Healthcare Strategy Consultant: Risk Adjustment

Highmark Health; Raleigh (NC); Hybrid; USD 109,000 - 181,000; Full time

Job summary

Highmark Health in Raleigh, NC seeks a senior strategic leader to support the Risk Adjustment Accuracy Management (RAAM) department with analytics, market research, forecasting and strategic recommendations.

This role can be hybrid or remote; onsite 3 days/week if within 50 miles of an office. You will partner with Medicare Advantage, Medicaid, and ACA lines and guide project teams toward actionable outcomes.

Qualifications

• Masters Degree in Business, Healthcare, Economics or related degree.
• 2 years of post-grad experience with strategy/management consulting firms or internal strategy groups of healthcare companies.
• 6 years of related experience in Business or Healthcare.
• Bachelor's degree and 3 years of relevant progressive strategic experience in lieu of Master's degree.

Responsibilities

• Work with business/ market owners to identify key business issues, apply right analytical framework, develop solution and recommendations, represent findings to stakeholders and own the outcome.
• Lead the successful delivery of evolving risk adjustment initiatives and projects, driving outcomes directly aligned with RAAM's strategic plan
• Manage major strategy projects with the help of internal or external strategy consulting resources.
• Serve as subject matter expert to Strategic Operations staff and stakeholders on risk adjustment programs for Medicare Advantage, Medicaid, and ACA lines of business.
• Provide periodic informal work guidance/direction to junior team members; Provide performance input and recommendations to management for development/ training plans. May have supervisory responsibilities on a project basis.
• Develop analytical frameworks, approach and methodology best practices to analyze strategy issues.
• Other duties as assigned or requested.

Skills

Strategic thinking

Leadership

Strong communication and presentation

Healthcare industry trends

Critical thinking

Project leadership

Education

Masters Degree in Business, Healthcare, Economics or related degree

2 years of post-grad strategy/ management consulting experience

6 years of related experience in Business or Healthcare

Bachelor's degree and 3 years of relevant progressive strategic experience in lieu of Master's degree

Tools

MS Office (PowerPoint & Excel)

Job description

Highmark Health in Raleigh, NC seeks a senior strategic leader to support the Risk Adjustment Accuracy Management (RAAM) department with analytics, market research, forecasting and strategic recommendations.

This role can be hybrid or remote; onsite 3 days/week if within 50 miles of an office. You will partner with Medicare Advantage, Medicaid, and ACA lines and guide project teams toward actionable outcomes.