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Added 6 mins ago
A
Business Process Manager
Actalent
Oro Valley, AZ
- $60 to $70 USD / hour
Job Title: Business Process ManagerJob DescriptionThis onsite Business Process Manager role sits within a Commercial Product Development organization and focuses on driving continuous…
Added 12 mins ago
Telecommunications Specialist 4 (Technical Specialist 4) - San Antonio, TX
M.C. Dean, Inc
San Antonio, TX
Provide ISP/OSP input to the project's lead engineer and program manager for design reviews, plan acceptance, and program team meetings.
Added 15 mins ago
SW
(USA) Senior Manager, Finance
Sam's West, Inc.
United States
- $90,000 to $180,000 USD / year
Role summary: We are seeking a highly analytical, results-driven Senior Manager to join the Sam’s Club FP&A team. This individual contributor will play a critical role in driving financial…
Added 18 mins ago
JL
Human Resources Manager
Jack Link's Protein Snacks
Underwood, IA
- $85,000 to $100,000 USD / year
Link Snacks is looking for a seasoned Human Resources Manager to serve as a strategic and hands-on HR business partner to manufacturing leadership, providing guidance and support to…
Added 19 mins ago
BE
Manager Fraud Operations
Boeing Employees' Credit Union
Remote, United States
- $89,000 to $164,700 USD / year
As the Manager, Fraud Operations, you will play a critical role in protecting our members, employees, and organization from fraud-related threats. You will lead a team responsible for fraud…
Added 20 mins ago
GV
Senior Manager - Engineering Capability & Transformation Leader (m/f)
GE Vernova
Charleroi, PA
- $162,900 to $244,000 CAD / year
Engineering Development Program Ownership: Lead the Edison program and any other assigned, new Engineering development programs, including their ongoing strategy, refresh, and execution,…
Added 21 mins ago
Controller
Concurrent Technologies Corporation
Johnstown, PA
Oversee the planning, staffing, and execution of large-scale projects and programs, ensuring adherence to schedules, budgets, and strategic goals.
Added 21 mins ago
Director Product Management - HW Platforms
MSI - (Marvell Semiconductor Inc.) US
Santa Clara, CA
This is an in-person role based in the United States. As a Product Manager on the Platform team, you will own the product strategy, roadmap, and business execution for one or more platform…
Added 22 mins ago
Engineering Project Manager - Turbine Mechanical Solutions
Emerson
Pittsburgh, PA
…purpose. If you are a project management professional who wants to lead work that truly matters, this role offers a unique opportunity to shape the future of critical infrastructure. You…
Added 22 mins ago
T
Senior Director, Sr Relationship Manager
TIAA
State College, PA · Pittsburgh, PA · Philadelphia, PA
- $121,000 to $163,000 USD / year
The Sr Relationship Manager plays a crucial role in our mission to deliver lifetime income to all, responsible for deepening client relationships and identifying sales opportunities within…
Added 26 mins ago
Store Manager - Kay Jewelers - Tysons Corner Center
Sterling Jewelers Inc.
McLean, VA
Reporting to the District Manager (DM), the Store Manager (SM) will lead the day-to-day operations of a single store to achieve all sales, profitability, customer satisfaction, inventory…
Added 28 mins ago
KC
Sales Account Manager
KLA Corporation
Austin, TX
- $129,400 to $220,000 USD / year
Drive impact. Build partnerships. Win where technology meets strategy. We are looking for a Technical Sales Account Manager who thrives at the intersection of sophisticated engineering and…
Added 34 mins ago
CO
Administrative Manager
County of San Luis Obispo
San Luis Obispo County, CA
- $44.83 to $60.06 USD / hour
…Communications. The incumbent will provide dedicated leadership, strategic direction, and operational oversight to ensure these functions are effectively managed, appropriately resourced,…
Added 39 mins ago
VP, Paid Media
Buyerlink
Beverly Hills, CA
Buyerlink is looking for a hands-on, strategic performance marketing leader to own and scale paid social and native advertising for our Home Services and Automotive business. This role will…
Added 41 mins ago
Manager, Integrated Marketing
Phaedon, LLC
Minneapolis, MN
As our Manager, Integrated Marketing, you will turn our positioning and business goals into coordinated campaigns that run across channels and reach the right accounts with one consistent…
Added 41 mins ago
Senior Compensation Partner, Sales & Marketing
Autodesk
CO · OR · Denver, CO · Portland, OR · BC, CA · ON, CA · Denver · Portland
Serve as the primary compensation resource for the COO Sales client group. Partner with COO PBPs, who lead the business relationship, along with People Consultants (PCs) and Talent…
Added 46 mins ago
Group/Life Insurance Management Consulting Manager
Accenture LLP Company
United States
Life Insurance and Group Benefits Consulting Managers lead defined workstreams across complex transformation programs. They translate business objectives into operating model designs,…
Added 48 mins ago
Director of Centralized Catering Operations
Compass Group
Mountain View, CA
…balances hands-on floor presence in logistics with 30,000-foot strategic vision, challenging the status quo and questioning the 'why' behind legacy practices. Metrics-focused, organized,…
Added 48 mins ago
WU
(USA) Staff, Product Manager - WMC Data Foundation
Wal-Mart.com USA, LLC
United States
- $132,000 to $264,000 USD / year
As a Staff Product Manager, you will lead strategy and execution for complex products, driving end-to-end outcomes from discovery through value realization. This role requires deep…
Added 54 mins ago
North America Compliance Manager
John Deere
Moline
Serve as the Fraud Risk Management Program Lead and coordinate enterprise fraud risk management activities.
Added 54 mins ago
New Product Development Program Manager
TKC Thermo King LLC
Minneapolis, MN
Thermo King has an exciting new opportunity to join our organization as a New Product Development Program Manager. This role will lead cross–functional product development teams to deliver…
Added 54 mins ago
Arterial Account Manager - Pittsburgh - Peripheral Vascular
Stryker Employment Company, LLC
Pittsburgh, PA
Are you a strategic, clinically savvy sales professional passionate about driving meaningful impact in vascular care? Join us as an Arterial Account Manager, where you’ll operate with…
Added 56 mins ago
Senior Operations Business Analyst – Capital Fire Protection
HOME DEPOT U.S.A., INC.
United States
…performance, financial analysis, vendor accountability, and strategic initiatives across The Home Depot's Fire Pump and Sprinkler systems capital programs. This role partners with field…
Added 57 mins ago
AC
Communications Manager
Aston Carter
Saint Paul, MN
- $40.87 to $45.67 USD / hour
We are seeking an experienced Communications Manager to lead and execute strategic internal communications initiatives for a growing organization within the engineering and technical…
Added 57 mins ago
Philanthropy Specialist
Tulsa Zoo Management, Inc.
Tulsa, OK
…strategy, development, and execution of multiple donor engagement programs. This role is also responsible for developing, implementing, and evaluating strategies for success and…

Closed listing

Highmark Health

Manager Strategic Risk Adjustment Programs

Harrisburg, PA, 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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