Strategic Risk Adjustment Analytics Lead

Highmark Health; Montgomery (AL); Hybrid; USD 109,000 - 181,000; Full time

Job summary

Highmark Inc. seeks a strategic leader to support the Risk Adjustment Accuracy Management program, driving analytics, scenario planning and market insights. You will guide project teams, design evidence-based recommendations, and communicate strategic findings to senior leaders.

This role supports RAAM’s goals with possible onsite/remote flexibility and mentorship responsibilities. The ideal candidate holds a Master’s degree in a health-related field with substantial healthcare strategy

Qualifications

• Master's degree in Business, Healthcare, Economics or related field.
• 2 years post-grad strategy/management consulting or healthcare strategy group experience.
• 6 years of related experience in Business or Healthcare.
• Bachelor's degree with 3 years strategic experience in lieu of Master's.
• Extensive knowledge of Health Insurance and/or Provider operations.
• Experience in operational improvement.
• Knowledge of CMS-HCC, HHS-HCC, and/or CDPS risk adjustment models.
• Experience implementing provider- and patient-facing programs.
• Knowledge of membership, rates, financial and competitive data.

Responsibilities

• Identify key business issues with owners; develop solutions and recommendations.
• Lead delivery of evolving risk adjustment initiatives aligned with RAAM plan.
• Manage major strategy projects with internal or external resources.
• Serve as SME to Strategic Operations on risk adjustment programs.
• Provide informal guidance to junior team members and management input.
• Develop analytical frameworks and best practices for strategy issues.
• Perform other duties as assigned.

Skills

Strategic thinking

MS Office

Healthcare knowledge

Critical thinking

Communication skills

Education

Master's degree in Business, Healthcare, Economics or related field

2 years post-grad experience in strategy consulting or healthcare strategy

6 years of related experience in Business or Healthcare

Bachelor's degree + 3 years strategic experience (in lieu of Master's)

Job description

Highmark Inc. seeks a strategic leader to support the Risk Adjustment Accuracy Management program, driving analytics, scenario planning and market insights. You will guide project teams, design evidence-based recommendations, and communicate strategic findings to senior leaders.

This role supports RAAM’s goals with possible onsite/remote flexibility and mentorship responsibilities. The ideal candidate holds a Master’s degree in a health-related field with substantial healthcare strategy