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

Specialty/Competency: Operations

Industry/Sector: Health Services

Time Type: Full time

Government Clearance Required: No

Available for Work Sponsorship: Yes

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 an authentic and inclusive leader, at all grades/levels and in all lines of service. 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:

  • Take action to ensure everyone has a voice, inviting opinion from all.

  • Establish the root causes of issues and tackle them, rather than just the symptoms.

  • Initiate open and honest 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.

  • Develop specialised expertise in one or more areas.

  • Advise stakeholders on relevant technical issues for their business area.

  • Navigate the complexities of global teams and engagements.

  • Build trust with teams and stakeholders through open and honest conversation.

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

Basic Qualifications :

Minimum Degree Required :

Bachelor Degree

Minimum Years of Experience :

7 year(s)

Preferred Qualifications :

Degree Preferred :

Master of Business Administration

Additional Educational Preferences :

Degrees in Science or Engineering may be considered.

Preferred Knowledge/Skills :

Demonstrates proven intimate knowledge and success 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;

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

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

  • Working experience with transaction lifecycles , Healthcare/Payer services and products;

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

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

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

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

  • Working experience with data and systems interactions including IT tools and technology;

  • Working experience with 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;

  • Working 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.

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.

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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