Payer STARS/Quality Clinical Consultant, Senior Manager

Posted 4 Days Ago
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45 Locations
Hybrid
124K-280K Annually
Senior level
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
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The Role
Lead payer-focused quality and operational consulting engagements, drive payer modernization and STARS improvement, manage stakeholder relationships, implement performance metrics and process improvements, coach teams, and deliver strategic, analytics-driven solutions for health services clients.
Summary Generated by Built In
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

Skills Required

  • Bachelor's degree
  • At least 6 years of experience
  • Advanced skills in business data analytics and transformation
  • Experience with Epic software and systems
  • Experience leading operational excellence initiatives within health services
  • Experience with payer modernization or STARS-related projects
  • Strong stakeholder engagement and coaching skills

What the Team is Saying

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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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