Payer Quality Consultant, Director

Posted 16 Hours Ago
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45 Locations
Hybrid
155K-410K Annually
Expert/Leader
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
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The Role
Lead payer modernization strategy and business development within operations consulting. Oversee multiple projects and executive client relationships, apply data analytics and change management to optimize payer operations, drive process improvement, conduct market and effectiveness reviews, and coach teams to deliver operational excellence and transformation.
Summary Generated by Built In
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
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

Skills Required

  • Bachelor's degree
  • At least 9 years of experience
  • Strategic leadership in operations consulting within health industries
  • Experience driving payer modernization and business transformation
  • Proficiency in business data analytics to improve operational effectiveness
  • Experience leading change management initiatives
  • Proven ability to cultivate executive-level client relations and stakeholder engagement
  • Experience in process improvement and operations optimization
  • Preferred 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

What the Team is Saying

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PwC Compensation & Benefits Highlights

  • Healthcare Strength Multiple medical plan options with integrated programs, mental-health apps, and primary care access indicate robust coverage. Fitness partnerships and specialized care navigation further broaden support.
  • Parental & Family Support Paid parental leave for all parents with a phased return, plus fertility, adoption, and surrogacy support, underscore strong family-forming benefits. Backup caregiving resources and caregiver leave extend support beyond new-parent needs.
  • Leave & Time Off Breadth Two firmwide U.S. shutdowns alongside vacation, holidays, and various paid leaves create predictable time-off opportunities. Additional paid and unpaid leave options offer flexibility for different life events.

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The Company
HQ: New York, NY
370,000 Employees
Year Founded: 1998

What We Do

Build what’s next — with tech that matters PwC provides professional services across Audit and Assurance, Advisory and Tax — powered by a global network of over 370,000 people in 149 countries. You may know us for our business expertise, but technology is core to how we help clients move faster, build trust and deliver meaningful outcomes. As a technologist, you’ll work on agile teams with experienced engineers and product thinkers — using AI, cloud, cybersecurity and more to design scalable, real-world solutions. You’ll keep learning, stay challenged and be part of a network where your growth is built in — and your work drives what’s next.

Why Work With Us

At PwC, our professionals include technologists, engineers, programmers and consultants working across AI, cloud, cybersecurity, data and more. You’ll explore innovative ways to help clients transform their business through technology—reducing complexity, unlocking value and shaping a more agile, data-driven future.

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