Payer Quality Consultant, Director

Posted An Hour Ago
Be an Early Applicant
40 Locations
Hybrid
155K-410K Annually
Expert/Leader
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Grow here. Go further.
The Role
Lead payer-focused operations consulting engagements, drive business development, oversee project delivery, mentor teams, ensure quality and compliance, analyze market trends, and promote innovation to improve payer operations and client outcomes.
Summary Generated by Built In
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

Skills Required

  • Bachelor's Degree
  • At least 10 years of experience
  • Master's Degree in Health Administration or Business Administration/Management
  • Government programs experience with Medicare Advantage and Medicaid program requirements
  • Proven leadership in building and leading teams
  • Client relationship management and business development experience
  • Strong written and verbal communication skills
  • Ability to perform and leverage quantitative analyses

What the Team is Saying

Art
Brandon
Nishana

PwC Compensation & Benefits Highlights

  • Leave & Time Off Breadth Two firmwide week‑long shutdowns each year in the US and a broad menu of paid and unpaid leaves add structured downtime beyond standard vacation. Flexible work options provide additional avenues to step away when client needs permit.
  • Parental & Family Support Paid parental leave is 12 weeks for all parents, with a four‑week phased return at 60% time on full base pay. Family‑forming and caregiving supports span infertility coverage, cryopreservation, adoption/surrogacy reimbursements, and nursing‑parent resources.
  • Wellbeing & Lifestyle Benefits Mental‑health and wellness resources include EAP, coaching, Headspace/Calm, Talkspace, and fitness programs. These offerings underscore a sustained emphasis on well‑being alongside core health coverage.

PwC Insights

Am I A Good Fit?
beta
Get Personalized Job Insights.
Our AI-powered fit analysis compares your resume with a job listing so you know if your skills & experience align.

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.

Gallery

Gallery
Gallery
Gallery
Gallery
Gallery
Gallery
Gallery

PwC Teams

Team
Cloud and Digital
Team
Strategic Alliances
Team
Oracle Consulting
Team
AI & Data
About our Teams

PwC Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Typical time on-site: Flexible
HQNew York, NY
Albany, NY
Atlanta, GA
Austin, TX
Baltimore, MD
Bentonville, AR
Birmingham, AL
Boston, MA
Buffalo, NY
Charlotte, NC
Chicago, IL
Chicago, IL
Cincinnati, OH
Cleveland, OH
Columbia, SC
Columbus, OH
Company Office Image
Dallas, TX
Company Office Image
Denver, CO
Des Moines, IA
Detroit, MI
El Segundo, CA
Fairport, NY
Florham Park, NJ
Fort Worth, Texas
Grand Rapids, MI
Greensboro, NC
Hartford, CT
Company Office Image
Houston, TX
Indianapolis, IN
Irvine, CA
Jacksonville, FL
Kansas City, MO
Las Vegas, NV
Little Rock, AR
Company Office Image
Los Angeles, CA
Louisville, KY
McLean, VA
Melville, NY
Miami, FL
Milwaukee, Wisconsin
Minneapolis, MN
Montpelier, Vermont
Nashville, TN
Oklahoma City, OK
Philadelphia, PA
Phoenix, Airzona
Pittsburgh, PA
Portland, OR
Raleigh, NC
Richmond, Virginia
Rosemont, IL
Sacramento, CA
Saint Louis, MO
Salt Lake City, Utah
San Antonio, Texas
San Diego, CA
Company Office Image
San Francisco, CA
Company Office Image
San Jose, CA
San Juan, Puerto Rico
Sarasota, FL
Seattle, WA
Seattle, Washington
Sofia, BG
Spartanburg, SC
Springdale, AR
Stamford, CT
Tampa, FL
Tampa, FL
Company Office Image
Tampa, FL
Toledo, OH
Tulsa, OK
Washington, DC
Washington, District of Columbia
West Palm Beach, FL
Learn more

Similar Jobs

PwC Logo PwC

Consultant

Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Remote or Hybrid
40 Locations
370000 Employees
77K-202K Annually

PwC Logo PwC

Data Scientist

Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Remote or Hybrid
60 Locations
370000 Employees
77K-202K Annually

PwC Logo PwC

Data Scientist

Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Remote or Hybrid
62 Locations
370000 Employees
99K-232K Annually

PwC Logo PwC

Consultant

Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Hybrid
40 Locations
370000 Employees
99K-232K Annually

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account