Payer Back Office Strategy / Technology / Operations Consultant, Senior Associate

Industry/Sector

Health Services

Specialism

Operations

Management Level

Senior Associate

Job Description & Summary

The Opportunity

As a Payer Back Office Strategy / Technology / Operations Consultant, Senior Associate you will support healthcare payer clients as they modernize back-office operations, core technology, and operating models across claims, reimbursement, government program support, digital experience, and customer-facing functions within our Advisory practice. As a Senior Associate you will analyze complex problems, manage assigned workstreams, build client relationships, and guide junior team members while using critical thinking, professional judgment, and a clear understanding of the business context to deliver work that aligns with project goals. In this role at PwC, you will contribute to strategy, technology, and operations efforts that help clients improve platform execution, streamline processes, and adapt operating models across payer functions and systems such as Oracle OHI, Epic, Facets, and Nasco.

Responsibilities

- Analyzing payer operations, technology, and strategy workstreams to identify process gaps and improvement opportunities
- Supporting transformation initiatives across claims, customer operations, core platforms, and administrative functions
- Developing deliverables that synthesize business data, operational metrics, and client input into practical recommendations
- Applying process improvement, change management, and digital tooling to streamline payer workflows and service delivery models
- Interpreting operational performance trends to inform decisions on cost reduction, efficiency, and platform modernization
- Collaborating on client engagements by building trusted relationships and responding to evolving business needs
- Reviewing work from junior team members and providing feedback to refine analyses and deliverables
- Contributing to solution development for health services organizations using payer modernization, operations strategy, and technology insights

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 payer modernization consulting experience in health services
- Leveraging operations strategy, process improvement, and service delivery models
- Analyzing business data and performance metrics for client recommendations
- Applying change management and stakeholder engagement across workstreams
- Using AI fluency, digital tooling, and learning agility in delivery

Travel Requirements

Up to 80%

Job Posting End Date

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