[Remote] Payer Operations & Transformation Consultant, Senior Associate

Note: The job is a remote job and is open to candidates in USA. PwC is an advisory and consulting firm serving health services clients. The Payer Operations & Transformation Consultant, Senior Associate will support payer modernization initiatives through business process improvement, operating model design, data analysis, and transformation planning. The role also involves managing workstreams, developing client deliverables, building client relationships, and guiding junior team members.

Responsibilities

• Analyzing payer operations challenges and translating findings into workstream plans that support transformation initiatives
• Developing client deliverables for health services organizations across process improvement, operating effectiveness reviews, and service delivery model changes
• Assessing operations strategy, performance metrics, and business data to identify trends, risks, and process gaps
• Applying management consulting methods and digital tooling to streamline workflows and improve operational execution
• Coordinating project tasks, timelines, and issue logs while adapting to changing client priorities and project scope
• Reviewing work from junior team members and providing feedback that supports accuracy, consistency, and professional growth
• Building client relationships by understanding operational needs and presenting clear recommendations grounded in analysis
• Using AI fluency, AI-human collaboration, and analytical thinking to support transformation planning and process optimization

Skills

• At least a Bachelor's degree
• At least 4 years of experience
• Demonstrating consulting experience supporting payer operations transformation initiatives
• Applying business data analytics to process improvement and performance metrics
• Navigating healthcare operations, service delivery models, and change management
• Collaborating across teams while mentoring junior colleagues on deliverables
• Translating complex operational findings into client-ready recommendations
• Accounting, Actuarial Science, Analytics/Data Science, Business Administration/Management, Computer Science/Information Systems, Economics, Engineering, Finance, Government/Public Policy, Health Administration/Public Health, Mathematics/Statistics, Operations/Supply Chain, Organizational Management/Behavior, Risk Management/Insurance

Benefits

• All hired individuals are eligible for an annual discretionary bonus.
• Medical benefits
• Dental benefits
• Vision benefits
• 401k
• Holiday pay
• Vacation
• Personal and family sick leave

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