Qnxt Claims Processing Jobs in Michigan (NOW HIRING)

Industry/Sector

Health Services

Specialism

Operations

Management Level

Manager

Job Description & Summary

At PwC, our people in operations consulting specialise in providing consulting services on optimising operational efficiency and effectiveness. These individuals analyse client needs, develop operational strategies, and offer guidance and support to help clients streamline processes, improve productivity, and drive business performance.
As an operations consulting generalist at PwC, you will possess a broad understanding of various aspects of operations consulting. You will provide comprehensive guidance and support to clients in optimising operational efficiency and effectiveness. Working in this area, you will analyse client needs, develop operational solutions, and offer recommendations tailored to specific business requirements.
Enhancing your leadership style, you motivate, develop and inspire others to deliver quality. You are responsible for coaching, leveraging team member's unique strengths, and managing performance to deliver on client expectations. With your growing knowledge of how business works, you play an important role in identifying opportunities that contribute to the success of our Firm. You are expected to lead with integrity and authenticity, articulating our purpose and values in a meaningful way. You embrace technology and innovation to enhance your delivery and encourage others to do the same.
Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to:
Analyse and identify the linkages and interactions between the component parts of an entire system.
Take ownership of projects, ensuring their successful planning, budgeting, execution, and completion.
Partner with team leadership to ensure collective ownership of quality, timelines, and deliverables.
Develop skills outside your comfort zone, and encourage others to do the same.
Effectively mentor others.
Use the review of work as an opportunity to deepen the expertise of team members.
Address conflicts or issues, engaging in difficult conversations with clients, team members and other stakeholders, escalating where appropriate.
Uphold and reinforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance), the Firm's code of conduct, and independence requirements.
The Opportunity
As part of the Operations Consulting Generalist team you are expected to lead the creation and implementation of impactful operational strategies. As a Manager you are to supervise, develop, and coach teams, manage client service accounts, and drive client engagement workstreams by solving and analyzing complex problems to develop quality deliverables. You are to use autonomous decision-making and professional skepticism when reviewing, analyzing, and producing deliverables across multiple client needs, and play a visible role in cultivating meaningful client relationships, inspiring your teams, and navigating ambiguity.
Responsibilities
- Supervise, develop, and coach teams to achieve client goals
- Manage client service accounts and engagement workstreams
- Create and implement impactful operational strategies
- Solve complex problems to develop exceptional deliverables
- Utilize autonomous decision-making and professional skepticism
- Cultivate meaningful client relationships
- Inspire teams and navigate ambiguity
- Facilitate meaningful dialogue between different perspectives
What You Must Have
- Bachelor's Degree
- 5 years of experience
What Sets You Apart
- Master's Degree preferred
- Proven record of success as a team leader
- Experience in payer back office operations
- Specialization in claims, enrollment, billing, and membership
- Familiarity with technology solutions enabling these functions
- Experience with transaction lifecycles and Healthcare/Payer Services
- Knowledge of COTS platforms including TriZetto Facets/QNXT
- Experience with Operations and administration of Healthcare/Payer
- Proficiency in data and systems interactions

Travel Requirements

Up to 80%

Job Posting End Date

The salary range for this position is: $99,000 - $232,000. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. All hired individuals are eligible for an annual discretionary bonus. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation, personal and family sick leave, and more. To view our benefits at a glance, please visit the following link: https://pwc.to/benefits-at-a-glanceAs PwC is anequal opportunity employer, 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 (including family medical history); veteran, marital, or citizenship status; or, any other status protected by law.PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy.Learn more about how we work: https://pwc.to/how-we-workFor only those qualified applicants that are impacted by the Los Angeles County Fair Chance Ordinance for Employers, the Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, San Diego County Fair Chance Ordinance, and the California Fair Chance Act, where applicable, arrest or conviction records will be considered for Employment in accordance with these laws. At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members. We evaluate these factors thoughtfully to establish a secure and trusted workplace for all.Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: https://pwc.to/us-application-deadlines