Strategy Consultant - Medical Policy

Highmark Health • Pierre, SD • 5d ago

Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job supports executive leadership of the Organization with a range of strategy activities essential to the Organization's membership and margin goals. Provide analytical/strategic-thinking and leadership support that enables the medical policy and utilization management teams to: 1) isolate business issues; 2) design and execute analytics for studying business issues (market research, scenario planning, forecasting, market share, profitability, etc.); 3) develop technical content (competitive intelligence, market trend analysis); 4) support development of formal recommendations to senior levels of Highmark leadership; 5) create documents (ex. operational strategies) that inform critical strategic issues and decisions.

ESSENTIAL 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.

EDUCATION

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

Substitution

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

Preferred

Extensive knowledge of Health Insurance and/or Provider operations

Experience in operational improvement

Through knowledge of membership, rates, financial, economic and competitive data

Knowledge of medical policy

LICENSES or CERTIFICATIONS

Required

None

Preferred

None

SKILLS

Broad application of principles, theories, and concepts in strategic thinking, plus working knowledge of other related fields

Strong PC application Skills (MS Office including PowerPoint and Excel)

Knowledge of healthcare industry trends and challenges

Strong critical thinking skills

Good communication and presentation skills

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Never

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Never

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$92,300.00

Pay Range Maximum:

$172,500.00

Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J273815

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