Hiring: Strategy Consultant - Risk Adjustment Accuracy Company: Highmark Location: United States Job Posted Time: 2026-09-03 14:40:24 Employment Type: Remote Target Skills & Keywords : Accessibility, HIPAA, Medicaid, Medicare, Microsoft Excel, Microsoft Office, Microsoft PowerPoint About the job Experience: •2 years of post-grad experience with strategy / management consulting firms (such as McKinsey, Boston Consulting Group, Booz & Company, Accenture (strategy Practice) or Deloitte (Strategy practice) ) or internal strategy groups of healthcare companies (such as Aetna, United Health Group, WellPoint, GE, ) •6 years of related experience in Business or Healthcare Required Skills: •Develop technical content (competitive intelligence, market trend analysis); 4) support development of formal recommendations to senior levels of Highmark leadership; 5) create documents that inform critical strategic issues and decisions. •This role can be hybrid or remote. However if you live within 50 miles of an office you are required to be onsite 3 days a week. T, W, TH. •Interface directly with business/ market owners to identify key business issues, apply right analytical 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 directly aligned with RAAM's strategic plan •Manage major strategy projects with the help of internal or external strategy consulting resources. •Serve as subject matter expert to Strategic Operations staff and stakeholders on risk adjustment programs for Medicare Advantage, Medicaid, and ACA lines of business. •Provide periodic informal work guidance/direction to junior team members; Provide performance input and recommendations to management for development/ training plans. May have supervisory responsibilities on a project basis. •Develop analytical frameworks, approach and methodology best practices to analyze strategy issues. Qualifications: •Masters Degree in Business, Healthcare, Economics or related degree •Bachelor's degree and 3 years of relevant progressive strategic experience in lieu of Master's degree •Extensive knowledge of Health Insurance and/or Provider operations •Extensive knowledge of government risk adjustment models, including CMS-HCC, HHS-HCC, and/or CDPS models •Extensive experience in implementing and managing provider-facing and/or patient-facing programs for the purposes of ensuring complete and accurate risk documentation •Through knowledge of membership, rates, financial, economic and competitive data •PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS •3 years of relevant progressive strategic experience in lieu of Master's degree Compensation: •Flexible work environment (work from home / hybrid options) •Extensive knowledge of Health Insurance and/or Provider operations Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!