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Payer STARS/Quality Clinical Consultant, Senior Manager

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Payer STARS/Quality Clinical Consultant, Senior Manager

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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: Senior Manager
  • 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 STARS/Quality Clinical Consultant, Senior Manager
Job Category
Operations Consulting
Level
Senior Manager
Specialty/Competency
Operations
Industry/Sector
Health Services
Job Type
Regular
Time Type
Full time
Travel Requirements
Up to 80%
Start Year
2026
Job ID
734740WD
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

The Opportunity

As a Payer STARS/Quality Clinical Consultant, Senior Manager, you will engage with clients in the health services sector, providing strategic guidance and operational consulting to enhance their clinical quality and performance metrics. Within our Management Consulting practice, you will leverage your skills to drive impactful solutions that align with industry trends and client needs. As a Senior Manager, you will lead large projects, innovate processes, and maintain operational excellence while interacting with clients at a strategic level to drive project success. You will apply sound judgment and communicate effectively, developing high-performing, diverse, and inclusive teams that contribute to the overall success of the firm.

In this role, you will focus on delivering quality results through strategic advising and problem-solving, motivating and coaching teams to tackle complex challenges. You will deepen your professional skills, staying relevant in the evolving health industries landscape, and initiate open and honest coaching conversations at all levels. Your commitment to excellence and ability to navigate ambiguity will be crucial in crafting and conveying clear, impactful messages that tell a holistic story. This opportunity allows you to validate outcomes with clients, share alternative perspectives, and act on client feedback, driving continuous improvement and innovation.

Responsibilities

- Leading strategic initiatives to enhance operational performance within health services
- Driving business transformation projects with a focus on payer modernization
- Utilizing analytical thinking to develop and implement quality standards in clinical consulting
- Managing stakeholder engagement to foster collaborative client relationships
- Overseeing process improvement efforts to optimize operational effectiveness
- Implementing business performance metrics to track and improve service delivery models
- Coordinating logistics management to streamline operations processes
- Applying change management techniques to support organizational transformation
- Facilitating coaching and feedback sessions to develop high-performing teams
- Conducting market research to inform strategic decision-making and innovation

What You Must Have

- At least a Bachelor's degree
- At least 6 years of experience

What Sets You Apart

- Demonstrating advanced skills in business data analytics and transformation
- Leading operational excellence initiatives within health services
- Innovating processes for payer modernization projects
- Utilizing Epic Software and Systems for healthcare operations
- Excelling in strategic questioning and stakeholder engagement
- Developing high-performing teams through effective coaching and feedback
- Applying analytical thinking to drive operational performance management


The salary range for this position is: $124,000 - $280,000. 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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