Health & Welfare Consulting Manager

  • PwC
  • San Francisco, CA, USA
  • Nov 05, 2017
Full time Health Care

Job Description

PwC/LOS Overview

Are you interested in the opportunity to work for an industry-leading firm that services clients that include the Fortune 500, and will give you the experience and exposure you need to build your career and personal brand? If you are, then PwC US (PricewaterhouseCoopers LLP and its subsidiaries) may be the firm for you. We're a member of the PwC network of firms located in 157 countries with more than 184,000 people who are committed to delivering quality in assurance, tax and advisory services. PwC US helps organizations and individuals create the value for which they are looking. Our professionals are at the heart of our business strategy and success by bringing personal and professional experiences; we understand that our business is impacted by a person's personal and professional lives. PwC US recruits top talent with traditional and nontraditional backgrounds, with a focus on diversity and inclusion, so that we continue to build PwC US as a great place to work. Our people are armed with the tools-including enriching professional experiences, everyday coaching, timely and productive feedback, and high-quality learning and development opportunities-to deliver each day. We are committed to building lasting relationships and delivering value to our clients. Learn more about us at The PwC network is a global market leader in tax services. We assist businesses, individuals, and organizations with tax strategy, planning, and compliance, while also delivering a wide range of business advisory services. With over 32,000 tax professionals, this means that the PwC network can support our clients both locally and globally. We have experience working with an expansive and diverse client-base, which comprises all types of businesses-multinationals, local companies, privately-owned organizations, entrepreneurs, family businesses, trusts, partnerships, and private individuals.

Job Description

PwC's Healthcare and Benefits consulting practice works with healthcare payers, providers, pharmaceuticals, and federal/state/local government agencies on a wide variety of consulting and assurance services to help them evaluate, strategize, develop, and manage their product portfolios, pricing/financial reporting, funding requirements, risk quantification, provider reimbursement, data analytics, and compliance.

Position/Program Requirements

Basic Qualifications:

Minimum Years of Experience: 5

Minimum Degree Required:

Bachelor's degree

Minimum Degree Required Major:

Actuarial Sciences, Mathematics, Statistics, Finance, Economics or Business

Certification(s) Required: One or more of the following certifications are required for this role: CPA, Enrolled Agent, Member of the Bar, Certified Equity Professional, Certified Pension Consultant, CCP, CPP, GRP, QKA, QPA, Licensed Insurance Consultant, Licensed Pharmacist, Associate, Society of Actuaries, Certified Employee Benefits Specialist, Chartered Financial Analyst, SPHR, Enrolled Actuary, Fellow, Life Management Institute, Fellow, or Society of Actuaries

Degree(s) Preferred:

Master's Degree

Preferred Degree Major:

Actuarial Sciences, Mathematics, Statistics, Finance, Economics, Public Policy or other analytics-based field

Knowledge Preferred:

Demonstrates proven extensive actuarial knowledge of and/or success in roles managing US federal government programs (Medicare/Medicaid) , as well as

commercial markets and issues in a major consulting firm or corporate environment.

Demonstrates proven extensive knowledge of health plan financial reporting, data analysis, pricing and underwriting, and compliance-related issues, which can include the following areas:

Product development, pricing, and/or rate filing;

Medicare strategy, including commercial risk adjustments;

Medicare, Medicaid, and ACA compliance;

Vendor selection and/or implementation;

Vendor and plan performance reviews;

Actuarial valuation and/or financial reporting;

Other actuarial analyses and data analytics;

Post-retirement programs and Medicare Part D;

Provider reimbursement redesign, contracting, and risk sharing; and,

Enterprise risk-management and risk assessments.

Skills Preferred:

Demonstrates proven extensive abilities and success in roles managing health plan financial reporting, data analysis, pricing and underwriting, and compliance-related issues, emphasizing the following areas:

ACA/Medicare/Medicaid pricing and

financial reporting issues;

Healthcare analytics, risk adjustment, and risk Management; and,

Use and training of others in a SAS environment.

Demonstrates proven record of success managing efforts with identifying and addressing client need: building, maintaining, and utilizing networks of client relationships and community involvement; communicating value propositions; managing resource requirements, project workflow, budgets, billing, collection; and, preparing or coordinating complex written and verbal materials.

Demonstrates extensive abilities and success as a team leader: leading teams to generate a vision, establishing direction and motivating members, creating an atmosphere of trust, leveraging diverse views, coaching staff, and encouragin improvement and innovation.

For positions based in San Francisco, consideration of qualified candidates with arrest and conviction records will be in a manner consistent with the San Francisco Fair Chance Ordinance.

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