Strategy Consultant - Risk Adjustment Accuracy

Location: Remote or hybrid in the United States; Pennsylvania-based employees living within 50 miles of an office must work onsite three days per week, Tuesday through Thursday.

Company

hirify.global provides health insurance and healthcare services, including risk adjustment programs across Medicare Advantage, Medicaid, and ACA lines of business.

What you will do

• Identify business issues with market and business owners and apply analytical frameworks to develop solutions and recommendations.
• Lead risk adjustment initiatives and strategy projects aligned with the department's strategic plan.
• Manage major projects with internal and external strategy consulting resources.
• Advise stakeholders on risk adjustment programs across Medicare Advantage, Medicaid, and ACA lines of business.
• Develop analytical methodologies and best practices for strategic decision-making.
• Provide guidance to junior team members and contribute performance input and development recommendations.

Requirements

• Master's degree in business, healthcare, economics, or a related field, or a bachelor's degree with three years of relevant progressive strategic experience in lieu of a master's degree.
• Two years of post-graduate experience in strategy or management consulting, or six years of related business or healthcare experience.
• Extensive knowledge of health insurance or provider operations and healthcare industry trends.
• Experience implementing and managing provider-facing or patient-facing programs for complete and accurate risk documentation.
• Knowledge of membership, rates, financial, economic, and competitive data.
• Strong critical thinking, communication, presentation, PowerPoint, and Excel skills.

Culture & Benefits

• Remote or hybrid work arrangement, with onsite attendance required three days per week for eligible Pennsylvania employees living within 50 miles of an office.
• Office-based or remote position with up to 25% travel.
• Regularly teaches and trains others.
• Work involves handling confidential customer information and requires compliance with HIPAA, data security policies, and the company code of conduct.