Strategic Risk-Adjustment Architect

Highmark Health; Saint Paul (MN); Hybrid; USD 109,000 - 181,000; Full time

Job summary

Highmark Inc. leads the Risk Adjustment Accuracy Management (RAAM) team, driving analytics and strategic initiatives to support Medicare Advantage, Medicaid and ACA programs.

The role blends leadership with hands-on analytics, market research and scenario planning to inform senior leaders and decision-makers. Hybrid or remote work is possible with onsite requirements within 50 miles of an office three days a week.

Qualifications

• Masters degree in Business, Healthcare, Economics or related field.
• 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.

Responsibilities

• Identify key business issues with market owners and apply analytical frameworks.
• Lead delivery of risk adjustment initiatives aligned with RAAM’s strategic plan.
• Manage strategy projects with internal or external resources.
• Serve as SME to Operational staff on risk adjustment programs.
• Provide guidance to junior team members and assist in training plans.

Skills

Strategic thinking

PowerPoint & Excel

Healthcare industry trends

Critical thinking

Communication & presentation

Education

Masters degree in Business or Healthcare

2 years post-grad strategy/consulting experience

6 years related experience in business/healthcare

Bachelor's degree substitution option

Tools

MS Office

Job description

Highmark Inc. leads the Risk Adjustment Accuracy Management (RAAM) team, driving analytics and strategic initiatives to support Medicare Advantage, Medicaid and ACA programs.

The role blends leadership with hands-on analytics, market research and scenario planning to inform senior leaders and decision-makers. Hybrid or remote work is possible with onsite requirements within 50 miles of an office three days a week.