Payer STARS/Quality Clinical Consultant, Senior Manager

PricewaterhouseCoopers•Boston, MA

About The Position

At PwC, our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs, develop operational strategies, and offer guidance and support to help clients streamline processes, improve productivity, and drive business performance. As an operations consulting generalist at PwC, you will possess a broad understanding of various aspects of operations consulting. You will provide comprehensive guidance and support to clients in optimising operational efficiency and effectiveness. Working in this area, you will analyse client needs, develop operational solutions, and offer recommendations tailored to specific business requirements. Growing as a strategic advisor, you leverage your influence, expertise, and network to deliver quality results. You motivate and coach others, coming together to solve complex problems. As you increase in autonomy, you apply sound judgment, recognising when to take action and when to escalate. You are expected to solve through complexity, ask thoughtful questions, and clearly communicate how things fit together. Your ability to develop and sustain high performing, diverse, and inclusive teams, and your commitment to excellence, contributes to the success of our Firm. Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to: Craft and convey clear, impactful and engaging messages that tell a holistic story. Apply systems thinking to identify underlying problems and/or opportunities. Validate outcomes with clients, share alternative perspectives, and act on client feedback. Direct the team through complexity, demonstrating composure through ambiguous, challenging and uncertain situations. Deepen and evolve your expertise with a focus on staying relevant. Initiate open and honest coaching conversations at all levels. Make difficult decisions and take action to resolve issues hindering team effectiveness. Model and reinforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance), the Firm's code of conduct, and independence requirements. The Opportunity As part of the Operations Consulting team, you will lead cross-functional teams in achieving performance in Medicare Stars and related quality initiatives through advanced clinical data strategies. As a Senior Manager, you will build trust with multi-level teams and stakeholders, motivating and coaching others to solve complex problems. This position provides an exciting opportunity to influence quality improvement initiatives and drive impactful change in healthcare data management.

Requirements

Bachelor's Degree
At least 8 years of experience

Nice To Haves

Master's Degree in Health Administration preferred
Demonstrating in-depth clinical data management experience
Leading multidisciplinary teams in clinical data operations
Managing large-scale quality improvement initiatives
Communicating technical insights to non-technical audiences
Developing frameworks for improving data reliability
Understanding regulatory compliance in Medicaid and Medicare
Utilizing AI/ML tools for clinical data accuracy

Responsibilities

Lead cross-functional teams to achieve exceptional performance in quality initiatives
Motivate and coach team members to address complex challenges
Build trust with stakeholders at multiple levels
Influence quality improvement initiatives in healthcare data management
Develop advanced clinical data strategies for impactful change
Confirm alignment with Medicare Stars and related programs
Drive collaboration across teams to enhance performance
Analyze clinical data sources to inform decision-making