Health Industries – Payer Service Ops – Associate

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 whats 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 operational excellence. 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 an Associate, youll 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: Invite and give in the moment feedback in a constructive manner. Share and collaborate effectively with others. Identify and make suggestions for improvements when problems and/or opportunities arise. Handle, manipulate and analyse data and information responsibly. Follow risk management and compliance procedures. Keep up-to-date with developments in area of specialism. Communicate confidently in a clear, concise and articulate manner – verbally and in the materials I produce. Build and maintain an internal and external network. Seek opportunities to learn about how PwC works as a global network of firms. Uphold the firms code of ethics and business conduct. Demonstrates proven thorough knowledge and success 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 within; 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 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 Financial operations, including the financial close, planning and forecasting processes; Working experience with Operations and administration of Financial, Healthcare/Payer, Federal, 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, Answering questions and providing direction to less experienced

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