[Hiring] Strategy Consultant @Highmark Health

Role Description

We are seeking a highly tactical and data-fluent Strategy Consultant to drive change within our Utilization Management and Medical Policy operations. In this role, you will bridge the gap between clinical decision-making and operational finance. You are a "doer" who can take a defined strategic goal, determine the tactical steps to achieve it, and get your hands dirty building the data models to prove it out. You will operate with a high degree of self-sufficiency, manipulating standardized healthcare data assets to build business cases, track administrative costs, and project future performance.

Key Responsibilities

• Develop Financial & Operational Models:
  • Build and implement robust data models to evaluate medical policy and utilization management strategies, quantify financial and operational impacts, and measure actual performance against expected outcomes.
• In the First 90 Days:
  • Lead the development of a foundational model accounting for cost savings and administrative costs at a procedure-code level for our prior authorization list, including trend analysis and future projections.
• Perform Hands-On Data Manipulation:
  • Extract and transform data from centralized IT/data offerings to create a fit-for-purpose data layer conducive to analyses.
• Cross-Functional Collaboration:
  • Partner with data engineering teams to secure necessary data assets, and translate those technical assets into actionable insights for clinical and operational stakeholders.
• Execute Tactical Strategy:
  • Work within leadership's strategic boundaries to independently define and execute the day-to-day tactical steps required to achieve high-level goals.

This is a remote based role, however we would like someone close to Pittsburgh, PA.

Qualifications

• 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.
• Substitution: Bachelor's degree and 3 years of relevant progressive strategic experience in lieu of Master's degree.

Requirements

• 3–5+ years in healthcare strategy, healthcare economics, clinical analytics, or a related consulting role focused on tactical execution.
• Highly proficient in data manipulation and modeling (e.g., advanced SQL, Python/R, or complex Power BI/Tableau builds).
• Deep understanding of healthcare financial and operational datasets (claims, procedure codes, cost-of-care).
• Working knowledge of Utilization Management, Medical Policy, and clinical terminologies (EHR, ICD-10, interoperability standards).
• Proven ability to collaborate with highly technical data teams and present compelling, data-backed operational changes to clinical leaders.

Benefits

• Pay Range Minimum: $108,600.00
• Pay Range Maximum: $180,600.00
• 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.

Company Description

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.

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