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Strong Tier-1 brand and mid-level consulting role attract many qualified applicants.
Payer back-office and TriZetto platform expertise restricts cross-industry transferability.
Explicit 5-year requirement and payer/COTS specialization create strict screening filters.
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Lead the creation and implementation of operational strategies focused on payer back office functions such as claims, enrollment, billing, and membership.
Manage client service accounts and engagement workstreams, supervising and coaching teams to achieve client goals and deliver quality outcomes.
Use autonomous decision-making and professional skepticism to solve complex problems, cultivate client relationships, and navigate ambiguous situations.
Bachelor's Degree is mandatory; Master's Degree preferred but not mandatory.
Minimum of 5 years of relevant experience in operations consulting or payer back office operations.
Experience with payer back office operations including claims, enrollment, billing, membership, and transaction lifecycles in healthcare/payer services.
Willingness to travel up to 80%.
Manager-level professional with proven team leadership experience, capable of coaching and developing consulting teams.
Strong operational background in healthcare payer services, including familiarity with COTS platforms like TriZetto Facets/QNXT and related technology solutions.
Comfortable managing complex client engagements independently, with excellent problem-solving and client relationship skills in ambiguous environments.