BSCO-Experienced Associate Payer Health Transformation

Industry/Sector

Specialism

Management Level

Job Description & Summary

JOB OVERVIEW

PwC US ADVISORY MANAGEMENT CONSULTING

Our Management Consulting team works with our global clients to design and implement growth operational and customer focused strategies for sustainable competitive advantage. Our thought leadership and unparalleled experience help clients turn formidable challenges into market advantage across the value chain and around the globe. Additionally our extensive expertise in various industries allow us to serve clients with consulting services with a focus on the most profitable elements of the value chain to create scalable businesses that will deliver increased sustainable profits.

Our Management Consultants work with the client and project teams to support global engagements from India through activities that are driven towards delivering results- conduct analyses and develop insights prepare excel models analyze large sets of data capture as-is processes prepare work plans design to-be processes support project lead work directly with client teams and facilitate meetings to enable decision making organize and prepare recommendations on client issues and participate actively in new business development thought leadership and firm building activities.

COMPETENCY OVERVIEW: HEALTH TRANSFORMATION (HT)

The HT team works with clients across healthcare supporting engagements in driving clients strategic vision and objectives assessing market expansion and growth strategies researching key market trends and its impact on key stakeholders driving operational and process improvements evaluating sustainable cost transformation alternatives and enabling technology driven business success.

Our consultants work to provide a range of client solutions across the following areas:

• Payer: We work with clients to bring operational and performance improvement in their core Payer functions with the help of our deep understanding of core functional areas. We help in designing the future operating model payment model growth strategy and functional/technical transformation Business transformation. Our services span across operational performance improvement including benchmarking process mapping and design operating model design project management data and analytics strategy technology effectiveness assessments and market strategy
• Provider: We work with health systems to develop design and implement organizational transformation to improve performance and generate lasting growth. Our services span across operational performance improvement including labor and productivity assessments portfolio rationalization benchmarking process mapping and design operating model design project management technology effectiveness assessments and market strategy
• Pharma & Life Sciences: We help clients in R&D and commercial domains. Our services span across launch & commercial planning portfolio optimization performance management R&D innovation product development product lifecycle management risk / compliance internal audit risk assessment management and control.

Capability - Healthcare Back Office Transformation

Knowledge - Essential

• Strong analytical and problem-solving skills

• Understanding ofcore payer operations (enrollmentclaims eligibility etc.) and systems

• Ability to conduct independent research

• Strong strategic and structured thinking skills

• Ability to run simple cost-benefit analyses

• Basic ability to use GenAI for research and storyboarding

• Ability to support technology-enabled operating model transformations including workflow redesign system implementation or platform optimization

Knowledge - Preferred

• Ability to run benchmarking analyses

• Experience analyzing largeandcomplex datasets

• Basic knowledge of SQL/automation tools

• Exposure to digital transformation and analytics initiatives

• Familiarity with AI/ML&NLPconcepts

• Familiarity with payerworkflows; provider data or credentialing
• Understanding of payer core platforms and ecosystems (e.g. enroll

Payer ModernizationHealthcareMiddle Office Transformation

Knowledge - Essential

• Strong analytical and problem-solving skills
• Ability to conduct independent research
• Ability to think strategically and drive outcomes
• Ability to perform benchmarking & cost-benefit analyses
• Basic ability to use GenAI for research and storyboarding

Skill Set - Preferred

• Understanding of payer middle office functions (e.g. care management utilization management pharmacy management network management provider engagement and payment integrity)
• Experience analyzing large and complex datasets
• Basic knowledge of SQL / automation tools
• General interest in AI ML and NLP concepts

Payer Modernization -Payer Analytics and Data Strategy

Knowledge - Essential

Travel Requirements

Job Posting End Date