Accenture is a leading global professional services company that helps the world’s leading businesses, governments and other organizations build their digital core,
 
optimize
 
their operations, accelerate revenue
 
growth
 
and enhance citizen services—creating tangible value at speed and scale. We are a talent- and
 
innovation
-led company with approximately
 
750,000 people
 
serving clients in more than 120 countries. Technology is at the core of change today, and we are one of the world’s leaders in helping drive that change, with strong ecosystem relationships. We combine our strength in technology and leadership in cloud, data and AI with unmatched industry experience, functional
 
expertise
 
and global delivery capability. We are uniquely able to deliver tangible outcomes because of our broad range of services, solutions and assets across Strategy & Consulting, Technology, Operations, Industry X and Song. These capabilities, together with our culture of shared success and commitment to creating 360° value, enable us to help our clients reinvent and build trusted, lasting relationships. We measure our success by the 360° value we create for our clients, each other, our shareholders,
 
partners
 
and communities. Visit us at
 

www.accenture.com

.
 

 

Strategy & Consulting:
 

We work with C-suite executives, leaders and boards of the world’s leading organizations, helping them reinvent every part of their enterprise to drive greater growth, enhance competitiveness, implement operational improvements, reduce cost, deliver sustainable 360° stakeholder value, and set a new performance frontier for themselves and the industry in which they operate. Our deep industry and functional
 
expertise
 
is
 
supported by proprietary assets and solutions that help organizations transform faster and become more resilient. Underpinned by technology, data, analytics, AI, change management, talent and sustainability capabilities, our Strategy & Consulting services help architect and accelerate all aspects of an organization’s total enterprise reinvention.
 

 

 

As a
 
Health Payer
 
Operations
 
Manager
/Consultant

,
 

your primary responsibilities
 
may include: 
 

Claims Operations

 

Lead initiatives to improve claims processing efficiency and accuracy, reducing operational
 
costs
 
and improving member satisfaction.
 

Analyze claims workflows and
 
identify
 
bottlenecks or opportunities for automation to streamline processes.
 

Transform
 
traditional operating models and
 
process
 
to incorporate innovative
 
designs
 
with
 
advanced technologies 
 

Ensure compliance with all regulatory requirements and payer policies across claims operations.
 

Partner with Technology teams to shape claims platform configuration and optimization
 

Strategic Operations & Improvement Initiatives

 

Develop, implement, and
 
monitor
 
process improvement initiatives across claims and provider operations.
 

Utilize data analytics and operational metrics to
 
identify
 
trends,
 
monitor
 
performance, and recommend adjustments as needed.
 
 

Lead training and support change management efforts for new initiatives to ensure smooth transitions and process adoption.
 

Design and operationalize KPI and performance management frameworks to
 
monitor
 
claims
 
health and support executive decision-making.
 

Stakeholder Management & Collaboration

 

Partner with internal teams (e.g., IT, compliance, customer service) to ensure project goals align with organizational priorities.
 

Communicate effectively with senior leadership, providing regular updates and progress reports.
 

Serve as a subject matter expert and provide guidance to junior consultants or team members.
 

Contribute
 
to Health Administration consulting practice by mentoring junior
 
team members,
 
maintain
 
currency on industry events and trends
 
as well as
 
develop
 
thought leadership to advance
 
industry
 
perspectives
 
on emerging trends.
 

Compliance & Risk Management

 

Maintain current knowledge of state and federal health payer regulations and ensure compliance across all operational activities.
 

Identify
 
and mitigate operational risks within claims and network operations.
 

Proactively
 
identify
 
risk as part of consulting engagements and
 
frame mitigation strategies in partnership with project leadership.
 

Leading
 
Transformation
al Change 
 

 

Lead large-scale transformation initiatives in health payer operations, focusing on streamlining processes, enhancing service delivery, and achieving operational excellence.
 

Drive transformational change
 
and lead
 
change initiatives that require a deep understanding of functional processes, combined with the ability to navigate across business domains and align with emerging technologies.
 

Develop
 
value architecture
 
spanning baseline
 
and target state metrics
 
supported by
 
defined capabilities driving value informed by best practices
 

 

 Travel

As needed, up to 80%

 
 

Why should I join the Accenture
 
Health
 
team?

 
 

Innovate every day.
 

Be at the forefront of designing
 
health
 
technology
 
solutions that push boundaries and create new opportunities for our clients. 
 

Lead with the industry’s best

. Join an industry-recognized
 
healthcare leader
 
with more than
 
20,000 global healthcare
 
professionals collaborating to drive enterprise-wide transformational projects on a global scale. Accenture has worked with more than
 
200
 
clients to deliver
 
healthcare
 
transformation
 
to meet the diverse needs of patients and members
.  
 
 

Learn and grow continuously.
 

Harness unmatched training and professional development to help you build and advance your
 
health
, consultative and delivery skills. With learning resources, interactive classroom courses, real-life client
 
simulations
 
and ongoing mentoring available when you need it,
 
you’ll
 
expand your thinking beyond the core Workday implementation.