PwC Logo

PwC

Payer STARS/Quality Clinical Consultant, Senior Manager

Posted 3 Hours Ago
Be an Early Applicant
Hybrid
Toledo, OH
Senior level
Hybrid
Toledo, OH
Senior level
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.
The summary above was generated by AI
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

Similar Jobs at PwC

3 Hours Ago
Hybrid
Senior level
Senior level
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Lead FP&A technology engagements using Anaplan to design financial performance frameworks, budgeting/forecasting, KPI development, data analysis and visualization, software integration, cost forecasting, client advisory, and team mentoring to drive business growth.
Top Skills: Anaplan
6 Hours Ago
Hybrid
Senior level
Senior level
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
The role involves managing system implementations and upgrades for Guidewire Digital Portals, leading large projects, and mentoring teams. Responsibilities include ensuring client satisfaction and providing strategic input for business strategies.
Top Skills: Billing CenterBitbucketClaim CenterCSSData ModelGitGosu ScriptingGuidewireGuidewire CloudGuidewire Cloud ConsoleGuidewire StudioHTMLJetbrainsJmsJSONNode.jsOraclePolicy CenterPostgresRest ApiSQL ServerUiVisual Code Studio
6 Hours Ago
Remote or Hybrid
Senior level
Senior level
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Lead the design and implementation of data architecture strategies within AI and ML, collaborating with stakeholders to enhance data solutions and ensure compliance with governance policies.
Top Skills: AWSAzureDatabricksFastapiGCPPythonSnowflakeSQL

What you need to know about the London Tech Scene

London isn't just a hub for established businesses; it's also a nursery for innovation. Boasting one of the most recognized fintech ecosystems in Europe, attracting billions in investments each year, London's success has made it a go-to destination for startups looking to make their mark. Top U.K. companies like Hoptin, Moneybox and Marshmallow have already made the city their base — yet fintech is just the beginning. From healthtech to renewable energy to cybersecurity and beyond, the city's startups are breaking new ground across a range of industries.

Sign up now Access later

Create Free Account

Please log in or sign up to report this job.

Create Free Account