationships with vendors that provide services, ensuring effective collaboration and value realization from partnerships.
• Business Development: Identify new business opportunities, partnerships, and market segments that align with the organization’s long-term strategic goals and growth plans.

• Risk Management and Mitigation: Assess risks associated with new strategies and ensure contingency plans are in place for successful implementation and sustainability.

• Monitor and Adjust Strategies: Continuously track the success of implemented strategies, make data-driven adjustments as needed, and report results to senior leadership and stakeholders.

Education

• Bachelor’s Degree or MBA

Experience:

• 8+ years of experience in healthcare strategy, healthcare consulting, or a related field.
• Demonstrated expertise in healthcare operations, strategic planning, or business development.
• Experience in both provider and payer environments is a plus.
• Proven ability to identify market needs, competitive landscape, and potential return on investment.
• Experience liaising between stakeholders and executive leadership, managing expectations through regular meetings and project status reports.
• Experience collecting and validating critical data for analysis and conducting market research and feasibility studies.
• Experience with Healthcare IT and data analytics domains
• Ability to create strategies and provide staff-level guidance
• Experience working in global delivery model.
• Excellent attention to detail and the ability to work independently without supervision, be self-directed and demonstrate initiative.
• Strong Excel and Presentation skills required.

Technical Skills:

• Strong understanding of healthcare systems, clinical workflows, and financial structures (including value-based care, fee-for-service, etc.).
• Proficient in using data analytics tools for healthcare insights (e.g., Excel, Tableau, SQL).
• Familiarity with healthcare IT solutions and digital health technologies.

Soft Skills:

• Strong leadership and project management skills.
• Excellent communication, negotiation, and presentation abilities.
• Ability to think critically, problem-solve, and adapt to a rapidly changing healthcare environment.
• Collaboration and relationship-building skills to work across multidisciplinary teams.

Preferred Skills:

• Knowledge of claims auditing is a plus.
• Experience in developing strategies for population health management, care coordination, or value-based care.
• Knowledge of emerging trends in healthcare technology, including telemedicine, AI, and patient-centered care models.
• Background in mergers and acquisitions, partnerships, or healthcare business development.

Skills

Teamwork:

• Working collaboratively with others to achieve common goals and positive results.

Continuous Learning:

• Creating the environment and processes to ensure continuous learning, leading to an increasing capacity to create the future – at an individual and organizational level. 

Customer Advocate:

• Prioritize the customer in all interactions, continuously seeking to understand and address their current and future needs.

Manage Change:

• Managing, leading, and enabling the process of change and its effect on individuals and the organization. 

What We Offer

• EXL Health offers an exciting, fast paced, and innovative environment, which brings together a group of sharp and entrepreneurial professionals who are eager to influence business decisions.
• From your very first day, you get an opportunity to work closely with highly experienced, world class Healthcare consultants.
• You can expect to learn many aspects of businesses that our clients engage in. You will also learn effective teamwork and time-management skills - key aspects for personal and professional growth.
• We provide guidance/ coaching to every employee through our mentoring program wherein every junior level employee is assigned a senior level professional as advisors.
• Sky is the limit for our team members. The unique experiences gathered at EXL Health sets the stage for further growth and development in our company and beyond.