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Senior Manager, Clinical Quality and Payer Consulting

Location
San Diego, California
Posted
17 May 2026

Specialty/Competency: Operations

Industry/Sector: Health Services

Time Type: Full time

Travel Requirements: Up to 80%

At PwC, our operations consulting professionals are dedicated to enhancing operational efficiency and effectiveness in health services. We work closely with clients to analyze their needs, create operational strategies, and provide actionable insights to optimize processes, boost productivity, and drive performance.

As a part of our operations consulting team, you will gain a comprehensive understanding of various operational aspects. You’ll analyze client needs, develop tailored operational solutions, and provide strategic recommendations to meet unique business challenges.

This role is an opportunity to grow as a strategic advisor. Your influence, expertise, and professional network will be pivotal in achieving high-quality results. You'll motivate and mentor your team in navigating complex problems while demonstrating sound judgment in decision-making. Your ability to build and maintain high-performing, diverse, and inclusive teams will contribute significantly to the firm's success.

Key skills, knowledge, and experiences essential for success in this position include:

  • Crafting and communicating clear, impactful messages that convey a cohesive narrative.

  • Applying systems thinking to uncover root issues and opportunities.

  • Validating outcomes with clients and responding to feedback with adaptability.

  • Guiding teams through complexities with composure and confidence.

  • Continually developing and refining your expertise to remain relevant in the field.

  • Encouraging transparent coaching conversations across all levels.

  • Making tough decisions to improve team functionality and effectiveness.

  • Upholding professional standards and adhering to the firm’s code of conduct.

The Opportunity

As a Senior Manager in the Operations Consulting team, you will lead cross-functional teams tailored toward achieving superior performance in Medicare Stars and related quality initiatives through advanced clinical data strategies. This role allows you to develop strong relationships across various levels of stakeholders, inspiring and guiding your team to address complex challenges effectively. It offers a remarkable opportunity to influence quality improvement efforts and enact significant change in healthcare data management.

Responsibilities

  • Lead cross-functional teams to achieve excellence in quality initiatives.

  • Inspire and coach team members to navigate complex challenges.

  • Foster trust with stakeholders at all organizational levels.

  • Drive healthcare quality improvement initiatives through effective data management.

  • Develop sophisticated clinical data strategies for meaningful impact.

  • Ensure alignment with Medicare Stars and similar programs.

  • Encourage collaboration across teams to boost performance.

  • Analyze clinical data sources to inform strategic decisions.

What You Must Have

  • Bachelor's Degree.

  • At least 8 years of relevant experience.

What Sets You Apart

  • Master's Degree in Health Administration preferred.

  • Proven expertise in clinical data management.

  • Experience leading multidisciplinary teams in clinical data operations.

  • Track record of managing large-scale quality improvement projects.

  • Skilled at translating technical insights for non-technical audiences.

  • Experience developing frameworks to enhance data reliability.

  • Understanding of compliance regulations in Medicaid and Medicare.

  • Proficient in utilizing AI/ML tools for ensuring clinical data accuracy.

The salary range for this position is: $124,000 - $280,000, depending on your skills, experience, qualifications, and location along with applicable employment laws. Eligible hires will also benefit from an annual discretionary bonus. PwC offers a comprehensive benefits package, including medical, dental, vision, 401k, holiday pay, and various forms of leave. For more details on our benefits, please refer to our resources.

PwC is an equal opportunity employer, committed to diversity and inclusion in the workplace. All qualified applicants will receive consideration for employment at PwC without regard to race; color; religion; national origin; sex (including pregnancy, sexual orientation, and gender identity), age; disability; genetic information; veteran, marital, or citizenship status; or any other status protected by law.

We do not intend to hire candidates requiring sponsorship in the future for employment opportunities. Applicants can refer to our policy for more specific details.

We look forward to connecting with professionals who are eager to make a substantial impact in operations consulting and healthcare management.

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Details

  • Job Reference: 2775507747-2
  • Date Posted: 17 May 2026
  • Recruiter: PwC
  • Location: San Diego, California
  • Salary: On Application