Health Payer Operations & Technology- Director

Published date Posted on Indeed on May 03, 2022 (59 d ago)
A career within Industry and Functional Apps services, will provide you with the opportunity to build secure and new digital experiences for customers, employees, and suppliers. We focus on improving apps or developing new apps for traditional and mobile devices as well as conducting usability testing to find ways to improve our clients’ user experience.


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 when necessary.
  • Arrange and sponsor appropriate assignments and experiences to help people realise their potential and support their long-term aspirations.
  • Identify gaps in the market and spot opportunities to create value propositions.
  • 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.


Basic Qualifications
:

Minimum Degree Required:

Bachelor Degree
Minimum Years of Experience:
10 year(s)


Preferred Qualifications
:

Degree Preferred:
Master Degree
Preferred Knowledge/Skills:

  • Demonstrates thought leader-level abilities with, and/or a proven record of success directing efforts in supporting large teams through the design and implementation of changes to Operations, including people, process and technology changes and the following:

    • Working experience across payer back office, specifically to drive growth across operations, IT and strategy engagements;

    • Working experience within domain areas that include: claims, enrollment, billing, membership, provider data, product management, and related functions;

    • Working experience with either process level familiarity and/or familiarity with the technology solutions that enable these functions;

    • Working experience with transaction lifecycles , Healthcare/Payer services and products;

    • Working experience with domain area knowledge and specialization in claims, enrollment, billing, membership, provider data, product management, and related functions;

    • Working experience with COTS platforms including TriZetto Facets/QNXT, HealthEdge, Oracle payer solution;

    • Working experience with (ORMB), ida/Advantasure, DST or other comparable solutions;

    • Working experience with Operations and administration of Healthcare/Payer, Product and Services businesses;

    • Working experience data and systems interactions including IT tools and technology;

    • Working experience documentation and the identification of key controls within the transaction lifecycle;

    • Working experience Trends of global organizations utilizing pragmatic approaches to achieve sustainable financial functions and operating models;

    • Working experience with business intelligence and performance management software tools. and techniques of financial effectiveness strategies for healthcare service clients;

    • Identifying, addressing and managing client needs related to building, maintaining, and utilizing networks of client relationships and community involvement;

    • Communicating value propositions, utilizing PC applications such as Microsoft Word, Excel, PowerPoint and project to write and deliver proposals to prospective clients;

    • Managing resource requirements, project workflows, budgets, billing and collections;

    • Preparing and/or coordinating complex written and verbal materials.

    • Supervising teams to create an atmosphere of trust and seeking diverse views to encourage improvement and innovation; and,


At PwC, our work model includes three ways of working: virtual, in-person, and flex (a hybrid of in-person and virtual). Visit the following link to learn more: https://pwc.to/ways-we-work.

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.

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.

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.

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

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