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PwC Health Payer Operations & Technology, Manager in New York, New York

Specialty/Competency: Functional & Industry Apps

Industry/Sector: Health Services

Time Type: Full time

Travel Requirements: Up to 80%

A career within Industry and Functional Apps services, will provide you with the opportunity to build secure and new digital experiences for customers, employees, and suppliers. We focus on improving apps or developing new apps for traditional and mobile devices as well as conducting usability testing to find ways to improve our clients’ user experience.

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 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:

  • Develop new skills outside of comfort zone.

  • Act to resolve issues which prevent the team working effectively.

  • Coach others, recognise their strengths, and encourage them to take ownership of their personal development.

  • Analyse complex ideas or proposals and build a range of meaningful recommendations.

  • Use multiple sources of information including broader stakeholder views to develop solutions and recommendations.

  • Address sub-standard work or work that does not meet firm's/client's expectations.

  • Use data and insights to inform conclusions and support decision-making.

  • Develop a point of view on key global trends, and how they impact clients.

  • Manage a variety of viewpoints to build consensus and create positive outcomes for all parties.

  • Simplify complex messages, highlighting and summarising key points.

  • Uphold the firm's code of ethics and business conduct.

Job Requirements and Preferences :

Basic Qualifications :

Minimum Degree Required :

Bachelor Degree

Minimum Years of Experience :

5 year(s)

Preferred Qualifications :

Degree Preferred :

Master Degree

Preferred Knowledge/Skills :

Demonstrates extensive abilities and/or a proven record of success as a team leader supporting large teams through the design and implementation of changes to Operations, including people, process and technology changes and the following:

  • Working experience across payer back office, specifically to drive growth across operations, IT and strategy engagements within;

  • Possessing experience within domain areas that include: claims, enrollment, billing, membership, provider data, product management, and related functions;

  • Possessing experience with either process level familiarity and/or familiarity with the technology solutions that enable these functions;

  • Demonstrating experience with transaction lifecycles, Healthcare/Payer Services products;

  • Working experience with domain area knowledge and specialization in claims, enrollment, billing, membership, provider data, product management, and related functions;

  • Demonstrating experience with COTS platforms including TriZetto Facets/QNXT, HealthEdge, Oracle payer solution;

  • Demonstrating experience with (ORMB), ida/Advantasure, DST or other comparable solutions;

  • Working experience with Operations and administration of Healthcare/Payer, Product and Services businesses;

  • Possessing experience in data and systems interactions including IT tools and technology;

  • Having experience in documentation and the identification of key controls within the transaction lifecycle;

  • Working experience with trends of global organizations utilizing pragmatic approaches to achieve sustainable financial functions and operating models;

  • Possessing experience with business intelligence and performance management software tools and techniques of financial effectiveness strategies for healthcare service clients;

  • Identifying, addressing and managing client needs related to building, maintaining, and utilizing networks of client relationships and community involvement;

  • Communicating value propositions, utilizing PC applications such as Microsoft Word, Excel, PowerPoint and project to write and deliver proposals to prospective clients;

  • Managing resource requirements, project workflows, budgets, billing and collections;

  • Preparing and/or coordinating complex written and verbal materials;

  • Supervising teams to create an atmosphere of trust and seeking diverse views to encourage improvement and innovation; and,

  • Answering questions and providing direction to less experienced staff

For positions in Colorado, visit the following link for information related to Colorado's Equal Pay for Equal Work Act: https://pwc.to/coloradoadvisorymanager .

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.

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

For positions based in San Francisco, consideration of qualified candidates with arrest and conviction records will be in a manner consistent with the San Francisco Fair Chance Ordinance.

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Please note that, at this time, to be in-person at a PwC office, client location or PwC-sponsored events, you must be fully vaccinated against COVID-19.

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