Payor Operations Expert

  • Atlanta
  • Austin
  • Boston
  • Charlotte
  • Chicago
  • Cleveland
  • Dallas
  • Detroit
  • Houston
  • Los Angeles
  • Miami
  • Minneapolis
  • New Jersey
  • New York City
  • Philadelphia
  • Phoenix
  • Pittsburgh
  • San Francisco
  • Silicon Valley
  • St. Louis
  • Stamford
  • Waltham
  • Washington DC

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.
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).
In this role you will also coordinate the efforts and supporting the development of domain affiliated colleagues (e.g., regular check-ins, ensuring fellows are aligned with workstreams that best support their development goals, creating roles that enable fellows to step up responsibilities) as a part of the firm’s people development mission. You will often collaborate closely with professional development and recruiting teams to ensure the goals of the domain are closely aligned and plays an active role in bring the people vision to life. 

What You'll Do

You will lead the creation, expansion, automation of core payor ops assets portfolio for accelerating client impact. 
The payor operations area in overall HALO is focused on building solutions, expertise, and capabilities to serve healthcare companies on their most important operating challenges. These include member-facing operations such as marketing and sales, member enrollment and on-boarding and care management; core internal operations such as underwriting and claims adjudication and provider facing operations such as provider contracting. Payor operations also covers core support functions such as HR, technology and automation and other support function.
In this role you will conceptualize, build and accelerate the deployment of relevant assets, expertise, and capabilities to enable the firm to rapidly understand and evaluate client performance, evaluate priorities and build robust, proven solutions to enable performance gains (such as member experience improvement, abrasion reduction, cost reduction, among others).
You will be responsible for managing refresh and deployment of current assets, strategizing, and creating a robust pipeline of assets, developing assets in the pipeline to support client development and client studies. You will work with practice team to ensure right tracking of asset utilization, sharing and radiating assets across the practice to ensure utilization for client impact.
You will also play a critical role with client development – bringing deep and relevant content and context to the challenge of optimizing operations at large payors – to support client development activities including leading content creation, setting up follow-ups and managing the pipeline. You will also be required to marshal teams, resources, and collaborations to ensure delivery of payor ops capabilities to clients on-time and under budget. You will also be responsible for driving the radiation of payor ops assets across client teams and support client conversations on payor ops topics and their incorporation into other firm publications.


  • Bachelor's degree; advanced graduate degree (e.g., MBA, PhD, etc.) or equivalent i.e. 5+ years prior relevant work experience, particularly in payor operations highly preferred
  • Excitement and interest in building assets and products that will delivery lasting value within the healthcare ecosystem
  • Material experience and track record in payor operations – particularly firsthand experience in running core payor services, delivering impact, and leading team members – is highly sought after
  • Direct experience in working with data, ops redesign, digitization and automation and leading improvement programs
  • Ability to work collaboratively in a team and create an inclusive environment with people at all levels of an organization
  • Strong entrepreneurial mindset and ability to bring ideas to life
  • Capacity to manage multiple projects and workstreams and effectively prioritize time and firm resources
  • Experience leading high performing and diverse teams

COVID-19 vaccination mandate:

Employment with McKinsey & Company, Inc. in the United States and Canada is conditioned on proof of full vaccination against the COVID-19 virus (with a WHO-approved or Health Canada-approved COVID-19 vaccine, as applicable) or approval of an exemption due to a qualifying medical condition or sincerely held religious belief prior to start date.

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Job Skill Group - CSS Associate
Job Skill Code - SGR1 - Solution Manager
Function -
Industry - Healthcare Systems & Services
Post to LinkedIn - Yes
Posted to LinkedIn Date - Tue Mar 01 00:00:00 GMT 2022
LinkedIn Posting City - Chicago
LinkedIn Posting State/Province - Illinois 
LinkedIn Posting Country - United States
LinkedIn Job Title - Payor Operations Expert
LinkedIn Function - Consulting;Health Care Provider;Other
LinkedIn Industry - Hospital & Health Care;Management Consulting;Medical Practice
LinkedIn Seniority Level - Associate