Payer Back Office Strategy / Technology / Operations Consultant, Director

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 Payer Operations team you will set the vision and strategic roadmap for technology and AI-enabled payer operations across core value chain functions. As a Director you will drive business growth by leading large, complex consulting engagements, delivering excellence, and acting as a trusted advisor to payer executives on operational transformation and AI adoption.
Responsibilities
- Drive initiatives for business growth through innovative solutions
- Work with cross-functional teams to refine core values chain functions
- Mentor and develop team members to enhance their skills
- Promote the adoption of AI technologies within operational frameworks
- Identify market opportunities and align strategies for success
What You Must Have
- Bachelor's Degree
- At least 10 years of experience
What Sets You Apart
- Master's Degree preferred
- Demonstrating strategic leadership in technology and AI
- Advising executive stakeholders with business cases
- Designing technology-enabled transformation programs
- Developing impactful use cases with advanced analytics
- Leading complex consulting engagements with delivery excellence
- Mentoring and developing teams across geographies
- Understanding payer operations and key platforms
- Navigating ambiguity in fast-evolving environments
- Experience with key platforms and vendors that enable payer operations (e.g., BPM/automation platforms, claims platforms, provider data solutions)
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