Strategy Consultant – Medical Policy

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…