Strategy Consultant - Utilization Management and Medical Policy
Core
Bridge clinical decision-making and operational finance by building data models to evaluate medical policy and utilization management strategies, quantifying financial impacts, and projecting future performance.
Role type
Senior Strategy Consultant (Healthcare Operations & Data)
Builds
Data models for cost savings, administrative costs, and performance projections for prior authorization lists
Domain
Healthcare (Utilization Management, Medical Policy, Healthcare Economics)
Deliverable
production ML models | dashboards & analysis
Required skills
Strategic thinking, data manipulation, financial modeling, stakeholder management, analytical framework development, project management, critical thinking, MS Office proficiency
Preferred skills
Advanced SQL, Python/R, Power BI/Tableau, healthcare claims data analysis, clinical terminologies (ICD-10, EHR), utilization management knowledge
Technologies
SQL, Python, R, Power BI, Tableau, MS Office
Responsibilities
Develop financial and operational models to evaluate strategies; extract and transform data from centralized IT offerings; partner with data engineering teams to translate technical assets into insights; execute tactical steps to achieve high-level strategic goals; identify key business issues and present data-backed recommendations to stakeholders
Seniority
Senior, hands-on IC with mentorship responsibilities
