Payer STARS/Quality Clinical Consultant, Senior Manager

Join PricewaterhouseCoopers as a Payer STARS/Quality Clinical Consultant, Senior Manager in Boston, delivering high-impact healthcare strategy to payer organizations across the United States. This full-time role combines clinical expertise with operational leadership, helping health plans optimize quality metrics, regulatory compliance, and member outcomes.

About the Role

As a Senior Manager, you will lead consulting engagements with major health plans and payer organizations, focusing on Medicare Advantage STARS ratings improvement, clinical quality program design, and performance metric optimization. You'll advise C-suite and operations teams on strategic approaches to quality enhancement, helping them navigate complex regulatory requirements and competitive market pressures in healthcare.

What You'll Do

• Direct multi-disciplinary consulting teams on STARS rating improvement initiatives, clinical quality assessments, and operational performance programs
• Develop and present strategic recommendations to senior leadership on clinical quality enhancement, cost management, and member satisfaction improvement
• Design and implement quality measurement frameworks, performance dashboards, and improvement roadmaps aligned with regulatory and organizational goals
• Lead stakeholder engagement across clinical, operations, compliance, and finance functions within client organizations
• Provide thought leadership on industry trends, quality standards, and best practices in healthcare quality management
• Manage client relationships, project delivery, and team performance across concurrent engagements

What We're Looking For

• 10+ years of healthcare consulting, payer operations, or clinical quality program experience
• Deep expertise in Medicare Advantage STARS ratings, clinical quality metrics, and performance measurement
• Demonstrated leadership managing consulting teams and high-stakes client engagements
• Strong analytical and problem-solving skills with ability to translate complex healthcare data into actionable strategy
• Excellent communication and presentation skills for executive-level audiences
• Bachelor's degree required; advanced degree in Healthcare Administration, Business, or related field preferred

About PricewaterhouseCoopers

PwC's Strategy& and Management Consulting practices are trusted advisors to leading healthcare organizations, helping them navigate transformation, drive quality improvement, and achieve operational excellence.

How to Apply

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