Strategic Risk Adjustment Lead (Remote/Hybrid)

Highmark Health / AHN; New York (NY); Hybrid; USD 109,000 - 181,000; Full time

Job summary

Highmark Inc. is seeking a strategic leader to support the Risk Adjustment Accuracy Management (RAAM) department. You will guide analytics, market research, forecasting, and competitive analysis to inform senior leadership decisions.

The role offers hybrid or remote work; if within 50 miles of an office, onsite 3 days a week (Tue/Wed/Thu). Strong communication and healthcare knowledge are essential for success.

Qualifications

• Master's 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

• Work with business/ market owners to identify key business issues, apply analytic 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 aligned with RAAM's strategic plan.
• Manage major strategy projects with internal or external strategy resources.
• Serve as SME to Strategic Operations on risk adjustment programs for Medicare Advantage, Medicaid, and ACA lines of business.
• Provide informal guidance to junior team members; may have supervisory responsibilities on a project basis.
• Develop analytic frameworks, approach and methodology best practices to analyze strategy issues.
• Other duties as assigned or requested.

Skills

Strategic thinking

MS Office

PowerPoint

Excel

Healthcare knowledge

Education

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

2 years post-grad strategy/management consulting experience or equivalent

6 years related experience in Business or Healthcare

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

Tools

MS Office

PowerPoint

Excel

Job description

Highmark Inc. is seeking a strategic leader to support the Risk Adjustment Accuracy Management (RAAM) department. You will guide analytics, market research, forecasting, and competitive analysis to inform senior leadership decisions.

The role offers hybrid or remote work; if within 50 miles of an office, onsite 3 days a week (Tue/Wed/Thu). Strong communication and healthcare knowledge are essential for success.