Payer STARS/Quality Clinical Consultant, Senior Manager

Join PwC as a Payer STARS/Quality Clinical Consultant, Senior Manager in Bonnie, Utah County, where you'll guide healthcare organizations in optimizing clinical quality performance and Medicare Advantage outcomes. This full-time role combines strategic consulting with hands-on improvement initiatives, serving as a trusted advisor to payer clients navigating complex healthcare operations.

The Opportunity

Healthcare payers face mounting pressure to improve quality metrics, control costs, and deliver measurable clinical outcomes. As a Payer STARS/Quality Clinical Consultant, Senior Manager, you'll work directly with health services organizations to assess their clinical capabilities, identify gaps in quality performance, and design actionable strategies to strengthen their competitive position. Your expertise will drive meaningful improvements across multiple clinical domains while positioning your clients for sustainable growth in an increasingly outcome-focused market.

Responsibilities

• Lead consulting engagements with payer clients, translating their strategic objectives into operational roadmaps and implementation plans
• Analyze clinical quality metrics, STARS performance indicators, and operational workflows to surface improvement opportunities
• Develop and implement quality improvement initiatives designed to enhance patient outcomes and market performance
• Build business cases for healthcare transformation projects that address both clinical and financial dimensions
• Manage senior-level client relationships and present insights and recommendations to C-suite executives
• Mentor junior consultants and contribute to team capability development
• Travel up to 80% to client sites as project demands require

Skills & Qualifications

• Advanced degree in healthcare administration, business, public health, or equivalent professional consulting experience at a senior level
• Deep knowledge of healthcare operations, payer business models, and quality improvement methodologies
• Familiarity with CMS programs, STARS metrics, and healthcare regulatory requirements
• Proven track record managing complex consulting projects and diverse client portfolios
• Strong analytical and problem-solving abilities, with comfort navigating ambiguous business challenges
• Excellent communication and presentation skills, translating complex insights for executive audiences
• Demonstrated ability to lead teams and influence at multiple organizational levels

Working at PwC

PwC's Healthcare Consulting practice brings together experts who understand the strategic imperatives reshaping payer and provider organizations. You'll join a collaborative team invested in your professional growth, supported by industry-leading tools and methodologies. Our culture emphasizes solving complex problems, building enduring client relationships, and creating tangible value in healthcare transformation.

Apply Today

To apply, complete your application directly on this page, or you'll be redirected to the employer's application platform to finish submitting there.