Health Plan Operations Jobs Near Me

Join our AI & Engineering team in transforming technology platforms, driving innovation, and helping make a significant impact on our clients' success. You'll work alongside talented professionals reimagining and re-engineering operations and processes that are critical to businesses. Your contributions can help clients improve financial performance, accelerate new digital ventures, and fuel growth through innovation.
AI & Engineering leverages cutting-edge engineering capabilities to build, deploy, and operate integrated/verticalized sector solutions in software, data, AI, network, and hybrid cloud infrastructure. These solutions are powered by engineering for business advantage, transforming mission-critical operations. We enable clients to stay ahead with the latest advancements by transforming engineering teams and modernizing technology & data platforms. Our delivery models are tailored to meet each client's unique requirements.

Recruiting for this role ends on 09/30/2026.

Work you'll do

As a Senior Manager on the Industry Solutions team, you will be responsible for helping health plan clients transform core administration, operations, and service delivery capabilities.

• Lead workstreams or full engagements focused on health plan operations transformation, including core administration, pharmacy operations, and operating model redesign
• Assess and redesign end-to-end processes across claims, enrollment, billing, customer service, utilization management, care management, and pharmacy or pharmacy benefit manager operations
• Translate business needs into transformation roadmaps, service delivery models, process improvements, and implementation plans aligned to client priorities
• Manage day-to-day delivery, team performance, quality of work product, and client stakeholder communication across complex transformation programs
• Support business development, proposal development, thought leadership, and go-to-market initiatives, while mentoring junior practitioners across project delivery and client service

A successful candidate would possess these skills:

• Ability to work independently and collaborate as part of a team
• Effective written and verbal communication skills
• Meticulous attention to detail and quality of work product
• Ability to build and sustain professional relationships
• Ability to lead projects or workstreams
• Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
• Strong interpersonal skills and professional demeanor
• Ability to meet deadlines
• Ability to mentor and provide clear guidance to others

The team

Deloitte's Industry Solutions team helps organizations address business, operational, and technology challenges through transformation programs tailored to industry needs. Within Healthcare Industry Solutions, practitioners work with health plan clients on core administration, operations, pharmacy, and service delivery transformation efforts designed to improve efficiency, compliance, and member experience.

Qualifications

Required:

• Bachelor's degree and 8+ years of experience in health care, health plan operations, or consulting
• 7+ years of experience implementing or configuring core administration platforms such as Facets, QNXT, HealthRules, or custom-developed core administration systems
• Experience with configuration or functional design across claims adjudication, enrollment, billing, and benefits setup
• Experience leading process redesign, operating model transformation, or large-scale business transformation initiatives for health plan organizations, including management of project delivery, workstreams, or cross-functional teams
• Experience developing client deliverables using Microsoft Excel and Microsoft PowerPoint
• Ability to travel 50%, on average, based on the work you do and the clients and industries/sectors you serve.
• Limited immigration sponsorship may be available.

Preferred:

• Master's degree in Business Administration, Master of Health Administration, or similar field
• Experience supporting health plan clients across claims, enrollment, billing, service operations, care management, or utilization management
• Experience with health plan technology such as application programming interface-enabled core administration, cloud migration, legacy-to-software as a service transitions, HealthEdge, FACETS, Tapestry, or custom solutions
• Experience delivering health plan implementations, including product launches, Affordable Care Act, Medicare, or Medicaid compliance builds, or platform migrations
• Experience contributing to business development, proposal development, or thought leadership
• Experience working with senior client stakeholders

The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $189,200 to $372,900.

You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance.

Qualifications:Join our AI & Engineering team in transforming technology platforms, driving innovation, and helping make a significant impact on our clients' success. You'll work alongside talented professionals reimagining and re-engineering operations and processes that are critical to businesses. Your contributions can help clients improve financial performance, accelerate new digital ventures, and fuel growth through innovation.
AI & Engineering leverages cutting-edge engineering capabilities to build, deploy, and operate integrated/verticalized sector solutions in software, data, AI, network, and hybrid cloud infrastructure. These solutions are powered by engineering for business advantage, transforming mission-critical operations. We enable clients to stay ahead with the latest advancements by transforming engineering teams and modernizing technology & data platforms. Our delivery models are tailored to meet each client's unique requirements.

Recruiting for this role ends on 09/30/2026.

Work you'll do

As a Senior Manager on the Industry Solutions team, you will be responsible for helping health plan clients transform core administration, operations, and service delivery capabilities.

• Lead workstreams or full engagements focused on health plan operations transformation, including core administration, pharmacy operations, and operating model redesign
• Assess and redesign end-to-end processes across claims, enrollment, billing, customer service, utilization management, care management, and pharmacy or pharmacy benefit manager operations
• Translate business needs into transformation roadmaps, service delivery models, process improvements, and implementation plans aligned to client priorities
• Manage day-to-day delivery, team performance, quality of work product, and client stakeholder communication across complex transformation programs
• Support business development, proposal development, thought leadership, and go-to-market initiatives, while mentoring junior practitioners across project delivery and client service

A successful candidate would possess these skills:

• Ability to work independently and collaborate as part of a team
• Effective written and verbal communication skills
• Meticulous attention to detail and quality of work product
• Ability to build and sustain professional relationships
• Ability to lead projects or workstreams
• Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
• Strong interpersonal skills and professional demeanor
• Ability to meet deadlines
• Ability to mentor and provide clear guidance to others

The team

Deloitte's Industry Solutions team helps organizations address business, operational, and technology challenges through transformation programs tailored to industry needs. Within Healthcare Industry Solutions, practitioners work with health plan clients on core administration, operations, pharmacy, and service delivery transformation efforts designed to improve efficiency, compliance, and member experience.

Qualifications

Required:

• Bachelor's degree and 8+ years of experience in health care, health plan operations, or consulting
• 7+ years of experience implementing or configuring core administration platforms such as Facets, QNXT, HealthRules, or custom-developed core administration systems
• Experience with configuration or functional design across claims adjudication, enrollment, billing, and benefits setup
• Experience leading process redesign, operating model transformation, or large-scale business transformation initiatives for health plan organizations, including management of project delivery, workstreams, or cross-functional teams
• Experience developing client deliverables using Microsoft Excel and Microsoft PowerPoint
• Ability to travel 50%, on average, based on the work you do and the clients and industries/sectors you serve.
• Limited immigration sponsorship may be available.

Preferred:

• Master's degree in Business Administration, Master of Health Administration, or similar field
• Experience supporting health plan clients across claims, enrollment, billing, service operations, care management, or utilization management
• Experience with health plan technology such as application programming interface-enabled core administration, cloud migration, legacy-to-software as a service transitions, HealthEdge, FACETS, Tapestry, or custom solutions
• Experience delivering health plan implementations, including product launches, Affordable Care Act, Medicare, or Medicaid compliance builds, or platform migrations
• Experience contributing to business development, proposal development, or thought leadership
• Experience working with senior client stakeholders

The wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the position may be filled. At Deloitte, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $189,200 to $372,900.

You may also be eligible to participate in a discretionary annual incentive program, subject to the rules governing the program, whereby an award, if any, depends on various factors, including, without limitation, individual and organizational performance.

Education:Bachelor's DegreeEmployment Type: