Strategy Consultant - Healthcare Policy & Utilization Analytics

Highmark Health; Pennsylvania; Hybrid; USD 109,000 - 181,000; Full time

Job summary

Highmark Health seeks a Strategy Consultant to drive change in Utilization Management and Medical Policy. Build data-driven models, bridge clinical decisions with operational finance, and develop cost-saving analyses.

You will work hands-on with healthcare data, partnering with data engineers to deliver actionable insights for clinical and operational stakeholders. The role is remote-based, with a preference for candidates near Pittsburgh, PA, and requires strong SQL/Python skills, solid Power

Qualifications

• Masters in Business, Healthcare, Economics or related field required or 6 years of related experience in lieu of Master’s degree.
• 2 years post-grad strategy/management consulting experience preferred or equivalent internal strategy group experience.

Responsibilities

• Develop Financial & Operational Models to evaluate medical policy and utilization management strategies.
• Lead foundational model development in first 90 days for prior authorization costs and trends.
• Perform hands-on data extraction, transformation, and data-layer construction for analyses.
• Collaborate with data engineering to secure data assets and translate them into insights.
• Define and execute day-to-day tactical steps within leadership’s strategic boundaries.

Skills

SQL

Python/R

Power BI/Tableau

Data modeling

Education

Master’s degree in Business/Healthcare/Economics

Bachelor’s degree with 3 years relevant experience

Job description

Highmark Health seeks a Strategy Consultant to drive change in Utilization Management and Medical Policy. Build data-driven models, bridge clinical decisions with operational finance, and develop cost-saving analyses.

You will work hands-on with healthcare data, partnering with data engineers to deliver actionable insights for clinical and operational stakeholders. The role is remote-based, with a preference for candidates near Pittsburgh, PA, and requires strong SQL/Python skills, solid Power