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Added 5 mins ago
J
Provider Escalation and Education Senior Manager
Jobgether
Remote, United States
- $110,500 to $150,000 USD / year
As a Provider Escalation and Education Senior Manager, you will lead the resolution of complex healthcare claims disputes while strengthening payment accuracy, regulatory compliance, and…
Added 8 mins ago
WJ
Administrative Secretary III ~ Educational Services ~ School Year 2026-2027 #27-97 REPOST
Woodland Joint Unified
Woodland, CA
- $23.15 to $28.14 USD / hour
…taking and transcribing of complex, specialized, or highly technical dictation, development and administration of office systems; independent research; assistance in budget development and…
Added 8 mins ago
SM
Elementary Principal - Grant Elementary School
Santa Monica-Malibu Unified
Santa Monica, CA
- $133,407 to $162,157 USD / year
…designs, and to execute procedures to evaluate instructional program effectiveness; to plan, develop, and conduct professional development and staff training programs; to plan, develop, and…
Added 10 mins ago
CO
Supervising Financial Analyst
City of Sacramento
Sacramento, CA
- $49.26 to $69.32 USD / hour
Limited direction is provided by a department head, or division manager on specific assignments. Responsibilities include direct and indirect supervision over professional, technical, and…
Added 16 mins ago
C
Eligibility Supervisor**County Promotional Only
CalHR
Willows, CA
- $30.1 to $36.6 USD / hour
…of this level is to provide supervisory, administrative and technical support to an eligibility work unit engaged in determining initial and continuing eligibility for multiple public…
Added 28 mins ago
Senior Manager – CMP/BTG, APTD Process
Micron Technology, Inc.
Boise, ID
…materials engineering, and manufacturing, tackling complex technical challenges and partnering across global organizations to bring new technologies from concept to production. If you're…
Added 33 mins ago
HS
Supply Chain Program Manager
Hyve Solutions Corporation
Fremont, CA
- $120,000 to $150,000 USD / year
…company rapidly delivers fast, agile execution through dep technical partnerships and co-innovation, and supply chain clarity. Hyve’s integrated ODM, CM, and SI capabilities eliminate…
Added 36 mins ago
Process Development Engineering Senior Scientific Associate
Vertex Pharmaceuticals Inc (US)
Boston, MA
Participate in weekend work rotations as needed to support ongoing cell-culture and bioreactor operations
Added 40 mins ago
Strategy & Planning Manager - ASP
Cisco Systems, Inc.
Remote, United States
The ASP Strategy, Planning, & Operations team is seeking a Managed Services Strategy & Planning Manager to help create go-to-market strategies and execution plans for our new Service…
Added 48 mins ago
Territory Manager - Small Commercial (P&C Insurance - Middle Tennessee)
Nationwide Mutual Insurance Co.
TN
*The successful candidate must live within the assigned territory
Added 49 mins ago
SAP Data Migration Senior Manager - CMT/SemiConductors
Accenture
Saint Louis, MO
+ Bachelor's Degree or equivalent (12 years) work experience (If an Associate's Degree, then 6 years of work experience required)
Added 52 mins ago
Regulatory Affairs Manager
Advanced Micro Devices, Inc
Austin, TX
The Manager, Product Environmental Regulatory Affairs is an individual contributor who serves as a senior AMD subject matter expert for emerging requirements governing product chemicals,…
Added 53 mins ago
Disaster Recovery AP Manager
Public Safety
Wake County, NC
The role provides leadership and technical guidance on complex financial, operational, and policy issues, supports audits and fiscal accountability, develops and improves business…
Added 55 mins ago
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Agricultural Equipment Mechanic (PT or FT)
Bish Enterprises
Giltner, NE
- $16.5 to $24 USD / hour
…ensuring a clean and safe work environment, continually develop technical skills with evolving products, and perform work at customers sites as…
Added 55 mins ago
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Sales Team Manager (on-site)
Bish Enterprises
Giltner, NE
- $55,000 to $100,000 USD / year
Bish Enterprises is seeking a hands-on, performance-driven Sales Team Manager to lead and strengthen our sales organization. This role is designed for a leader who is comfortable managing…
Added 55 mins ago
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Mechanical Technician (PT or FT)
Bish Enterprises
Giltner, NE
- $16.5 to $24 USD / hour
…ensuring a clean and safe work environment, continually develop technical skills with evolving products, and perform work at customers sites as…
Added 58 mins ago
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Information Technology Infrastructure Manager
Ada County
Boise, ID
- $135,000 USD / year
…planning, and oversight and does not include routine hands-on technical…
Added 1 hour ago
Sr. Manager, Event Technology Systems
Salesforce, Inc.
IN
Salesforce Strategic Events is seeking a Senior Manager, Event Technology Systems to help shape how technology powers some of the company’s most important global event experiences. From…
Added 1 hour ago
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Talent Advisor, AI Labs
Salesforce, Inc.
CA
- $117,400 to $193,700 USD / year
Partner deeply with senior engineering and research leaders to shape hiring strategy, define ideal candidate profiles, and influence how we compete for elite technical talent
Added 1 hour ago
Sr. Program Manager, Business Ops
Avalara
UNAVAILABLE
As a Senior Program Manager, you will lead the cross-functional operations of this flagship initiative. You will drive alignment, accountability, and execution across dedicated engineering…
Added 1 hour ago
Community Development Manager, Strategic Partnerships Office
Google
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…everyone, whether down the street or across the globe. As a Program Manager at Google, you’ll lead complex, multi-disciplinary projects from start to finish - working with stakeholders to…
Added 1 hour ago
Technical Senior Project Engineer
HNTB Corporation
Atlanta, GA
This opportunity entails being responsible for the production and modification of design calculations, technical reports, engineering plans and specifications for assigned projects. This…
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Electric Propulsion Systems, Hardware Manager, Prime Air
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This is a people-manager role with direct reports. You will own the technical roadmap and execution for electric propulsion hardware, driving innovation while meeting fast program…
Added 1 hour ago
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Elite Stylist
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- $14.81 to $21.4 USD / hour
…emphasis on the guest’s total look. They support the Experience Manager (EM) and Assistant Services Manager (ASM) and focus on performance (service sales, and productivity), people (guest…
Added 1 hour ago
Pharmacy Technician
Woodward Detroit CVS, L.L.C.
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Once in role, Technicians are required to complete a rigorous company training program and satisfy all registration, licensing, and certification requirements according to their State’s…

Closed listing

Highmark Health

Manager Strategic Risk Adjustment Programs

Baton Rouge, LA, 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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Work requirements

Jobs in the United States