Payer Health Transformation - Associate

Industry/Sector

Not Applicable

Specialism

Operations

Management Level

Associate

Job Description & Summary

The Opportunity

Join our Acceleration Center India and help shape the future of business for our diverse client portfolio across geographies and jurisdictions. You’ll work at the heart of global teams across Advisory, Assurance, Tax and Business Services—solving real client challenges through connected collaboration. We’ll help you grow your skills so you can go further. With hands-on learning, cutting-edge tools and an inclusive culture, this is your opportunity to do inspiring work that makes a difference—every day.

As a Payer Health Transformation Associate you will support client engagements focused on payer modernization, healthcare back office transformation, and data-driven analysis within our Management Consulting practice. As an Associate you will contribute to project tasks, conduct research, build analyses, and support senior team members while developing your skills, adapting to changing priorities, and learning how to turn complex healthcare and operations issues into practical recommendations. In this role at PwC Acceleration Center India, you will help prepare work plans, capture current-state processes, develop insights from data, support meetings with client teams, and contribute to transformation efforts across enrollment, claims, eligibility, care management, and analytics workstreams.

Responsibilities

• - Supporting payer modernization projects through analysis, research, and preparation of client-ready materials
• - Analyzing payer data, operational workflows, and benchmark information to identify trends, gaps, and improvement opportunities
• - Building simple models in Excel and using SQL or automation tools to organize data and support findings
• - Capturing current-state processes and helping document future-state workflows for enrollment, claims, eligibility, care management, and payment integrity
• - Preparing work plans, meeting materials, and issue summaries to support project leads and client teams
• - Applying GenAI tools for research, storyboarding, and insight development in healthcare transformation work
• - Conducting cost-benefit analyses and supporting business cases for process redesign, digital tools, and technology-enabled operating model changes
• - Contributing to data governance, analytics, and reporting activities across payer modernization initiatives
• - Translating technical findings into clear recommendations for business stakeholders and healthcare clients

-Basic ability to use GenAI for research and storyboarding • Ability to support technology-enabled operating model transformations, including workflow redesign, system implementation, or platform optimization

-Exposure to predictive modeling and forecasting techniques

-Ability to encourage innovation using data-driven ideas

-General familiarity with AI, ML, and NLP concepts

-Familiarity with risk scoring, anomaly detection, or payment integrity patterns • Exposure to predictive modeling

-Understanding of payer middle office functions (e.g., care management, utilization management, pharmacy management, network management, provider engagement, and payment integrity)

What You Must Have

• - At least a Bachelor's degree
• - At least 2-4 years of experience
• - Oral and written proficiency in English required

What Sets You Apart

• - Analyzing large healthcare datasets and benchmarking payer operations
• - Applying SQL, Python, or R for data insights
• - Familiarity with payer workflows, enrollment, claims, and eligibility
• - Supporting digital transformation, automation, and analytics initiatives
• - Conducting independent research and translating findings into recommendations
• - Using GenAI, AI, ML, or NLP for research and storyboarding

Travel Requirements

0%

Job Posting End Date