Payer CO&I AI Consultant, Director

Industry/Sector

Health Services

Specialism

Operations

Management Level

Director

Job Description & Summary

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.

Translating the vision, you set the tone, and inspire others to follow. Your role is crucial in driving business growth, shaping the direction of client engagements, and mentoring the next generation of leaders. You are expected to be a guardian of PwC's reputation, understanding that quality, integrity, inclusion and a commercial mindset are all foundational to our success. You create a healthy working environment while maximising client satisfaction. You cultivate the potential in others and actively team across the PwC Network, understanding tradeoffs, and leveraging our collective strength.

Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to:

• Lead in line with our values and brand.
• Develop new ideas, solutions, and structures; drive thought leadership.
• Solve problems by exploring multiple angles and using creativity, encouraging others to do the same.
• Balance long-term, short-term, detail-oriented, and big picture thinking.
• Make strategic choices and drive change by addressing system-level enablers.
• Promote technological advances, creating an environment where people and technology thrive together.
• Identify gaps in the market and convert opportunities to success for the Firm.
• Adhere to and enforce 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 Payer Operations team you will set the vision and strategic roadmap for technology and AI-enabled payer operations across core value chain functions. As a Director you will drive business growth by leading large, complex consulting engagements, delivering excellence, and acting as a trusted advisor to payer executives on operational transformation and AI adoption.

Responsibilities

- Drive initiatives for business growth through innovative solutions

- Work with cross-functional teams to refine core values chain functions

- Mentor and develop team members to enhance their skills

- Promote the adoption of AI technologies within operational frameworks

- Identify market opportunities and align strategies for success

What You Must Have

- Bachelor's Degree

- At least 10 years of experience

What Sets You Apart

- Master's Degree preferred

- Demonstrating strategic leadership in technology and AI

- Advising executive stakeholders with business cases

- Designing technology-enabled transformation programs

- Developing impactful use cases with advanced analytics

- Leading complex consulting engagements with delivery excellence

- Mentoring and developing teams across geographies

- Understanding payer operations and key platforms

- Navigating ambiguity in fast-evolving environments

- Experience with key platforms and vendors that enable payer operations (e.g., BPM/automation platforms, claims platforms, provider data solutions)

Travel Requirements

Up to 80%

Job Posting End Date

Learn more about how we work: https://pwc.to/how-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.

As PwC is an equal opportunity employer, all qualified applicants will receive consideration for employment at PwC without regard to rac