Remote Healthcare Strategy Consultant: Utilization Policy

NurseRemotely; United States; Remote; USD 109,000 - 181,000; Full time

Job summary

Highmark Inc. is seeking a Strategy Consultant to drive change in Utilization Management and Medical Policy operations.

You will build data models to prove financial and operational impacts, and develop a foundation for cost savings analyses in the initial 90 days. You will work with data engineers, translate assets into actionable insights, and independently define and execute day-to-day steps within strategic boundaries.

Qualifications

• Masters in Business, Healthcare, Economics or related field.
• 2+ years post-grad strategy/consulting or internal strategy groups in healthcare.
• 6+ years related experience in business or healthcare.
• Bachelor's + 3 years experience acceptable in lieu of Masters.

Responsibilities

• Develop financial and operational models for medical policy and utilization management strategies.
• Lead baseline model development for cost savings and admin costs at procedure-code level.
• Manipulate data from centralized IT/data offerings to create fit-for-purpose data layers.
• Collaborate with data engineering to secure data assets and translate them to insights.
• Define and execute day-to-day tactical steps within leadership's strategic boundaries.

Skills

Strategic thinking

MS Office Proficiency

Healthcare domain knowledge

Critical thinking

Communication & presentation

Education

Master's degree

2+ years post-grad strategy experience

6+ years related experience

Bachelor's +3 years substitution

Tools

SQL

Python/R

Power BI/Tableau

Job description

Highmark Inc. is seeking a Strategy Consultant to drive change in Utilization Management and Medical Policy operations.

You will build data models to prove financial and operational impacts, and develop a foundation for cost savings analyses in the initial 90 days. You will work with data engineers, translate assets into actionable insights, and independently define and execute day-to-day steps within strategic boundaries.