Health Plan Compliance Project Manager (Remote)

Highmark Health Company; Santa Fe (NM); Hybrid; USD 68,000 - 106,000; Full time

Job summary

Highmark Inc. is seeking a Project Manager to drive organization-wide project execution, audit readiness, and strategic compliance initiatives for complex health plan accreditation programs.

This role bridges a clinical or legal background with cross-functional operational execution across Quality Management, Utilization Management, and Credentialing. This position can be hybrid or remote; if you live within 50 miles of an office you are required to be onsite 3 days a week (T, W, TH).

Qualifications

• 1–3 years of project manager or project leadership experience.
• Health care insurance industry knowledge is preferred.
• Familiarity with industry-standard software development lifecycle.
• PMP certification or equivalent training preferred.
• Experience with regulatory programs (NCQA, CMS, URAC) is a plus.

Responsibilities

• Drive program strategy and maintain cross-functional roadmaps.
• Assemble project teams and develop comprehensive program plans.
• Engage with Sponsors to align objectives and business goals.
• Monitor scope, schedule, and budget; report status and take corrective action.
• Deliver stakeholder presentations and maintain positive relationships.
• Adhere to project management methods and contribute to process improvements.
• Perform other duties as assigned.

Skills

CRM experience

Presentation skills

Negotiation skills

Conflict resolution

Risk mitigation planning

Team building

Interpersonal skills

Verbal and written communication

Organizational and planning skills

Leadership

Education

High School Diploma/GED

Bachelor's degree

Job description

Highmark Inc. is seeking a Project Manager to drive organization-wide project execution, audit readiness, and strategic compliance initiatives for complex health plan accreditation programs.

This role bridges a clinical or legal background with cross-functional operational execution across Quality Management, Utilization Management, and Credentialing. This position can be hybrid or remote; if you live within 50 miles of an office you are required to be onsite 3 days a week (T, W, TH).