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Added 1 min ago
BN
Software Developer
Boldyn Networks US Operations LLC
Remote, United States
- $110,000 to $130,000 USD / year
Passionate about software design? Your next role could deliver the software that powers a smart, inclusive, and sustainable future for higher education. We’re on the lookout for an…
Added 4 mins ago
Executive Director, Head, Global Trial Optimization
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Upper Gwynedd, PA
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Added 4 mins ago
Data Expert - Data and Automation GenAI Governance
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Firstside Center Bldg, PA
Application Design, Architecture, Business Intelligence, Data Architecture, Data Governance, Data Mining, Emerging Technologies, Informatics/Information Sciences, IT Standards, Procedures &…
Added 4 mins ago
WP
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West Pharmaceutical Services
Jersey Shore, PA
- Part-time
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Added 4 mins ago
Sr. Manager, Commercial Operations
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…Operations to improve decision-making through automation and data insights while ensuring a best-in-class customer experience. This position also provides leadership for the Customer…
Added 4 mins ago
Sr. Manager, Commercial Operations
Dorman Products, Inc.
Colmar, PA
…Operations to improve decision-making through automation and data insights while ensuring a best-in-class customer experience. This position also provides leadership for the Customer…
Added 4 mins ago
Sr. Manager, Commercial Operations
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Colmar, PA
…Operations to improve decision-making through automation and data insights while ensuring a best-in-class customer experience. This position also provides leadership for the Customer…
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Added 4 mins ago
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Added 4 mins ago
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…position, balancing direct early discovery project support (~50%), design, and deployment of data science and machine learning models (~50%). They will apply advanced computational…
Added 4 mins ago
GV
Senior Manager - Engineering Capability & Transformation Leader (m/f)
GE Vernova
Charleroi, PA
- $162,900 to $244,000 CAD / year
…translating business demand signals, attrition risk, and pipeline data into actionable workforce decisions in partnership with talent management, talent acquisition, HR business partners,…
Added 4 mins ago
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Added 4 mins ago
CNC Machinist (Operator A) - 2nd Shift
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Experience or formal education in design/drafting with emphasis on CAD
Added 4 mins ago
SL
Full Time Physical Therapist
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- Full-time
…patient’s functional abilities. The Physical Therapist will design and implement individualized treatment plans that address the specific goal and needs of each patient, as well as…
Added 4 mins ago
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…software on product models to determine most efficient tooling design and metal pouring processes 15. Design methods to ensure product quality 16. Evaluate effects of product design changes…
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Coaldale, PA
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Added 4 mins ago
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Analytics Director, Data Modeling and Automation
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Statewide, PA
- $130,000 to $145,000 USD / year
The Director, Analytics Data Modeling & Automation leads a high-performing team responsible for the design, development, governance, and support of Biomedical Services analytics data…
Added 4 mins ago
DA
Board Certified Behavior Analyst
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- $86,000 to $90,000 USD / year
Review behavioral data, evaluate treatment effectiveness, and modify interventions based on clinical outcomes.
Added 4 mins ago
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Added 4 mins ago
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Coatesville, PA
Added 4 mins ago
Associate Director, Marketing
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…launch readiness. The ideal candidate will be a strategic, data-driven marketer who thrives in ambiguity, brings strong problem-solving skills, collaborates effectively across functions,…
Added 4 mins ago
Associate Director, Digital Engagement Operations (Hybrid)
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North Wales, PA
…among marketing teams, information technology, user experience/design, content publishing, analytics, legal, regulatory, medical review partners, accessibility discoverability specialists,…
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Manufacturing Engineer I
Honeywell Aerospace
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Collaborate with design, quality, and production teams to ensure manufacturability and product quality.

Closed listing

Highmark Health

Manager Strategic Risk Adjustment Programs

Topeka, KS, 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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