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Added 3 mins ago
BN
Manager, Inventory Control & Process Improvement
Blue Nile
NY · New York, NY
- $85,000 to $120,000 USD / year
The Manager, Inventory Control & Process Improvement is a newly created, highly visible role responsible for the accuracy, control, and health of Blue Nile's inventory. The role owns…
Added 23 mins ago
Manager, Transportation
Sysco
COLLEGE PARK, GA
None, however a CDL driver's license and certificate of Department of Transportation (DOT) regulations training is preferred. Important Notice for CDL Holders: If you hold a valid Class A…
Added 23 mins ago
Micro. Medical Technologist
PruittHealth
NORCROSS, GA
Assist Laboratory Manager with daily lab functions.
Added 23 mins ago
VP, Relationship Manager - Floor & Decor
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Alpharetta, GA
The VP, Relationship Manager is responsible for the performance of Floor & Decor and Installation Made Easy portfolios. This program will feature both a Consumer PLCC and Business Revolving…
Added 23 mins ago
Cook - Dietary (Experience)
PruittHealth
Atlanta, GA
The Dietary Aide Assists with food preparation in accordance with our established procedural guidelines, and as directed by the Food Service/Dietary Manager/Supervisor.
Added 23 mins ago
AU
Security Officer Flex Patrol Access Control
Allied Universal
Atlanta, GA
- $21.82 USD / hour
…schedule will vary week to week, based on a combination of manager-assigned shifts and those you pick up through our Earn More, Claim-A-Shift self-scheduling program. Shifts, days,…
Added 23 mins ago
AU
Security Officer Flex Patrol Availability
Allied Universal
Atlanta, GA
- $18.85 USD / hour
…schedule will vary week to week, based on a combination of manager-assigned shifts and those you pick up through our Earn More, Claim-A-Shift self-scheduling program. Shifts, days,…
Added 30 mins ago
Human Resources Site Specialist
Freeport McMoRan
Morenci, AZ
Manage the Drug & Alcohol program, working with all related stakeholders. Ensures processes and legal requirements are in place pertaining to D&A program are followed. Collaborates with…
Added 45 mins ago
Correctional Treatment Specialist (Case Manager)
Justice, Bureau of Prisons/Federal Prison System
Yazoo City, MS
…assist him in developing new adjustment techniques. The Case Manager helps the offender view problems objectively and to deal with them realistically. Routinely deals with community…
Added 45 mins ago
People and Culture Senior Manager / Starkville, MS
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Starkville, MS
Added 45 mins ago
Field Service Technician / 2026-18042 / Canton, MS
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Added 45 mins ago
Branch Manager-General Tool / 2026-17995 / Flowood
Sunbelt Rentals
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Added 45 mins ago
Project Manager | CDC | **NOT AN IT ROLE**
Nobis Works
Columbus, MS
The Project Manager’s primary responsibility will be to oversee the daily operations of Mail Screening and delivery to CDC facilities as well as supervising and handling all personnel…
Added 45 mins ago
Plant Quality Manager
Fairbanks Scales Inc.
Meridian, MS
Works directly with the managers, supervisors and operations team to develop effective employee training programs, develop and confirm competence, and drive implementation and compliance of…
Added 45 mins ago
Universal Banker II
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Job Description Universal Banker II Classification Non-Exempt Reports to: Bank Manager or Assistant Bank Manager Summary/Objective The Universal Banker ll (UB ll) must have exceptional…
Added 45 mins ago
Registered Nurse-Assistant Nurse Manager, Emergency Department
Veterans Affairs, Veterans Health Administration
Jackson, MS
Added 46 mins ago
UO
Insurance Specialist
University of Colorado Denver
Aurora, CO
- $33,800 USD / year
This position will report to and serve under the supervision of the Supervisor and Business Services Manager at the Department of Psychiatry.
Added 46 mins ago
UO
Coordinator for Undergraduate Programs
University of Colorado Denver
Boulder, CO
- $50,000 to $55,000 USD / year
Work with Career Operations Program Manager and Engagement, Marketing, and Communications team to plan and implement all details of the event, which will occur two times per year.
Added 46 mins ago
IP
HSE Manager
Integrated Power Ser
Denver, CO
- $40,123 USD / year
Extensive Training & Career Development Programs
Added 46 mins ago
UO
HR IT Program Manager
University of Colorado Denver
Boulder, CO
- $109,000 to $119,000 USD / year
Human Resources at CU Boulder invites applications for an HR IT Program Manager! This position will serve as a program manager for Human Resources Information Technology (HRIT) and reports…
Added 46 mins ago
IP
Customer Service Manager
Integrated Power Ser
Denver, CO
- $40,123 USD / year
Extensive Training & Career Development Programs
Added 46 mins ago
IP
Area Field Service Manager - Power Transformers
Integrated Power Ser
Denver, CO
- $40,123 USD / year
Extensive Training & Career Development Programs
Added 46 mins ago
UO
Crisis Counseling Manager
University of Colorado Denver
Denver, CO
- $84,206 to $93,070 USD / year
Job Description* Applications are accepted electronically ONLY at www.cu.edu/cu-careers *The Crisis Counseling Manager is a licensed mental health professional within the CU Denver Student…
Added 46 mins ago
UO
0.5 - 0.9 FTE MFM Diagnostic Medical Sonographer- MFM, Denver Metro
University of Colorado Denver
Aurora, CO
- $88,452 to $100,246 USD / year
…position reports directly to the MFM Operations and Strategy Manager and indirectly to the Medical Directors and the MFM Business Services Program…
Added 46 mins ago
GI
Business Development Executive, Large Enterprise Finance
Gartner, Inc.
Denver, CO
- $102,000 to $147,000 USD / year
Competitive salary, generous paid time off policy, charity match program, and more!

Closed listing

Highmark Health

Manager Strategic Risk Adjustment Programs

Columbia, SC, 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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Jobs in the United States

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0.5 - 0.9 FTE MFM Diagnostic Medical Sonographer- MFM, Denver Metro

Business Development Executive, Large Enterprise Finance

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