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Added 4 mins ago
LN
Senior Project Manager
Luster National
Sacramento, CA
- $140,000 to $200,000 USD / year
…oversee delivery of rail systems on a major passenger rail program in several areas, including traction power, OCS, or wayside communications. We’re looking for real depth in one or more,…
Added 7 mins ago
Customer Service Representative-OMNI-AFDM
Centex Technologies
Remote, United States
…rollout plans, and user-success measures. Coordinate with the program manager and technical, product and business-analysis teams. This is a customer adoption and rollout role - not a…
Added 20 mins ago
HH
Quality Assurance & Compliance Manager
Helpful Hearts Health Services Inc
Columbia, MD
- $60,000 to $68,000 USD / year
The Quality Assurance & Compliance Manager (QA) is responsible for ensuring Helpful Hearts Health Services Inc’s compliance with all applicable federal, state, and local regulations…
Added 25 mins ago
Manager, Strategic Accounts (Remote)
BioTissue Holdings Inc
Miami, FL · Atlanta, GA · Dallas, TX · Charlotte, NC · Philadelphia, PA · New York, NY · Chicago, IL
The Manager, Strategic Accounts maximizes sales and profitability within strategic Health Systems, GPOs and Private Equity backed ocular organizations. The incumbent will establish, advance…
Added 48 mins ago
UO
Design and Construction Project Manager
University of Colorado Denver
Boulder, CO
- $82,000 to $87,500 USD / year
The Project Manager serves as a key representative of the University in the planning and execution of construction and renovation projects across campus. In this role, you will define…
Added 48 mins ago
UO
Design and Construction Estimator
University of Colorado Denver
Boulder, CO
- $114,000 to $129,000 USD / year
The PD&C department consists of three teams (Planning, Engineering, and Design & Construction) responsible for the planning, design, and construction of buildings on campus, in support of…
Added 50 mins ago
CONSTRUCTION SURVEILLANCE ENGINEER
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NEW ORLEANS, LA
A minimum of seven (7) years of experience as a Construction Manager, Field Engineer, Project Engineer or Quality Control Manager on commercial/industrial type facilities, utility or…
Added 53 mins ago
G
Quality Control Manager - Asphalt Production
GPAC
Denver, CO
- $120,000 to $150,000 USD / year
We are seeking an experienced Quality Control Manager to oversee our asphalt and aggregate quality control program. This individual will lead a team of laboratory technicians, ensure all…
Added 54 mins ago
G
General Superintendent - Structural Steel Construction (Traveling)
GPAC
Detroit, MI
- $130,000 to $170,000 USD / year
Coordinate design revisions, field modifications, and change orders.
Added 54 mins ago
G
Traveling General Superintendent - Structural Steel
GPAC
Cincinnati, OH
- $130,000 to $170,000 USD / year
Coordinate design revisions, field modifications, and change orders.
Added 1 hour ago
G
Traveling General Superintendent - Structural Steel
GPAC
Eau Claire, WI
- $130,000 to $170,000 USD / year
Coordinate design revisions, field modifications, and change orders.
Added 1 hour ago
SI
Senior Project Manager - Federal
STV, Inc.
Louisville, KY
- $7.25 USD / hour
STV is seeking an experienced Federal Design-Build Project Manager (PE/RA Required) to support our growing Federal Buildings practice. The ideal candidate is a licensed Professional…
Added 1 hour ago
Food Service - Food Service Runner
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For more than 50 years, SSA has partnered with cultural attractions to design the hospitality experience journey, freeing our partners to remain mission-focused.
Added 1 hour ago
Senior Account Manager, Consumer Electronics
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Remote, United States
The Senior Account Manager, Consumer Electronics is a senior commercial leadership role within Outform's Consumer Electronics Vertical, accountable for deepening the level of strategic…
Added 1 hour ago
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Senior Specialist-IC Market Risk Oversight & Governance I
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- $138,632 to $247,000 USD / year
…with stakeholders to implement the methodology, metrics, and program standards for the assigned portfolio to ensure compliance and effective monitoring, timely reporting and identification…
Added 1 hour ago
BO
Senior Specialist-IC Market Risk Oversight & Governance I
Bank of Montreal (U.S.)
Chicago, IL
- $138,632 to $247,000 USD / year
…with stakeholders to implement the methodology, metrics, and program standards for the assigned portfolio to ensure compliance and effective monitoring, timely reporting and identification…
Added 1 hour ago
Community Health and Nutrition Manager
Community FoodBank of New Jersey
Remote, United States
Support the design and implementation of a comprehensive dietetic internship program to expand CFBNJ’s ability to support and achieve priority community nutrition goals.
Added 1 hour ago
TU
Sr Regional Marketing Manager: Marketing Operations & Field Programs Manager
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Denver, CO
- $82,300 to $148,500 USD / year
…infrastructure allows. The Marketing Operations & Field Programs Manager is the person who builds and maintains that infrastructure. This role owns the vendor ecosystem that supports field…
Added 1 hour ago
UO
Marketing and Communications Specialist
University of Colorado Denver
Boulder, CO
- $58,200 to $67,500 USD / year
Design, Photography, and Digital Communications:
Added 1 hour ago
DH
Internal Communications Specialist III
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- $63,500 to $95,400 USD / year
…volunteers. Works closely with the Internal Communications Manager to improve internal communications throughout the health care delivery system. Participates in the planning and…
Added 1 hour ago
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…accounts. Provides subject matter expertise (SME) as project manager for assigned SRM fuel and non-fuel facilities. Provides advice and guidance to DLA representatives responding to OSD and…
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…Management approach. Join us to make a meaningful impact on a program of national…
Added 1 hour ago
Quality Control Manager - Media Services
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Six Sigma Black Belt - Iron River Area
The Pivot Group Network
Iron River · Iron River, MI
Run design of experiments and measurement system studies.

Closed listing

Highmark Health

Manager Strategic Risk Adjustment Programs

Richmond, VA, 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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