Strategy Lead: Risk Adjustment Accuracy

Highmark Health; Boston (MA); 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 analyze market trends, forecast scenarios, and develop actionable recommendations for senior leadership, shaping risk-adjusted strategies across Medicare, Medicaid, and ACA lines.

The role supports hybrid or remote work, with onsite presence three days/week within 50 miles of an office. Strong communication and leadership capabilities are required.

Qualifications

• Masters Degree in Business, Healthcare, Economics or related degree
• 2 years of post-grad experience with strategy / management consulting firms or healthcare internal strategy groups
• 6 years of related experience in Business or Healthcare

Responsibilities

• Identify key business issues with owners and apply analytical frameworks to develop solutions and recommendations
• Lead delivery of evolving risk adjustment initiatives aligned with RAAM's strategic plan
• Manage major strategy projects with internal or external resources
• Serve as SME to Strategic Operations on risk adjustment programs for Medicare Advantage, Medicaid, and ACA lines
• Provide guidance to junior team members and support training plans

Skills

Strategic thinking

MS Office

PowerPoint

Excel

Healthcare industry knowledge

Communication skills

Presentation skills

Education

Masters Degree in Business, Healthcare, Economics or related degree

2 years of post-grad experience with strategy/management consulting

6 years of related experience in Business or Healthcare

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

Tools

MS Office Suite

Strategy consulting experience

Data analysis frameworks

Job description

Highmark Inc. is seeking a strategic leader to support the Risk Adjustment Accuracy Management (RAAM) department. You will analyze market trends, forecast scenarios, and develop actionable recommendations for senior leadership, shaping risk-adjusted strategies across Medicare, Medicaid, and ACA lines.

The role supports hybrid or remote work, with onsite presence three days/week within 50 miles of an office. Strong communication and leadership capabilities are required.