Analyze payer operations and health services data to identify trends, improve claims and member processes, and support modernization initiatives. Build dashboards, reports, and statistical analyses; validate data across systems; translate findings into client recommendations; collaborate on requirements and deliverables; manage workstreams; and mentor junior team members in a client-facing advisory environment.
The Opportunity
As a Payer Analytics Business Analyst, you will support client work within our Advisory practice by turning health services data into clear insights that help guide decisions, shape operating models, and support payer modernization efforts.
As a Senior Associate you will analyze complex problems, manage assigned workstreams, build meaningful client connections, and use critical thinking to break down concepts while guiding junior team members and adapting as priorities shift. In this role at PwC, you will apply data science and analytics methods to interpret trends, develop deliverables, communicate findings, and support client-facing work across payer and health services engagements.
Responsibilities
- Analyzing payer operations data to identify trends, patterns, and business issues that affect member, provider, and claims processes
- Developing descriptive and exploratory analyses that support platform modernization, operating model changes, and service improvement efforts
- Translating complex data findings into clear recommendations for client teams focused on payer operations and healthcare performance
- Building dashboards, visual summaries, and recurring reporting that track core metrics across claims, utilization management, and member experience
- Applying statistical and analytical methods to support data-driven decisions across healthcare payer programs and modernization efforts
- Working through data quality, data mapping, and source validation activities across multiple systems and business domains
- Collaborating across client teams to gather requirements, interpret feedback, and refine analytical deliverables
- Supporting analytics workstreams by organizing tasks, tracking progress, and adapting to changing priorities and project needs
- Applying knowledge of healthcare payer processes, regulatory requirements, and operational workflows to frame analysis and recommendations
- Mentoring junior team members on analytical methods, reporting techniques, and delivery of assigned workstreams
What You Must Have
- At least a Bachelor's degree
- At least 3 years of experience
What Sets You Apart
- Preference for at least one of the following fields of study: Accounting, Analytics/Data Science, Artificial Intelligence/Robotics, Business Administration/Management, Computer Science/Information Systems, Cybersecurity, Engineering, Mathematics/Statistics, Operations/Supply Chain, Project/Technology Management, Risk Management/Insurance
- Analyzing payer data, claims trends, and operational patterns
- Using SQL, Python, or analytics tools for healthcare insights
- Developing dashboards, visualizations, and executive-ready summaries
- Interpreting healthcare payer workflows, utilization, or membership data
- Communicating findings to clients and guiding junior team members
The salary range for this position is: $77,000 - $202,000. 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-glance
As PwC is an equal 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-work
For 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
As a Payer Analytics Business Analyst, you will support client work within our Advisory practice by turning health services data into clear insights that help guide decisions, shape operating models, and support payer modernization efforts.
As a Senior Associate you will analyze complex problems, manage assigned workstreams, build meaningful client connections, and use critical thinking to break down concepts while guiding junior team members and adapting as priorities shift. In this role at PwC, you will apply data science and analytics methods to interpret trends, develop deliverables, communicate findings, and support client-facing work across payer and health services engagements.
Responsibilities
- Analyzing payer operations data to identify trends, patterns, and business issues that affect member, provider, and claims processes
- Developing descriptive and exploratory analyses that support platform modernization, operating model changes, and service improvement efforts
- Translating complex data findings into clear recommendations for client teams focused on payer operations and healthcare performance
- Building dashboards, visual summaries, and recurring reporting that track core metrics across claims, utilization management, and member experience
- Applying statistical and analytical methods to support data-driven decisions across healthcare payer programs and modernization efforts
- Working through data quality, data mapping, and source validation activities across multiple systems and business domains
- Collaborating across client teams to gather requirements, interpret feedback, and refine analytical deliverables
- Supporting analytics workstreams by organizing tasks, tracking progress, and adapting to changing priorities and project needs
- Applying knowledge of healthcare payer processes, regulatory requirements, and operational workflows to frame analysis and recommendations
- Mentoring junior team members on analytical methods, reporting techniques, and delivery of assigned workstreams
What You Must Have
- At least a Bachelor's degree
- At least 3 years of experience
What Sets You Apart
- Preference for at least one of the following fields of study: Accounting, Analytics/Data Science, Artificial Intelligence/Robotics, Business Administration/Management, Computer Science/Information Systems, Cybersecurity, Engineering, Mathematics/Statistics, Operations/Supply Chain, Project/Technology Management, Risk Management/Insurance
- Analyzing payer data, claims trends, and operational patterns
- Using SQL, Python, or analytics tools for healthcare insights
- Developing dashboards, visualizations, and executive-ready summaries
- Interpreting healthcare payer workflows, utilization, or membership data
- Communicating findings to clients and guiding junior team members
The salary range for this position is: $77,000 - $202,000. 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-glance
As PwC is an equal 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-work
For 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
PwC Boston, Massachusetts, USA Office
101 Seaport Boulevard, Boston, MA, United States, 02210
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