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Added 1 min ago
O
Lead Software Engineer - City
OKC
OKLAHOMA CITY, OK · Oklahoma City, OK
- $39.52 to $60.39 USD / hour
The Lead Software Engineer is responsible for being a lead technical resource on a team of software engineers and developers and ensuring the successful delivery of high-quality software…
Added 4 mins ago
Store Manager - Kay Jewelers - Town Square Las Vegas
Sterling Jewelers Inc.
Las Vegas, NV
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 4 mins ago
Store Manager - Kay Jewelers Outlet - Tanger Outlet Center - Locust Grove
Sterling Inc
Locust Grove, GA
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 6 mins ago
Inert Process Engineering First Line Manager (Manufacturing Manager 3)
Los Alamos National Laboratory
Los Alamos, NM
The successful First Line Manager will provide effective personnel management while leading Process Engineering activities. Process Engineering is tasked with the development,…
Added 6 mins ago
Weapons Product Definition Deputy Group Leader (R&D Manager 3)
Los Alamos National Laboratory
Los Alamos, NM
…Office to develop budgets, staffing plans, and execute the strategic vision of the group. This may include creating project plans, monitoring milestones, and guiding technical staff to…
Added 6 mins ago
Work Execution Manager (Maintenance Manager 3)
Los Alamos National Laboratory
Los Alamos, NM
As the Work Execution Manager (WEM), you will provide technical leadership and day-to-day management for the Workplace Experience work execution team. This highly visible position requires…
Added 6 mins ago
Earth & Environmental Sciences Deputy Division Leader (R&D Manager 5)
Los Alamos National Laboratory
Los Alamos, NM
Strategy: Experience in strategic planning and implementation to identify challenges and opportunities, foster science, strengthen an organization, build technical capability, and improve…
Added 6 mins ago
Manager of Projects 3
Los Alamos National Laboratory
Los Alamos, NM
…leader to manage multiple concurrent work fronts while providing strategic direction and oversight to Project Managers, Construction Managers and Construction Superintendents in support of…
Added 6 mins ago
CA
Senior Manager, Upward Mobility
CAPITAL AREA FOOD BANK
Washington, DC
- $86,300 to $116,800 USD / year
The Senior Manager of Upward Mobility plays a critical role in advancing the Capital Area Food Bank’s mission and strategic priorities by managing and growing CAFB’s Upward Mobility work, a…
Added 6 mins ago
Human Resources Manager 2
Los Alamos National Laboratory
Los Alamos, NM
Lead Workforce Lifecycle Operations: Oversee backgrounds, new-hire transactions, work locations and guests, and student and postdoctoral employment programs, balancing priorities and…
Added 6 mins ago
Radiation Protection Team Leader (Radiation Protection Manager 3)
Los Alamos National Laboratory
Los Alamos, NM
…(RP) professional to provide leadership and oversite for RP programs. This is a unique opportunity with great growth potential to support national and global…
Added 6 mins ago
Control Account Manager (Science-Engineer Program Manager 2/3)
Los Alamos National Laboratory
Los Alamos, NM
As a Science-Engineer Program Manager 2-3 (SE-PM 2-3) within the Associate Laboratory Directorate for Weapons Production (ALDWP) you will manage control accounts within the Plutonium…
Added 6 mins ago
Regional Claims Manager
Hub International
Las Cruces, NM
Lead advocacy efforts on first party property claims frominitialreport through settlement, challenge carrierpositionsand work to maximize recovery for clients
Added 6 mins ago
Construction Risk Manager
Yearout Mechanical LLC
Albuquerque, NM
Yearout Mechanical is looking for a Construction Risk Manager to join their team in Albuquerque, NM. The Construction Risk Manager identifies, evaluates, and mitigates contractual,…
Added 6 mins ago
Directed Energy Materials Planning and Production Control Manager
AeroVironment
Albuquerque, NM
…inventory levels, and manufacturing schedules are aligned with program objectives, engineering requirements, customer commitments, quality standards, and financial targets. The manager…
Added 6 mins ago
Manager Strategic Risk Adjustment Programs
Highmark Health
Santa Fe, NM
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…
Added 6 mins ago
Principal Aftermarket Technical Product Manager
GE Aerospace
Santa Fe, NM
As Principal Technical Product Manager – Aftermarket, you will own the product vision, strategy and roadmap for the digital solutions that support the Service & Repair value streams in…
Added 6 mins ago
Manager, CAM Business Operations Lead
CVS Health
Santa Fe, NM
The Claims Assist Manager (CAM) team is seeking a Manager, CAM Business Integration & Readiness, to support the implementation and operational integration of CAM capabilities across…
Added 7 mins ago
M
Senior ALC Developer PART TIME
Maximus
Santa Fe, NM
- Part-time
Lead and contribute to technical architecture, system design, and strategic development planning.
Added 7 mins ago
GA
Principal Technical Product Manager, Data & Platform
GE Aerospace
Santa Fe, NM
- $152,000 to $222,000 USD / year
…Defense & Systems (D&S) business, the Principal Technical Product Manager, Data & Platform owns the D&S Palantir Foundry environment and leads delivery across the technical teams that build…
Added 9 mins ago
GE
Principal Technical Product Manager, Data & Platform
General Electric Company
United States
- $152,000 to $222,000 USD / year
…Defense & Systems (D&S) business, the Principal Technical Product Manager, Data & Platform owns the D&S Palantir Foundry environment and leads delivery across the technical teams that build…
Added 12 mins ago
GA
Principal Technical Product Manager, Data & Platform
GE Aerospace
Providence, RI
- $152,000 to $222,000 USD / year
…Defense & Systems (D&S) business, the Principal Technical Product Manager, Data & Platform owns the D&S Palantir Foundry environment and leads delivery across the technical teams that build…
Added 14 mins ago
Fleet Maintenance Manager – Waste Pro – Heavy Duty Diesel – West Palm Beach, FL
Waste Pro
West Palm Beach, FL
As the Fleet Maintenance Manager, you will lead all aspects of a high-volume maintenance operation supporting a fleet of approximately 110 heavy-duty diesel trucks. You will be responsible…
Added 16 mins ago
M
Senior ALC Developer PART TIME
Maximus
Annapolis, MD
- Part-time
Lead and contribute to technical architecture, system design, and strategic development planning.
Added 16 mins ago
Program Manager w/Public Trust
TekSynap
Suitland, MD
We are seeking a Program Manager to support a federal agency. Lead all contract operations supporting a large federal enterprise infrastructure and end-user support environment. Serve as…

Closed listing

Highmark Health

Manager Strategic Risk Adjustment Programs

Providence, RI, 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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