Payer Health Transformation - Associate
Core
Support client-focused consulting work to address payer modernization, operating model improvements, and transformation initiatives across healthcare organizations.
Role type
Associate management consultant (healthcare payer transformation)
Builds
Process maps, workflow assessments, operating models, improvement recommendations, and analytics deliverables for payer clients.
Domain
Healthcare payer operations, transformation, and analytics
Required skills
Healthcare payer operations knowledge, process mapping, workflow assessment, operating model design, benchmarking, cost-benefit analysis, data analysis, GenAI research, stakeholder communication
Preferred skills
Medicare Advantage/Medicaid/commercial payer models, risk adjustment, HCCs, Stars, HEDIS, CAHPS, Pharmacy Benefit Management (PBM), predictive modeling, healthcare interoperability, automation concepts
Technologies
SQL, Python, R, Automation tools, AI/ML, NLP, GenAI
Responsibilities
Assess existing processes and develop process maps and operating models; Conduct benchmarking and cost-benefit analyses; Analyze large healthcare datasets to identify trends and insights; Support technology-enabled operating model transformation; Contribute to analytics initiatives addressing risk adjustment and payment integrity; Evaluate opportunities to leverage automation and AI/ML to improve payer processes.
Seniority
Associate, early-career IC
