Supports payer operations modernization and transformation initiatives for health services clients. Analyzes operational challenges, performance metrics, and business data; develops process improvement deliverables and operating model recommendations; coordinates project workstreams; manages timelines and issue logs; presents client recommendations; and mentors junior team members. The role applies consulting methods, digital tooling, AI collaboration, and analytical thinking to improve workflows and service delivery.
The Opportunity
As a Payer Operations & Transformation Consultant, Senior Associate you will help shape payer operations and modernization efforts within our Operations Consulting practice, focusing on business process improvement, operating model design, and transformation support for health services clients. As a Senior Associate you will analyze complex issues, manage assigned workstreams, build client relationships, and guide junior team members while using critical thinking and professional judgment to support deliverables. In this role at PwC, you will contribute to payer modernization initiatives, develop insights from data and stakeholder input, and help translate business needs into practical solutions that support client operations and broader organizational goals.
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
What You Must Have
- At least a Bachelor's degree
- At least 4 years of experience
What Sets You Apart
- Preference for at least one of the following fields of study: 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
- 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
The salary range for this position is: $77,000 - $202,000. 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
#LI-Hybrid
#BI-Hybrid
As a Payer Operations & Transformation Consultant, Senior Associate you will help shape payer operations and modernization efforts within our Operations Consulting practice, focusing on business process improvement, operating model design, and transformation support for health services clients. As a Senior Associate you will analyze complex issues, manage assigned workstreams, build client relationships, and guide junior team members while using critical thinking and professional judgment to support deliverables. In this role at PwC, you will contribute to payer modernization initiatives, develop insights from data and stakeholder input, and help translate business needs into practical solutions that support client operations and broader organizational goals.
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
What You Must Have
- At least a Bachelor's degree
- At least 4 years of experience
What Sets You Apart
- Preference for at least one of the following fields of study: 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
- 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
The salary range for this position is: $77,000 - $202,000. 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
#LI-Hybrid
#BI-Hybrid
PwC Denver, Colorado, USA Office
1900 Sixteenth Street, Denver, CO, United States, 80202
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