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Added 1 min ago
M
Senior Business Operations Manager
Microsoft
United States
- $97,600 to $206,400 USD / year
As WDS expands its Enterprise Commercial initiatives, we are establishing a new Senior Business Operations Manager role, focused on Enterprise Programs, to strengthen execution oversight…
Added 1 min ago
M
Principal Product Manager
Microsoft
WA · CA · Redmond, WA · Mountain View, CA · Redmond · Mountain View
- $142,800 to $304,200 USD / year
Bachelor's Degree AND 8+ years experience in product/service/program management or software development
Added 1 min ago
Experience Manager
Ulta Beauty, Inc.
Gresham, OR
Support all aspects of manager and associate professional development, including training, providing individualized competency-based feedback and coaching, performance reviews, succession…
Added 1 min ago
M
Principal Technical Program Manager
Microsoft
United States
- $142,800 to $304,200 USD / year
We are looking for a Principal Technical Program Manager to connect enterprise customer needs, field insights, and engineering execution across Microsoft's security portfolio. You will lead…
Added 1 min ago
M
Senior Hardware Engineer
Microsoft
WA · CA · OR · Redmond, WA · Mountain View, CA · Hillsboro, OR · Redmond · Mountain View · Hillsboro
- $119,800 to $261,000 USD / year
The SPPO (SCHIE Product and Procurement Optimization) team is seeking a Senior Hardware Engineer, Technical Program Manager to drive complex hardware initiatives. This role requires a…
Added 3 mins ago
Registered Nurse (RN) - Emergency Services (Campus Flex)
Confluence Health
Wenatchee, WA
Participates in performance evaluation/improvement processes with Director/Clinical Manager. Assumes responsibility for own professional development and personal growth.
Added 3 mins ago
Registered Nurse (RN) - Emergency Services (Campus Flex)
Confluence Health
Wenatchee, WA
Participates in performance evaluation/improvement processes with Director/Clinical Manager. Assumes responsibility for own professional development and personal growth.
Added 7 mins ago
Human Resources Technology Consultant
Regions Bank
Birmingham, AL · Charlotte, NC · Atlanta, GA
Focuses on product and service development, delivery and support, and applying key technologies
Added 13 mins ago
G
Generalist Commercial Lines Account Manager
GPAC
Clio, MI
- $65,000 to $85,000 USD / year
We are seeking an experienced Commercial Lines Account Manager to join an established insurance organization serving clients throughout Michigan.
Added 13 mins ago
G
Generalist Commercial Lines Account Manager
GPAC
Sault Ste Marie, MI
- $65,000 to $85,000 USD / year
We are seeking an experienced Commercial Lines Account Manager to join an established insurance organization serving clients throughout Michigan.
Added 13 mins ago
G
Generalist Commercial Lines Account Manager
GPAC
Rochester, MI
- $65,000 to $85,000 USD / year
We are seeking an experienced Commercial Lines Account Manager to join an established insurance organization serving clients throughout Michigan.
Added 13 mins ago
G
Generalist Commercial Lines Account Manager
GPAC
Woodhaven, MI
- $65,000 to $85,000 USD / year
We are seeking an experienced Commercial Lines Account Manager to join an established insurance organization serving clients throughout Michigan.
Added 13 mins ago
G
Generalist Commercial Lines Account Manager
GPAC
Fenton, MI
- $65,000 to $85,000 USD / year
We are seeking an experienced Commercial Lines Account Manager to join an established insurance organization serving clients throughout Michigan.
Added 13 mins ago
G
Generalist Commercial Lines Account Manager
GPAC
Zeeland, MI
- $65,000 to $85,000 USD / year
We are seeking an experienced Commercial Lines Account Manager to join an established insurance organization serving clients throughout Michigan.
Added 13 mins ago
G
Architecture Project Manager
GPAC
Denver, CO
- $90,000 to $110,000 USD / year
…architecture and design firm is seeking an Architecture Project Manager to join its team in the Grand Rapids, Michigan…
Added 14 mins ago
G
Architecture Project Manager
GPAC
Colorado Springs, CO
- $90,000 to $110,000 USD / year
…architecture and design firm is seeking an Architecture Project Manager to join its team in the Grand Rapids, Michigan…
Added 14 mins ago
G
Architecture Project Manager
GPAC
Aurora, CO
- $90,000 to $110,000 USD / year
…architecture and design firm is seeking an Architecture Project Manager to join its team in the Grand Rapids, Michigan…
Added 14 mins ago
G
Architecture Project Manager
GPAC
Fort Collins, CO
- $90,000 to $110,000 USD / year
…architecture and design firm is seeking an Architecture Project Manager to join its team in the Grand Rapids, Michigan…
Added 14 mins ago
G
Architecture Project Manager
GPAC
Lakewood, CO
- $90,000 to $110,000 USD / year
…architecture and design firm is seeking an Architecture Project Manager to join its team in the Grand Rapids, Michigan…
Added 14 mins ago
G
Architecture Project Manager
GPAC
Thornton, CO
- $90,000 to $110,000 USD / year
…architecture and design firm is seeking an Architecture Project Manager to join its team in the Grand Rapids, Michigan…
Added 14 mins ago
G
Architecture Project Manager
GPAC
Arvada, CO
- $90,000 to $110,000 USD / year
…architecture and design firm is seeking an Architecture Project Manager to join its team in the Grand Rapids, Michigan…
Added 14 mins ago
G
Architecture Project Manager
GPAC
Westminster, CO
- $90,000 to $110,000 USD / year
…architecture and design firm is seeking an Architecture Project Manager to join its team in the Grand Rapids, Michigan…
Added 14 mins ago
G
Architecture Project Manager
GPAC
Pueblo, CO
- $90,000 to $110,000 USD / year
…architecture and design firm is seeking an Architecture Project Manager to join its team in the Grand Rapids, Michigan…
Added 15 mins ago
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Architecture Project Manager
GPAC
Greeley, CO
- $90,000 to $110,000 USD / year
…architecture and design firm is seeking an Architecture Project Manager to join its team in the Grand Rapids, Michigan…
Added 15 mins ago
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Architecture Project Manager
GPAC
Phoenix, AZ
- $90,000 to $110,000 USD / year
…architecture and design firm is seeking an Architecture Project Manager to join its team in the Grand Rapids, Michigan…

Closed listing

Highmark Health

Manager Strategic Risk Adjustment Programs

Columbus, OH, United States

This opening has closed.

The original listing is kept below for reference.

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About employer

Job details

Posting language: English
Posted: Nov 6, 2026

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Original job description

Archived listing. The details below describe a past opening.

Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs (MA and ACA), using skills including, but not limited to: capability analysis and definition; operating model definition; incentive model design; governance and decision rights; process engineering, and metrics design. The incumbent works closely with senior/executive leadership, Physicians and technical staff within the Enterprise and within strategic hospital partners, to identify, prioritize, and deliver large and small scale projects that advance business outcomes and achieve strategic objectives relative to new and existing Risk Adjustment Programs. Supports other key objectives designed to build/strengthen patient care delivery and capture of Risk Adjustment documentation/ reporting capabilities, as well as driving continuous improvement efforts. Will be responsible for professional coaching and mentoring of program team members.

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; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
Lead the day-to-day execution of Strategic Risk Adjustment Program engagements taking ownership of the engagement deliverables, resources, and outcomes.
Develop the engagement business case, scope, staffing and incentive model for RPM engagement with Providers on internal programs (UDC, Internal Chart Retrieval and RSA).
Lead and manage project team members and/or external consultants by implementing and managing changes and interventions to ensure project goals are achieved.
Work closely with executive project sponsors and stakeholders to make communication easy and transparentto ensure ongoing alignment with project objectives, activities, and outcomes.
Regularly brief the executive leadership of the Enterprise (both Highmark and Highmark Health), including CFO, EVP, Chief Actuary, and Vice President, on project status including program strategy, performance, timelines, risks, and issues.
Evaluate risks to risk adjustment programs goals and objectives and escalate as appropriate.
Conduct periodic market review to understand industry leading practices and drive continuous improvement in department approaches, methods, and tools and organizational awareness of department capabilities.
Other duties as assigned or requested.

EDUCATION

Requied

Bachelor's Degree in Business Administration/Management or Computer and Information Science

Substitutions

Six (6) years relevant and progressive experience in lieu of Bachelor's degree

Preferred

Master's Degree in Business Administration/Management or Mental Health Services

EXPERIENCE

Required

7 - 10 years Project / Program Management

To Include

3 - 5 years Leadership
3 - 5 years Risk Revenue
1 - 3 years Strategic Planning

Preferred

3 - 5 years Healthcare Industry
1 -3 years Consulting
1 -3 years Cross-Functional Project Teams

LICENSES or CERTIFICATIONS

Required

None

Preferred

Project Management Professional (PMP)

SKILLS

Excellent Multi-Tasker
Analytical and Logical Reasoning/Thinking
Information Technology
Enterprise Systems
Financial Statements

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

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Rarely

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 position 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:

$102,700.00

Pay Range Maximum:

$164,600.00

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.

California Consumer Privacy Act Employees, Contractors, and Applicants Notice (https://dokumfe7mps0i.cloudfront.net/oms/4391/document/2026/1/doclib_458575_QLVK9_1769448333304228022_1769448333396/1769448333396.pdf)

Req ID: J291267

About employer

More about this job

Skills

ACA
Process engineering
Patient care
Documentation
Reporting
Process improvement
Coaching
Performance management
Communication skills
Mental health
Program management
Leadership
Strategic planning
Microsoft Teams
PMP
Computer technology
Financial statements
Sell products
Sales
Regulatory compliance

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