Payer Transformation

Job Title Payer Transformation - Healthcare Government Programs & Payers - Sr Manager Job Category Operations Consulting Level Senior Manager Specialty/Competency Operations Industry/Sector Health Services Job Type Regular Time Type Full time Travel Requirements Up to 80% Job ID 524606WD Location(s) NC-Charlotte, GA-Atlanta, IL-Chicago, TX-Austin, DC-Washington, OH-Columbus, MO-Kansas City, TX-Dallas, FL-Miami, CO-Denver, MN-Minneapolis, TN-Nashville, MA-Boston, NY-New York, PA-Philadelphia, PA-Pittsburgh, TX-Houston
A career within Operations Consulting services, will provide you with the opportunity to help our clients optimise all elements of their operations to move beyond the role of a cost effective business enabler and become a source of competitive advantages. We focus on product innovation and development, supply chain, procurement and sourcing, manufacturing operations, service operations and capital asset programmes to drive both growth and profitability.

To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be a purpose-led and values-driven leader at every level. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future.

As a Senior Manager, you'll work as part of a team of problem solvers, helping to solve complex business issues from strategy to execution. PwC Professional skills and responsibilities for this management level include but are not limited to:

• Encourage everyone to have a voice and invite opinion from all, including quieter members of the team.
• Deal effectively with ambiguous and unstructured problems and situations.
• Initiate open and candid coaching conversations at all levels.
• Move easily between big picture thinking and managing relevant detail.
• Anticipate stakeholder needs, and develop and discuss potential solutions, even before the stakeholder realises they are required.
• Contribute technical knowledge in area of specialism.
• Contribute to an environment where people and technology thrive together to accomplish more than they could apart.
• Navigate the complexities of cross-border and/or diverse teams and engagements.
• Initiate and lead open conversations with teams, clients and stakeholders to build trust.
• Uphold the firm's code of ethics and business conduct.

Minimum Years of Experience :
7 years Preferred Qualifications: Degree Preferred:
Master level degree (including MBA, MHA, MPH, MSW) Preferred Fields of Study:
Health Administration, Business Administration/Management , Public Policy , Economics, Government  Preferred Knowledge/Skills:
Detailed understanding and/or experience of the inner workings of how federal or state agencies operate and govern Medicaid, Dual Eligible, or similar healthcare programs.

Demonstrates intimate level abilities and/or a proven record of success with Government Programs regarding Medicaid State program requirements such as:

• Deep expertise with designing, operating , and launching Medicaid programs, including DSNP, CHIP, and other state funded health care programs

• Experience with Health Plan Medicaid operations, finances, business processes, and program design

• Understand how to optimize existing Medicaid programs and launch new program designs within the Federal and State regulatory environment  

• Experience designing, implementing, and running state Medicaid programs to enable product / market expansion and growth

• Experience using Medicaid data to develop financial models and apply insights to enable organizational goals

• Experience in the Payer industry market trends and industry-leading practices in order to develop insights and provide recommendations.

Demonstrates intimate level abilities and/or a proven record of success with leadership, strategic and creative thinking, problem solving, individual initiative as well as the following abilities:

• Leading teams to generate a vision and creating an atmosphere of trust, leveraging diverse views and encouraging improvement and innovation;

• Building productive and collaborative relationships with team members and proactively providing and seeking guidance, clarification and feedback;

• Leading a team to a successful project conclusion through problem solving complex operations issues;

• Managing the planning, organizing and delivery of operations tasks and projects;

• Overseeing independent analyses and ensuring the quality of client deliverables;

• Leading the development and improvement of various frameworks and methodologies within operations;

• Identifying and addressing client needs: building, maintaining , and utilizing networks of

• Communicating cogently in an organized and knowledgeable manner in written and verbal formats; and,

• Leveraging quantitative analyses to construct analytical frameworks and synthesize complex data into meaningful insights.

Learn more about how we work: 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: All qualified applicants will receive consideration for employment at PwC without regard to race; creed; color; religion; national origin; sex; age; disability; sexual orientation; gender identity or expression; genetic predisposition or carrier status; veteran, marital, or citizenship status; or any other status protected by law. PwC is proud to be an affirmative action and equal opportunity employer. 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: For positions in California, Colorado, Hawaii, Nevada, New York State, or Washington State, or for opportunities that will report to a supervisor, office or other work site in New York State, please visit the following link for pay range information: