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:
This role is hybrid or remote - If you live within 50 miles of an office you will be hybrid 3 days a week onsite. T, W, Th. Outside of 50 miles will be remote.
ESSENTIAL RESPONSIBILITIES
Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.
Plan, organize, staff, direct, and control the day-to-day operations of the department; develops and implements policies and programs as necessary; may have budgetary responsibility and authority.
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.
Supports Enterprise Strategy office in development of overall Enterprise Focus 5 strategy portfolio and cross-enterprise strategies as needed.
Other duties as assigned or requested.
EDUCATION
Required
Bachelor's Degree in Healthcare Administration, Finance, Economics, or related discipline or relevant experience and/or education as determined by the company in lieu of bachelor’s degree
Preferred
Master's Degree in Business or Public Health or an MD
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
None
LICENSES AND CERTIFICATIONS
Required
None
Preferred
None
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:
$126,400.00Pay Range Maximum:
$236,000.00Base 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.
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