Strategy Consultant - Risk Adjustment jobs in United States
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Highmark · 1 day ago

Strategy Consultant - Risk Adjustment

Highmark Inc. is seeking a Strategy Consultant to support executive leadership with strategic initiatives focused on Risk Adjustment Accuracy Management and clinical data strategy. The role involves leading project teams, providing analytical insights, and developing recommendations to enhance business value.

Health CareHealth InsuranceInsuranceWellness
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H1B Sponsor Likelynote

Responsibilities

Work 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
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 membership, growth and operational strategy issues
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
Other duties as assigned or requested

Qualification

Analytical skillsHealthcare industry knowledgeClinical data standardsData integration technologiesHealthcare IT securityPC application skillsProblem-solving skillsCommunication skillsPresentation skillsCritical thinking skills

Required

Masters Degree in Business, Healthcare, Economics or related degree
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
Strong analytical and problem-solving skills
Strong PC application Skills (MS Office including PowerPoint and Excel)
Knowledge of healthcare industry trends and challenges, especially in the context of interoperability
Hands-on experience working with and applying clinical data standards (FHIR, CDA, HL7, etc.)
Experience leveraging data integration technologies and cloud platforms to address business needs
Proficiency in gathering and facilitating the translation of business requirements into technical requirements
Strong knowledge of healthcare IT security and privacy regulations (e.g., HIPAA)
Strong critical thinking skills
Good communication and presentation skills across various audience levels

Preferred

Extensive knowledge of Health Insurance and/or Provider operations, especially related to Risk Adjustment
Experience in operational improvement and process optimization

Company

Highmark

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Highmark provides health insurance plans for individuals and businesses.

H1B Sponsorship

Highmark has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (11)
2024 (7)
2023 (19)
2022 (21)
2021 (18)
2020 (23)

Funding

Current Stage
Late Stage
Total Funding
$27.3M
2018-04-06Grant· $25M
2014-08-07Grant· $2.3M

Leadership Team

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Deborah Rice-Johnson
CEO, Diversified Businesses at Highmark Inc. and Chief Growth Officer
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Paul Sikora
CTO Provider Services
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Company data provided by crunchbase