Specialty/Competency: Operations
Industry/Sector: Health Services
Time Type: Full time
Travel Requirements: Up to 80%

A career within Operations Consulting services, will provide you with the opportunity to help our clients optimise all elements of their operations to move beyond the role of a cost effective business enabler and become a source of competitive advantages. We focus on product innovation and development, supply chain, procurement and sourcing, manufacturing operations, service operations and capital asset programmes to drive both growth and profitability.

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 an Associate, 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:

  • Invite and give in the moment feedback in a constructive manner.
  • Share and collaborate effectively with others.
  • Identify and make suggestions for improvements when problems and/or opportunities arise.
  • Handle, manipulate and analyse data and information responsibly.
  • Follow risk management and compliance procedures.
  • Keep up-to-date with developments in area of specialism.
  • Communicate confidently in a clear, concise and articulate manner – verbally and in the materials I produce.
  • Build and maintain an internal and external network.
  • Seek opportunities to learn about how PwC works as a global network of firms.
  • Uphold the firm's code of ethics and business conduct.

– Demonstrates intimate knowledge of, and/or success in operations roles within a professional services firm or corporate environment, helping companies to identify, clarify and resolve complex issues critical to their strategic and operating success.

Demonstrates intimate knowledge of, and proven success in:

  • Payer operations strategy – Sales, Marketing, Benefits/Products, Clinical Management, and Core Operations (Enrollment, Claims, Billing, and Customer Service)
  • Domain expertise – Data & Analytics, Automation, Artificial Intelligence, Health Advocacy, Medical Trend Analysis, and Cost Benchmarking.
  • Government Programs Experience with Medicare Advantage and Medicaid program requirements such as:
  • Program implementation, product/market expansion and Growth
  • Program compliance, risk and regulatory compliance
  • Experience with Risk Adjustment programs and methodologies, experience with quality programs and provider network design.

o Business Development – growing existing clients and developing new clients within the Payor sector

o Payer industry market trends and industry-leading practices in order to develop insights and provide recommendations.

– Demonstrates a high level of leadership, strategic and creative thinking, problem solving, individual initiative, and the following abilities: – Leading teams to generate a vision and creating an atmosphere of trust, leveraging diverse views and encouraging improvement and innovation

  • Building productive and collaborative relationships with team members and proactively providing and seeking guidance, clarification and feedback
  • Leading a team to a successful project conclusion through problem solving complex operations issues
  • Managing the planning, organizing and delivery of operations tasks and projects, overseeing independent analyses and ensuring the quality of client deliverables – Leading the development and improvement of various frameworks and methodologies within operations
  • Identifying and addressing client needs: building, maintaining, and utilizing networks of client relationships
  • Communicating effectively in an organized and knowledgeable manner in written and verbal formats
  • Leveraging quantitative analyses to construct analytical frameworks and synthesize complex data into meaningful insights.

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


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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Health Industries- Payer Service Operations- Experienced Associate