Payor Operations Specialist

Key Skills

AI technology, Analytical and Problem solving, Automation, Payor Operations

Job Description

WHO YOU'LL WORK WITH

You’ll work with McKinsey’s Healthcare Access, Quality and Outcomes improvement (HALO) domain as part of our Social Sector, Healthcare & Public Sector Entities (SHaPE) practice in one of our offices in North America.

HALO aspires to build solutions, expertise, and capabilities to deliver a comprehensive, end-end performance impact to payors (including provider-led health plans) and services clients (including Investor entities and those that operate like payors and take risk) across affordability, access, quality, and efficiency. Taken together, HALO aspires to improve the performance of healthcare worldwide, by means of these levers and capabilities. The domain is the combination of an impact-focused, interdisciplinary team and a robust suite of analytics, insights, expertise, and solutions to enable payors to transform their core medical and administrative operations. These assets can be rapidly deployed across our clients either directly, or in partnership with other domains (e.g. pharmacy, value-based care, clinical operations).

Given this, you will be expected to collaborate both with other HALO colleagues other SHaPE domains (primarily in healthcare areas, such as Provider Performance Improvement, Episodes of Care, Population Health, Healthcare Data Management, etc.), as well as the broader global practice of McKinsey consultants and teams (Design, Quantum Black, Academy, etc.). You will also work closely with professional development and recruiting teams to ensure the goals of the domain are closely aligned and play an active role in bringing our people development vision to life, as well

WHAT YOU'LL DO

You will be staffed on active client engagements focused on health care value with the ultimate goal of making healthcare better, more affordable and more accessible for billions of people around the world.

In this role, you will be deliver high-quality outputs to help guide decisions on the business problems for our clients. These outputs range from identifying potential opportunity areas in medical / admin / pharmacy costs, to developing initiatives and plans to enhance essential functions within payor organizations to supporting implementations of the initiatives you’ve helped develop. You will be actively engaged with front-line client teams involved in helping payors implement operational improvements and organizational enhancements that improve experiences and support the quality and cost of healthcare. You will leverage our proprietary big data and analytical platform, Nebula.

You will also leverage your project management and client communication skills as you participate in problem-solving sessions with clients and McKinsey leadership. You will leverage your expertise to take ownership of tenure-appropriate client relationships and guide clients through appropriate syndication discussions as well as longer-term front-line implementation projects. Note, you will also devote some portion of time to creating new assets/solutions for the domain and practice in partnership with HALO leadership.

QUALIFICATIONS

• Bachelor's degree, advanced degree preferred

• 2+ years prior relevant work experience, particularly in payor operations highly preferred

• Strong problem-solving skills with ability to process complex information, break it into logical steps/tasks to help solve, present it clearly to a range of audiences

• High level of entrepreneurship, professionalism and presence to succeed on the ground with clients; go-getter who can multi-task across multiple asset development and client delivery priorities

• Client service and operation mindset

• Able to provide leadership over and influence individuals and across multiple stakeholders from different levels, backgrounds by tailoring approach

• Ability to be a strong team player in a dynamic and changing environment

• Knowledge of automation or other AI is a plus
• Understanding of the healthcare ecosystem, particularly payors; knowledge of medical or administrative cost optimization is a plus