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Added 1 min ago
VH
Nursing Assistant
Veterans Health Administration
Dayton, OH
- $37,650 to $61,471 USD / year
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Added 1 min ago
VH
Nurse Manager - Community Living Center
Veterans Health Administration
Bath, NY
- $107,175 to $142,540 USD / year
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VAInsurance: Federal health/vision/dental/term life/long-term care (many federal…
Added 1 min ago
VH
Registered Nurse - Community Living Center
Veterans Health Administration
Fort Meade, SD
- $71,638 to $134,624 USD / year
Serve as a clinical resource and liaison between nursing staff and the Nurse Manager to support communication and coordinated care delivery.
Added 1 min ago
VH
License Practical Nurse (SE Gilbert, VAH HCC, Outpatient Clinic)
Veterans Health Administration
Gilbert, AZ
- $48,240 to $82,972 USD / year
Education. Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing Accrediting Commission…
Added 1 min ago
DA
Emergency Management Specialist
Deputy Assistant Secretary for Finance
Austin, TX
- $109,428 to $142,259 USD / year
Plan and monitor development and administration of a risk-based Comprehensive Emergency Management Program (CEMP) which supports the Office of Management and subordinate/field locations.
Added 1 min ago
VH
Physical Therapist - Physical Therapy/Kinesiotherapy Supervisor - EDRP Authorized
Veterans Health Administration
Temple, TX
- $110,392 to $143,511 USD / year
(4) Foreign Graduates. Graduates of foreign physical therapy programs meet the requirements in subparagraph 3b if they have a full unrestricted and current license to practice physical…
Added 1 min ago
VH
License Practical Nurse (SE Gilbert, VAH HCC, Outpatient Clinic)
Veterans Health Administration
Gilbert, AZ
- $48,240 to $82,972 USD / year
Education. Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing Accrediting Commission…
Added 1 min ago
VH
Biomedical Engineer
Veterans Health Administration
Chesapeake, VA · Hampton County, VA
- $61,008 to $140,686 USD / year
…facility. Works in support of the medical equipment management program. In addition to duties at the full performance level, the BME assists in the maintenance of medical servers and…
Added 1 min ago
VH
Supervisory Social Worker (HUD-VASH)
Veterans Health Administration
Spokane, WA
- $93,537 to $121,601 USD / year
This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in…
Added 1 min ago
VH
Licensed Practical Nurse
Veterans Health Administration
Washington, DC
- $51,811 to $87,810 USD / year
Education - Graduate of a school of practical or vocational nursing approved by the appropriate State agency and/or accredited by the National League for Nursing Accrediting Commission…
Added 1 min ago
AN
SUPERVISORY FACILITY OPERATIONS SPECIALIST
Air National Guard Units
Camp Murray, WA
- $83,935 to $109,122 USD / year
Incumbent typically supervises the following personnel and their functions: Production Control (Construction), Production Controller, Power Production Technician, Water & Fuels Maintenance…
Added 1 min ago
VH
Optometrist
Veterans Health Administration
Warren, OH
- $110,000 to $350,000 USD / year
Paid Time Off: 50-55 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year and possible 5 day paid absence for CME)
Added 1 min ago
TS
Transportation Security Officer
Transportation Security Administration
Florence, SC
- $40,736 to $56,844 USD / year
Engaging in continuous development of critical thinking skills, necessary to mitigate actual and potential security threats, by identifying, evaluating, and applying appropriate situational…
Added 1 min ago
AN
SURFACE MAINTENANCE MECHANIC
Army National Guard Units
North Las Vegas, NV
- $35 to $41 USD / hour
Independently performs repairs and maintenance functions in remote locations that can beaccomplished by removing, cleaning, reinstalling, or replacing defective parts of components…
Added 1 min ago
VH
Pharmacy Technician - Outpatient
Veterans Health Administration
Hot Springs, SD
- $57,603 to $74,885 USD / year
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Added 4 mins ago
VH
Psychologist (PCMHI)
Veterans Health Administration
Ventura, CA
- $105,262 to $195,037 USD / year
New VHA psychology internship programs that are in the process of applying for APA accreditation are acceptable in fulfillment of the internship requirement, provided that such programs…
Added 4 mins ago
AF
SUPERVISORY COMMUNITY PLANNER
Air Force Special Operations Command
Cannon AFB, NM
- $106,437 to $138,370 USD / year
The primary purpose of this position is: To serve as Chief and program manager, organizing, directing, and exercising control over nonsupervisory employees within the Civil Engineer…
Added 4 mins ago
VH
Clinical Laboratory Scientist
Veterans Health Administration
Wyoming, MI
- $61,555 to $118,435 USD / year
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Added 4 mins ago
VH
Audiologist
Veterans Health Administration
Anderson, SC · Greenville, SC
- $74,678 to $116,362 USD / year
Incumbent plans, conducts, and coordinates auditory (aural) rehabilitation, tinnitus and/or vestibular rehabilitation programs for patients; designs patient-centered treatment plans to…
Added 4 mins ago
VH
Blind Rehabilitation Outpatient Specialist
Veterans Health Administration
Des Moines, IA
- $75,284 to $117,307 USD / year
This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and…
Added 4 mins ago
VH
Audiologist
Veterans Health Administration
Anderson, SC · Greenville, SC
- $74,678 to $116,362 USD / year
Incumbent plans, conducts, and coordinates auditory (aural) rehabilitation, tinnitus and/or vestibular rehabilitation programs for patients; designs patient-centered treatment plans to…
Added 4 mins ago
VH
Blind Rehabilitation Outpatient Specialist
Veterans Health Administration
Des Moines, IA
- $75,284 to $117,307 USD / year
This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and…
Added 4 mins ago
VH
Medical Support Assistant
Veterans Health Administration
Kansas City, MO
- $49,745 to $64,669 USD / year
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Added 4 mins ago
VH
Training Instructor
Veterans Health Administration
Reno, NV
- $61,965 to $80,559 USD / year
Evaluates training courses for EMS's training programs and works closely with senior specialists to evaluate courses to enhance EMS's overall training program.
Added 4 mins ago
NP
Maintenance Worker Leader (Trails)
National Park Service
Los Alamos, NM
- $29 to $34 USD / hour
For current Federal employees, if hours worked per week are not included on your resume, you must submit a non-award SF-50 as part of your application to be used to validate your work…

Closed listing

Highmark Health

Manager Strategic Risk Adjustment Programs

Boston, MA, United States

This opening has closed.

The original listing is kept below for reference.

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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

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