Lead payer-focused clinical quality and STARS initiatives for health services clients. Drive payer modernization, operational performance, process improvement, stakeholder engagement, change management, analytics-driven quality standards, team coaching, and market-informed strategic advising.
The Opportunity
As a Payer STARS/Quality Clinical Consultant, Senior Manager, you will engage with clients in the health services sector, providing strategic guidance and operational consulting to enhance their clinical quality and performance metrics. Within our Management Consulting practice, you will leverage your skills to drive impactful solutions that align with industry trends and client needs. As a Senior Manager, you will lead large projects, innovate processes, and maintain operational excellence while interacting with clients at a strategic level to drive project success. You will apply sound judgment and communicate effectively, developing high-performing, diverse, and inclusive teams that contribute to the overall success of the firm.
In this role, you will focus on delivering quality results through strategic advising and problem-solving, motivating and coaching teams to tackle complex challenges. You will deepen your professional skills, staying relevant in the evolving health industries landscape, and initiate open and honest coaching conversations at all levels. Your commitment to excellence and ability to navigate ambiguity will be crucial in crafting and conveying clear, impactful messages that tell a holistic story. This opportunity allows you to validate outcomes with clients, share alternative perspectives, and act on client feedback, driving continuous improvement and innovation.
Responsibilities
- Leading strategic initiatives to enhance operational performance within health services
- Driving business transformation projects with a focus on payer modernization
- Utilizing analytical thinking to develop and implement quality standards in clinical consulting
- Managing stakeholder engagement to foster collaborative client relationships
- Overseeing process improvement efforts to optimize operational effectiveness
- Implementing business performance metrics to track and improve service delivery models
- Coordinating logistics management to streamline operations processes
- Applying change management techniques to support organizational transformation
- Facilitating coaching and feedback sessions to develop high-performing teams
- Conducting market research to inform strategic decision-making and innovation
What You Must Have
- At least a Bachelor's degree
- At least 6 years of experience
What Sets You Apart
- Demonstrating advanced skills in business data analytics and transformation
- Leading operational excellence initiatives within health services
- Innovating processes for payer modernization projects
- Utilizing Epic Software and Systems for healthcare operations
- Excelling in strategic questioning and stakeholder engagement
- Developing high-performing teams through effective coaching and feedback
- Applying analytical thinking to drive operational performance management
The salary range for this position is: $124,000 - $280,000. 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
As a Payer STARS/Quality Clinical Consultant, Senior Manager, you will engage with clients in the health services sector, providing strategic guidance and operational consulting to enhance their clinical quality and performance metrics. Within our Management Consulting practice, you will leverage your skills to drive impactful solutions that align with industry trends and client needs. As a Senior Manager, you will lead large projects, innovate processes, and maintain operational excellence while interacting with clients at a strategic level to drive project success. You will apply sound judgment and communicate effectively, developing high-performing, diverse, and inclusive teams that contribute to the overall success of the firm.
In this role, you will focus on delivering quality results through strategic advising and problem-solving, motivating and coaching teams to tackle complex challenges. You will deepen your professional skills, staying relevant in the evolving health industries landscape, and initiate open and honest coaching conversations at all levels. Your commitment to excellence and ability to navigate ambiguity will be crucial in crafting and conveying clear, impactful messages that tell a holistic story. This opportunity allows you to validate outcomes with clients, share alternative perspectives, and act on client feedback, driving continuous improvement and innovation.
Responsibilities
- Leading strategic initiatives to enhance operational performance within health services
- Driving business transformation projects with a focus on payer modernization
- Utilizing analytical thinking to develop and implement quality standards in clinical consulting
- Managing stakeholder engagement to foster collaborative client relationships
- Overseeing process improvement efforts to optimize operational effectiveness
- Implementing business performance metrics to track and improve service delivery models
- Coordinating logistics management to streamline operations processes
- Applying change management techniques to support organizational transformation
- Facilitating coaching and feedback sessions to develop high-performing teams
- Conducting market research to inform strategic decision-making and innovation
What You Must Have
- At least a Bachelor's degree
- At least 6 years of experience
What Sets You Apart
- Demonstrating advanced skills in business data analytics and transformation
- Leading operational excellence initiatives within health services
- Innovating processes for payer modernization projects
- Utilizing Epic Software and Systems for healthcare operations
- Excelling in strategic questioning and stakeholder engagement
- Developing high-performing teams through effective coaching and feedback
- Applying analytical thinking to drive operational performance management
The salary range for this position is: $124,000 - $280,000. 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
PwC New York, New York, USA Office
300 Madison Ave, New York, NY, United States, 10017
PwC Florham Park, New Jersey, USA Office
400 Campus Drive, Florham Park, NJ, United States, 7932
Similar Jobs at PwC
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Design and implement AI systems and scalable ML models (Python, TensorFlow); build/maintain data pipelines and integrations; apply NLP (NLTK) and deep learning for analytics; deploy and optimize models (including open-weight LLMs); collaborate with stakeholders and continuously learn to improve AI solutions and deployment reliability.
Top Skills:
AWSDatabricksGemmaGCPLanggraphLlamaAzureMistralNltkPythonScikit-LearnSnowflakeTensorFlow
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Lead end-to-end delivery of AI and ML services within Managed Services. Manage project planning, budgeting, execution, and quality. Mentor and develop team members, cultivate client relationships, implement model monitoring and operationalization practices, and collaborate with architects and engineers to ensure compliant, reusable AI solutions.
Top Skills:
AIItilMachine Learning
Artificial Intelligence • Professional Services • Business Intelligence • Consulting • Cybersecurity • Generative AI
Lead tax strategy and client engagements for financial services real estate clients, advising on international and domestic tax structuring, compliance, risk mitigation, and profit-sharing. Drive business development, oversee multiple projects, mentor teams, ensure regulatory filings accuracy, and build scalable efficiencies while maintaining executive client relationships and ethical standards.
What you need to know about the NYC Tech Scene
As the undisputed financial capital of the world, New York City is an epicenter of startup funding activity. The city has a thriving fintech scene and is a major player in verticals ranging from AI to biotech, cybersecurity and digital media. It also has universities like NYU, Columbia and Cornell Tech attracting students and researchers from across the globe, providing the ecosystem with a constant influx of world-class talent. And its East Coast location and three international airports make it a perfect spot for European companies establishing a foothold in the United States.
Key Facts About NYC Tech
- Number of Tech Workers: 549,200; 6% of overall workforce (2024 CompTIA survey)
- Major Tech Employers: Capgemini, Bloomberg, IBM, Spotify
- Key Industries: Artificial intelligence, Fintech
- Funding Landscape: $25.5 billion in venture capital funding in 2024 (Pitchbook)
- Notable Investors: Greycroft, Thrive Capital, Union Square Ventures, FirstMark Capital, Tiger Global Management, Tribeca Venture Partners, Insight Partners, Two Sigma Ventures
- Research Centers and Universities: Columbia University, New York University, Fordham University, CUNY, AI Now Institute, Flatiron Institute, C.N. Yang Institute for Theoretical Physics, NASA Space Radiation Laboratory
