PWC

Payer Quality Consultant, Director

PWC$155K — $410K *
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree required; advanced degree preferred.
  • Minimum 9 years of experience in operations consulting, particularly in health services.
  • Strong background in fields like Accounting, Actuarial Science, Data Science, or Health Administration.
  • Proven experience in strategic leadership and change management within health industries.
  • Demonstrated expertise in business data analytics and operational optimization.

Responsibilities

  • Lead strategic initiatives to modernize payer operations and enhance operational excellence.
  • Oversee multiple projects while fostering executive-level client relationships to drive growth.
  • Leverage analytical thinking to improve operational processes and performance metrics.
  • Implement change management strategies that elevate service delivery models.
  • Develop operations strategies aligned with client needs and industry trends.
  • Encourage innovation and systemic thinking in operations management for continuous improvement.
  • Build and maintain relationships with stakeholders for effective communication and collaboration.

Benefits

  • Comprehensive medical, dental, and vision insurance.
  • 401k plan with company match.
  • Generous holiday pay, vacation, and personal/sick leave policies.
  • Eligibility for annual discretionary bonuses.
  • Access to professional development opportunities and training programs.
Full Job Description
Industry/Sector
Health Services

Specialism
Operations

Management Level
Director

Job Description & Summary
The Opportunity

As a Payer Quality Consultant, Director, you will lead strategic initiatives within our Operations Consulting practice, focusing on transforming payer operations in the health services sector. As a Director, you will set the strategic direction and lead business development efforts, making impactful decisions and overseeing multiple projects while maintaining executive-level client relations. Your role is crucial in driving business growth, shaping the direction of client engagements, and mentoring the next generation of leaders. You are expected to be a guardian of our reputation, understanding that quality, integrity, inclusion, and a commercial mindset are foundational to our success.

In this role, you will collaborate with clients to modernize their payer operations, leveraging your skills to deliver innovative solutions that enhance operational efficiency and effectiveness. You will cultivate potential in others and actively team across our network, understanding tradeoffs and leveraging our collective strength. This position offers the opportunity to work within our Business & Supply Chain Operations network, providing a dynamic environment where you can make a significant impact on the health industries sector.

Responsibilities

- Leading strategic initiatives in payer modernization to drive operational excellence within health services
- Overseeing multiple projects and maintaining executive-level client relations to enhance business growth
- Utilizing analytical thinking and business data analytics to optimize operations processes and performance metrics
- Implementing change management strategies to support business transformation and improve service delivery models
- Developing and executing operations strategies that align with client needs and industry trends
- Promoting innovation and creativity in operations management to foster continuous improvement and systemic thinking
- Building and nurturing relationships with stakeholders to facilitate effective communication and engagement
- Conducting market research and operating effectiveness reviews to identify opportunities for process optimization and improvement
- Coaching and mentoring teams to cultivate potential and drive strategic questioning and planning operations

What You Must Have

- At least a Bachelor's degree
- At least 9 years of experience

What Sets You Apart

- Preference for at least one of the following fields of study: Accounting, Actuarial Science, Analytics/Data Science, Business Administration/Management, Computer Science/Information Systems, Economics, Engineering, Finance, Government/Public Policy, Health Administration/Public Health, Mathematics/Statistics, Operations/Supply Chain, Organizational Management/Behavior, Risk Management/Insurance
- Demonstrating strategic leadership in operations consulting within health industries
- Driving business transformation through innovative payer modernization strategies
- Excelling in business data analytics to enhance operational effectiveness
- Leading change management initiatives to optimize service delivery models
- Cultivating executive-level client relations and stakeholder engagement
- Promoting operational excellence through process improvement and optimization

Travel Requirements
Up to 80%

Job Posting End Date

The salary range for this position is: $155,000 - $410,000. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. All hired individuals are eligible for an annual discretionary bonus. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation, personal and family sick leave, and more. To view our benefits at a glance, please visit the following link: https://pwc.to/benefits-at-a-glance

Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: https://pwc.to/us-application-deadlines

About PWC

PwC is a multinational professional services network of firms headquartered in London, United Kingdom, operating as partnerships under the PwC brand. PwC ranks as the second-largest professional services network in the world and is considered one of the Big Four accounting firms, along with Deloitte, EY and KPMG. PwC firms operate in 157 countries, 742 locations, with 276,000 people. As of 2020, 26% of the workforce worked in the Americas, 26% in Asia, 32% in Western Europe, 5% in Middle East and Africa and 11% in Central and Eastern Europe and Central Asia.
Learn more about PWC
Size
284,000 employees
Industry
Founded
1998

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