Enterprise Risk Management Analyst providing expertise and governance on new products and services initiatives. Collaborating with teams across the organization to enhance risk management processes.
About the role
- Strategy Consultant focusing on Risk Adjustment Accuracy Management and clinical data strategy at Highmark Health. Collaborating on strategic initiatives with executive leadership and managing complex business issues.
Responsibilities
- Support executive leadership with a range of strategic initiatives, specifically focusing on Risk Adjustment Accuracy Management (RAAM) and clinical data strategy
- Work with business/market owners to identify key business issues
- Apply analytical frameworks, develop solutions and recommendations
- Manage major strategy projects with help from internal or external consulting resources
- Serve as subject matter expert on membership, growth and operational strategy issues
- Provide informal work guidance/direction to junior team members
- Develop analytical frameworks, approaches, and best practices to analyze strategy issues
- Other duties as assigned or requested.
Requirements
- Required Masters Degree in Business, Healthcare, Economics or related degree
- 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
- Extensive knowledge of Health Insurance and/or Provider operations, especially related to Risk Adjustment (preferred)
- Experience in operational improvement and process optimization (preferred)
- 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.
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development opportunities
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