Strategy& Health Industries - Payer Service Ops - Director
Posted on: June 13, 2021
A career within Operations Strategy services, will provide you
with the opportunity to help organisations reimagine their
operations through a strategic lens to turn complexity into a
competitive advantage. Our focus is to help our clients create
differentiating capabilities that drive competitive advantages by
developing plans to navigate their challenges, seeing what's
possible, and turning that into a reality. We assist our clients in
transforming operations from the way they engage their customers to
executing strategic programmes to achieve enterprise wide
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 a Director, 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:
- Support team to disrupt, improve and evolve ways of working
- Arrange and sponsor appropriate assignments and experiences to
help people realise their potential and support their long-term
- Identify gaps in the market and spot opportunities to create
- Look for opportunities to scale efficiencies and new ways of
working across multiple projects and environments.
- Create an environment where people and technology thrive
together to accomplish more than they could apart.
- I promote and encourage others to value difference when working
in diverse teams.
- Drive and take ownership for developing connections that help
deliver what is best for our people and stakeholders.
- Influence and facilitate the creation of long-term
relationships which add value to the firm.
- Uphold the firm's code of ethics and business conduct.
Minimum Degree Required: Bachelor Degree
Minimum Years of Experience: 7 year(s)
Preferred Qualifications: Degree Preferred, Masters Degree
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
- 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.
Business Development - growing existing clients and developing
new clients within the Payor sector
- 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.
Keywords: PwC, Atlanta , Strategy& Health Industries - Payer Service Ops - Director, Other , Atlanta, Georgia
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