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Director Strategy - Risk Adjustment
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Director Strategy - Risk Adjustment
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PA, Working at Home - Pennsylvania
Company :
Highmark Inc.
Job Description :
JOB SUMMARY
The Director of Strategy for Risk Adjustment (Risk Adjustment Accuracy Management (RAAM)) plays a pivotal role in driving the strategic planning, operational efficiency, and programmatic execution within the RAAM department. This role is responsible for facilitating strategic initiatives, managing key projects, overseeing critical programs, and ensuring effective team coordination. The Director will act as a central point for managing performance reporting, budgetary oversight, and cross-functional engagement to optimize risk adjustment accuracy and achieve organizational goals.
Key Responsibilities:
ESSENTIAL RESPONSIBILITIES
EDUCATION
Required
Preferred
EXPERIENCE
Required
3 years of experience in a management or leadership role
3 years of experience as a consultant/client-facing member of services business, or 4 years of strategy experience,
2 years of experience in a healthcare related field, preferably inside health or hospital system or health plan
Preferred
LICENSES AND CERTIFICATIONS
Required
Preferred
SKILLS
Understanding of the healthcare industry
Ability to solve complex conceptual and operational problems; demonstrated ability to lead teams in problem-solving exercises
Strong quantitative and analytical skills
Demonstrated client relationship, influencing, and teamwork skills. Needs to be able to lead cross-functional, cross-BU teams in complex problem-solving exercises
Basic project management skills
Strong emotional intelligence, with servant leadership mind-set
Commitment to self development and the development of others
Language (Other than English):
None
Travel Requirement:
0% - 25%
PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS
Position Type
Office-based or Remote
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Rarely
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
Occasionally
Lifting: 25 to 50 pounds
Rarely
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:
$142,000.00
Pay Range Maximum:
$236,000.00
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
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Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.
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.
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Highmark provides millions of people with the security of quality health insurance
Our history of helping families and companies with their health insurance needs dates to the 1930s, when our predecessor companies were established to help Pennsylvania's residents pay for health care.
Highmark was created in 1996 by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) and Blue Cross of Western Pennsylvania (now Highmark Blue Cross Blue Shield). We are now one of the largest health insurers in the United States.
Highmark's officers and board of directors set the company's strategic direction and corporate policies. They are guided by our mission, vision and values.