Job Title Payer - Stars/Quality Strategy & Operations - 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 60% Start Year 2025 Job ID 589518WD Location(s) IN-Indianapolis, NC-Charlotte, GA-Atlanta, IL-Chicago, TX-Austin, DC-Washington, MO-Kansas City, TX-Dallas, FL-Miami, CA-Los Angeles, MD-Baltimore, MN-Minneapolis, CO-Denver, TN-Nashville, MI-Detroit, MA-Boston, NY-New York, CA-San Francisco, PA-Philadelphia, WA-Seattle, 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.

Growing as a strategic advisor, you leverage your influence, expertise, and network to deliver quality results. You motivate and coach others, coming together to solve complex problems. As you increase in autonomy, you apply sound judgment, recognising when to take action and when to escalate. You are expected to solve through complexity, ask thoughtful questions, and clearly communicate how things fit together. Your ability to develop and sustain high performing, diverse, and inclusive teams, and your commitment to excellence, contributes to the success of our Firm.

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

• Craft and convey clear, impactful and engaging messages that tell a holistic story.
• Apply systems thinking to identify underlying problems and/or opportunities.
• Validate outcomes with clients, share alternative perspectives, and act on client feedback.
• Direct the team through complexity, demonstrating composure through ambiguous, challenging and uncertain situations.
• Deepen and evolve your expertise with a focus on staying relevant.
• Initiate open and honest coaching conversations at all levels.
• Make difficult decisions and take action to resolve issues hindering team effectiveness.
• Model and reinforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance), the Firm's code of conduct, and independence requirements.

Job Requirements and Preferences:

Basic Qualifications:

Minimum Degree Required:
Bachelor Degree

Additional Educational Requirements:

.

Minimum Years of Experience:
7 year(s)

Preferred Qualifications:

Degree Preferred:
Master of Business Administration

Preferred Fields of Study:
Health Administration, Business Administration/Management

Preferred Knowledge/Skills:

Demonstrates intimate level abilities and/or a proven record of success with Government Programs Experience regarding Medicare Advantage and Medicaid program requirements, such as:

• Experience with Stars (e.g., CAHPS, HEDIS) programs and methodologies;
• Experience with quality programs;
• Program compliance, risk and regulatory compliance;
• Familiar with provider and member engagement strategies;
•  Understanding of key enterprise capabilities that drive Stars performance;
• Program implementation, product/market expansion and growth;
• Business Development - growing existing clients and developing new clients within the Payor sector; and,
• Payer industry market trends and industry-leading practices in order to develop insights and provide recommendations.

Demonstrates intimate level abilities and/or a proven record of success with leadership, strategic and creative thinking, problem solving, individual initiative, as well as the following abilities:

• Leading teams to generate a vision and creating an atmosphere of trust, leveraging diverse views and encouraging improvement and innovation;
• Building productive and collaborative relationships with team members and proactively providing and seeking guidance, clarification and feedback;
• Leading a team to a successful project conclusion through problem solving complex operations issues;
• Managing the planning, organizing and delivery of operations tasks and projects;
• Overseeing independent analyses and ensuring the quality of client deliverables;
• Leading the development and improvement of various frameworks and methodologies within operations;
• Identifying and addressing client needs: building, maintaining, and utilizing networks of client relationships;
• Communicating cogently in an organized and knowledgeable manner in written and verbal formats; and,
• Leveraging quantitative analyses to construct analytical frameworks and synthesize complex data into meaningful insights.

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

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.

All qualified applicants will receive consideration for employment at PwC without regard to race; creed; color; religion; national origin; sex; age; disability; sexual orientation; gender identity or expression; genetic predisposition or carrier status; veteran, marital, or citizenship status; or any other status protected by law. PwC is proud to be an affirmative action and equal opportunity employer.

For positions based in San Francisco, consideration of qualified candidates with arrest and conviction records will be in a manner consistent with the San Francisco Fair Chance Ordinance.

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

The salary range for this position is: $130,000 - $256,000, plus individuals may be eligible for an annual discretionary bonus. For roles that are based in Maryland, this is the listed salary range for this position. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation and more. To view our benefits at a glance, please visit the following link: https://pwc.to/benefits-at-a-glance