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Payer Quality Consultant, Director

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Payer Quality Consultant, Director

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Overview

A career within Operations Consulting services will provide you with the opportunity to help our clients optimize all elements of their operations to move beyond the role of a cost effective business enabler and become a source of competitive advantages. We focus on product innovation and development, supply chain, procurement and sourcing, manufacturing operations, service operations and capital asset programs to drive both growth and profitability.

  • Job Type: Full time
  • Level: Director
  • Travel: Up to 80%
The PwC Professional

What does it take?

At PwC, we support our people at every stage in their career, with year-round transparency into how they are performing and action-oriented coaching to drive their development and help achieve their aspirations.

All our employees are recruited, developed and managed against the global PwC Professional framework that focuses on two dimensions: Trusted Leadership and Distinctive Outcomes. It guides us on “what to do” and “how to do it”, emphasizing impact and behaviors.

Together, Trusted Leadership and Distinctive Outcomes are how we deliver on our purpose and strategy, serving our clients and living our values in every interaction, everyday.

Grow here. Go further.

Our People Value Proposition —‘Grow here. Go further.’ — sets the foundation for a distinctive, shared experience at PwC, shaped by mutual expectations and guided by the PwC Professional, helping us grow and learn together.

  • Shaping tomorrow
  • Committing to growth
  • Bringing your best, every day
  • Embracing inclusion, driving impact

Benefits / Rewards

  • Health Care

    We offer comprehensive medical coverage, vision care, dental and health savings accounts.

  • Retirement

    PwC offers a 401(k) Savings Plan and a Wealth Builder retirement plan completely funded by PwC.

  • Maternity / Paternity Leave

    Eligible new parents receive, within the first year from birth or adoption/foster placement, 12 weeks of paid parental leave. Parents have the option to work 60% of hours, at full-time pay, for an additional four weeks immediately following paid parental leave.

  • Paid Time Off

    The Firm recognizes 13 paid holidays and provides extended Firm holidays around the July 4 holiday and Christmas and New Year holiday. You accrue vacation time of between three weeks (15 work days) and one month (22 work days) per year, based upon staff classification and length of service with PwC.

  • Committing to growth

    You’ll receive AI training and human skills you need to become a leader in today's workplace

  • Bring your best, every day

    We empower our people and strive to provide a people experience grounded in care for you and your well-being.

Job details

Job Title
Payer Quality Consultant, Director
Job Category
Operations Consulting
Level
Director
Specialty/Competency
Operations
Industry/Sector
Health Services
Job Type
Regular
Time Type
Full time
Travel Requirements
Up to 80%
Start Year
2026
Job ID
711572WD
Location(s)
IN-Indianapolis, NC-Raleigh, NC-Charlotte, IL-Chicago, FL-Jacksonville, OH-Cincinnati, OH-Cleveland, SC-Columbia, OH-Columbus, MO-Kansas City, TX-Dallas, NV-Las Vegas, CA-Los Angeles, MD-Baltimore, MA-Boston, MO-St. Louis, AL-Birmingham, UT-Salt Lake City, CA-San Diego, CA-San Francisco, CA-Silicon Valley, WA-Seattle, CT-Stamford, FL-Tampa, OH-Toledo, TX-Austin, DC-Washington, NY-Melville, FL-Miami, CO-Denver, IA-Des Moines, MI-Detroit, TN-Nashville, LA-New Orleans, NJ-Florham Park, NY-New York, OK-Oklahoma City, PA-Philadelphia, AZ-Phoenix, PA-Pittsburgh, TX-Houston

At PwC, our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs, develop operational strategies, and offer guidance and support to help clients streamline processes, improve productivity, and drive business performance. As an operations consulting generalist at PwC, you will possess a broad understanding of various aspects of operations consulting. You will provide comprehensive guidance and support to clients in optimising operational efficiency and effectiveness. Working in this area, you will analyse client needs, develop operational solutions, and offer recommendations tailored to specific business requirements.

Translating the vision, you set the tone, and inspire others to follow. 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 PwC's reputation, understanding that quality, integrity, inclusion and a commercial mindset are all foundational to our success. You create a healthy working environment while maximising client satisfaction. You cultivate the potential in others and actively team across the PwC Network, understanding tradeoffs, and leveraging our collective strength.

Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to:

  • Lead in line with our values and brand.
  • Develop new ideas, solutions, and structures; drive thought leadership.
  • Solve problems by exploring multiple angles and using creativity, encouraging others to do the same.
  • Balance long-term, short-term, detail-oriented, and big picture thinking.
  • Make strategic choices and drive change by addressing system-level enablers.
  • Promote technological advances, creating an environment where people and technology thrive together.
  • Identify gaps in the market and convert opportunities to success for the Firm.
  • Adhere to and enforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance) the Firm's code of conduct, and independence requirements.


The Opportunity

As part of the Operations Consulting team you lead the strategic direction and execution of impactful initiatives within the payer sector. As a Director, you drive business growth by overseeing multiple projects, cultivating executive-level client relations, and mentoring the future leaders. This role offers a unique chance to shape client engagements while fostering an environment where innovation and integrity thrive.

Responsibilities

- Drive business development efforts to enhance client engagement and satisfaction

- Oversee project execution, maintaining alignment with organizational goals

- Mentor and develop team members to foster their professional growth

- Analyze market trends to identify opportunities for service enhancement

- Promote collaboration across teams to leverage diverse skills

- Uphold adherence to professional standards and ethical guidelines

- Cultivate a culture of innovation and continuous improvement

What You Must Have

- Bachelor's Degree

- At least 10 years of experience

What Sets You Apart

- Master's Degree in Health Administration, Business Administration/Management preferred

- Demonstrating Government Programs Experience with Medicare Advantage and Medicaid program requirements

- Leading teams to generate a vision and trust

- Building collaborative relationships and seeking feedback

- Managing planning, organizing, and delivery of operations tasks

- Overseeing independent analyzes and client deliverables quality

- Communicating cogently in organized written and verbal formats

- Leveraging quantitative analyzes for meaningful insights


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

As PwC is an equal opportunity employer, all qualified applicants will receive consideration for employment at PwC without regard to race; color; religion; national origin; sex (including pregnancy, sexual orientation, and gender identity); age; disability; genetic information (including family medical history); veteran, marital, or citizenship status; or, any other status protected by law. 

PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy.

Learn more about how we work: https://pwc.to/how-we-work

For only those qualified applicants that are impacted by the Los Angeles County Fair Chance Ordinance for Employers, the Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, San Diego County Fair Chance Ordinance, and the California Fair Chance Act, where applicable, arrest or conviction records will be considered for Employment in accordance with these laws.  At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members. We evaluate these factors thoughtfully to establish a secure and trusted workplace for all.

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

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