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Added 8 mins ago
BS
Infrastructure and Operations Principal Architect, ITD
Brookhaven Science Associates, LLC
Upton, NY
- $126,000 to $222,500 USD / year
Brookhaven National Laboratory is seeking a multidisciplinary technical leader to serve as the Infrastructure and Operations (I&O) Principal Architect within the Information Technology…
Added 22 mins ago
Health Industry - Patient Access & Experience Manager
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As a Patient Access & Experience Manager in our Health Provider business, you lead and support patient access and experience transformations for complex provider organizations such as…
Added 1 hour ago
Professional Services, Program Manager
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Senior Product Manager, Data Platform
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Added 2 hours ago
Security Operations Technical Program Manager
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Tempe, AZ
Lead Security Operations Programs: Lead, plan, and execute strategic program initiatives for the Global Security Operations team.
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Senior Program Manager of Production Programs Portfolio 1
L3Harris
Camden, NJ
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CI
Manager/Principal Scientist Research & Development - Polymer Formulation
Cresilon, Inc.
Brooklyn, NY
- $130,000 to $180,000 USD / year
The R&D Manager/Principal Scientist - Polymer Formulation will lead the design, development, and implementation of novel formulations and polymer materials for use in medical devices,…
Added 2 hours ago
C
Program Manager B-52 (WBD) - (Part-Time) - 01.3.11
Credence
Tinker Air Force Base, OK
- Part-time
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Added 2 hours ago
Data Analytics and AI Integrator
Credence
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Senior Program Manager F-16 WAM (Top Secret)- 211
Credence
WPAFB, OH
Credence has an upcoming need for a Senior Program Manager who will be primarily responsible for supporting the Air Force Life Cycle Management Center WAM (AFLCMC/WAM) directorate, F-16…
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Program Manager - Aircraft Installation B-2 (WBZ) 01.6.06
Credence
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Added 3 hours ago
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Fremont, CA
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Senior Project Manager
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San Antonio, TX
The Senior Project Manager serves as the municipality’s lead advisor for complex, developer-led capital projects that advance public objectives. The role oversees planning, procurement,…
Added 3 hours ago
Program Manager, Transformation Office
AVEVA Solutions
Philadelphia, PA
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Added 4 hours ago
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Fort Worth, TX
…where the incumbent must possess an advanced level of quality engineering knowledge. Tasks at this level fall in areas where technical requirements are substantially complex. The Principal…
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Military Spouse Jobs & VetJobs
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Senior Project Superintendent (Traveling)
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Reporting to the General Superintendent, the Senior Project Superintendent provides overall administrative and technical management of the construction project. The Senior Superintendent…
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Senior Project Superintendent (Traveling)
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Poughkeepsie, NY
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Senior Project Superintendent (Traveling)
Consigli Construction
Albany, NY
Reporting to the General Superintendent, the Senior Project Superintendent provides overall administrative and technical management of the construction project. The Senior Superintendent…
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Senior Project Superintendent
Consigli Construction
White Plains, NY
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Senior Project Superintendent
Consigli Construction
NY · New York, NY
Reporting to the General Superintendent, the Senior Project Superintendent provides overall administrative and technical management of the construction project. The Senior Superintendent…
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Customer Service Manager-OMNI-AFDM
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Lead stakeholder engagement, onboarding readiness, adoption and outreach for users of a secure, distributed Data Mesh Environment. Serve as a primary liaison for government stakeholders and…

Closed listing

Highmark Health

Manager Strategic Risk Adjustment Programs

Charleston, WV, 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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