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Added 8 mins ago
Pharmacy Technician Home Delivery Call Center
Intermountain Health
Cheyenne, WY
…verifying and monitoring controlled substance inventories to ensure security, accuracy, cost effectiveness, and 340B/Charging management as required to practice…
Added 8 mins ago
Powell Preschool Teacher
Absaroka Head Start
Powell, WY
POSITION: PRESCHOOL TEACHER ** ** **IMMEDIATE ** **SUPERVISOR: ** Education Manager **SUPERVISES: ** Teacher Aide **CLASSIFICATION: ** Exempt **GENERAL SUMMARY: ** Work as the lead in a…
Added 11 mins ago
Pharmacy Technician Home Delivery Call Center
Intermountain Health
Pierre, SD
…verifying and monitoring controlled substance inventories to ensure security, accuracy, cost effectiveness, and 340B/Charging management as required to practice…
Added 16 mins ago
Licensed Practical/Vocational Nurse
Veterans Affairs, Veterans Health Administration
Fort Harrison, MT
Added 16 mins ago
Licensed Practical/Vocational Nurse
Veterans Affairs, Veterans Health Administration
Fort Harrison, MT
Added 21 mins ago
Training Instructor (Vocational Training Instructor - Culinary)
Justice, Bureau of Prisons/Federal Prison System
Salters, SC
…training instructor in a vocational or occupational training program in the Education Department of a Federal Bureau of Prisons (BOP) correctional facility and may also serve as a program…
Added 21 mins ago
EC
Team Lead - Daylight (4x10's)
Eaton Corporation
Jonesville, SC
- $29 to $32 USD / hour
Educational Assistance Program, Employee Discounts, and many more!
Added 22 mins ago
EC
NPI Engineering Manager
Eaton Corporation
Sumter, SC
- $113,000 to $165,000 USD / year
Eaton’s ES AMER ARS division is currently seeking a NPI Engineering Manager. Relocation assistance will be provided for candidates residing outside a 50-mile radius of Sumter, SC!
Added 22 mins ago
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Deputy Project Quality Manager-Kiewit Nuclear Solutions-ID
Kiewit
Aiken, SC
- $134,000 to $140,000 USD / year
Located at the project location, the Project Quality Manager (PQM) is responsible for the development, implementation, and management of a contract-specific Project Quality Plan (PQP) and…
Added 38 mins ago
Registered Nurse (O-2/O-3/O-4 Billet) Non-Supervisory
Immigration and Customs Enforcement
Eloy, AZ
…accordance with agency directives. Maintains non-involvement in the security/custody aspects of care. Assists the medical provider with medical appointments by taking the detainees vital…
Added 38 mins ago
Facility Health and Safety Officer (O-5 Billet) Non-Supervisory
Immigration and Customs Enforcement
Eloy, AZ
…control; occupational health; environmental health, safety and security; and all hazards emergency preparedness and response. Serves as a key member of IHSC National PHSP program…
Added 38 mins ago
Registered Nurse (O-2/O-3/O-4 Billet) Non-Supervisory
Immigration and Customs Enforcement
Florence, AZ
…accordance with agency directives. Maintains non-involvement in the security/custody aspects of care. Assists the medical provider with medical appointments by taking the detainees vital…
Added 38 mins ago
Clinical Pharmacist
Veterans Affairs, Veterans Health Administration
Prescott, AZ
Added 38 mins ago
Pharmacy Technician
Veterans Affairs, Veterans Health Administration
Prescott, AZ
Added 38 mins ago
Supervisory Acquisition Utilization Specialist
Veterans Affairs, Veterans Health Administration
Prescott, AZ
Added 38 mins ago
Supervisory Social Worker
Veterans Affairs, Veterans Health Administration
Prescott, AZ
Added 38 mins ago
Lead Medical Support Assistant
Veterans Affairs, Veterans Health Administration
Gilbert, AZ
Added 38 mins ago
Inventory Management Specialist
Veterans Affairs, Veterans Health Administration
Tucson, AZ
Added 38 mins ago
AE
Senior Manager - Application Security Research
American Express
Phoenix, AZ
- $123,000 to $215,250 USD / year
American Express is seeking a highly technical and innovative Senior Manager of Application Security Research to help advance our application security research, vulnerability discovery, and…
Added 38 mins ago
Physical Therapist (Clinical Specialist) - Neurology
Veterans Affairs, Veterans Health Administration
Phoenix, AZ
Added 38 mins ago
Program Specialist
Veterans Affairs, Veterans Health Administration
Phoenix, AZ
Added 47 mins ago
CP
Fleet Technician
CALIFORNIA PATROL OPERATIONS
SACRAMENTO, CA
- $16.9 to $18.5 USD / hour
California Patrol Operations is a private security company that currently holds many contracts from property management to business owners, to big public contracts like both Florin Road and…
Added 48 mins ago
BP
Manager of IT Security
Babcock Power
Louisville, KY
- $120,000 to $165,000 USD / year
The Manager of IT Security provides leadership for day-to-day security operations while helping advance the organization’s security strategy, operating model, and program maturity. This…
Added 48 mins ago
BP
Manager of IT Security
Babcock Power
Marlborough, MA
- $120,000 to $165,000 USD / year
The Manager of IT Security provides leadership for day-to-day security operations while helping advance the organization’s security strategy, operating model, and program maturity. This…
Added 49 mins ago
Manager, Enterprise Communications & Channels
Amentum
Jefferson City, MO
…address their most significant and complex challenges in science, security and sustainability. Headquartered in Chantilly, Virginia, we have approximately 50,000 employees in more than 70…

Closed listing

Highmark Health

Manager Strategic Risk Adjustment Programs

Santa Fe, NM, 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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