Program Manager - Government Programs

Highmark Health; Pennsylvania; Hybrid; USD 94,000 - 151,000; Full time

Job summary

Highmark Health is seeking an experienced Program Manager to lead high-stakes, multi-million-dollar government initiatives, including Medicare, Medicaid, and D-SNP portfolios, with autonomy and accountability.

You will align clinical, compliance, provider network, actuarial, and IT teams, navigate CMS/state guidelines, and manage risk while delivering compliant care to vulnerable populations.

Qualifications

• Minimum 7–10 years in project management or delivering business solutions using information technology.
• Bachelor’s or higher in business administration or technology management; MBA preferred.
• PMP certification preferred; knowledge of government programs a plus.
• Ability to navigate CMS and state guidelines and manage risk.

Responsibilities

• Assemble project teams and work groups to deliver defined program objectives.
• Lead managers to develop and maintain comprehensive program plans.
• Coordinate cross-functional activities to deliver results within scope, time and budget.
• Report progress and metrics to the executive sponsor and steering committee.
• Assess risks and implement mitigation strategies; manage vendor relationships as needed.

Skills

Project management

Governance

Stakeholder management

Regulatory compliance

Cross-functional leadership

Education

High School Diploma / GED

Bachelor’s degree in Business Administration or Technology Management

MBA or Master’s in Technology Management

Job description

Company : Highmark Inc. Job Description :

GENERAL OVERVIEW

As a Program Manager you will operate with a high degree of autonomy to lead high-stakes, multi-million-dollar implementations that directly drive the organization’s government business growth. This role is pivotal in launching, scaling, and optimizing our Medicare, Medicaid, and D-SNP (Dual Eligible Special Needs Plan) portfolios, requiring a deep, nuanced understanding of the complex regulatory, operational, and financial landscapes unique to government-sponsored healthcare. You will independently define, execute, and deliver complex, enterprise-level programs within strict scope, quality, time, and budget constraints. Serving as the linchpin for cross-functional collaboration, you will align clinical, compliance, provider network, actuarial, and IT teams to manage intricate interdependencies across multiple workstreams. Leveraging your mastery of government program complexities, you will proactively navigate shifting CMS and state-level guidelines, data privacy mandates, and risk factors. Additionally, you will lead and influence a matrixed team of professionals and contractors, ensuring seamless execution that expands our market footprint and delivers high-quality, compliant care to vulnerable populations.

ESSENTIAL RESPONSIBILITIES

• Work with management to assemble project teams and work groups to produce deliverables required to achieve the objectives of a defined corporate program.
• Lead project managers and work group leaders in the development and maintenance of comprehensive plans for a defined corporate program.
• Organize, direct and coordinate cross-functional activities to focus corporate resources on the successful delivery and implementation of the desired results for a defined corporate program and/or strategic initiative.
• Work with the executive sponsor of a corporate program (VP or higher), and other management as required to achieve the objectives of a defined corporate program.
• Acquire detailed understanding of the business objectives for an assigned area.
• Monitor and evaluate the progress, alignment and financial “health” of a cross-functional group of projects and related activities which together, constitutes a defined corporate program.
• Direct corrective action as needed to maintain the viability of the program.
• If required - Report to the executive team/sponsor/steering committee on the progress, business impacts and strategies around the program(s).
• Assess risks that might jeopardize successful achievement of the desired results of a program, develop risk mitigation strategies and tactics, and implement risk mitigation plans.
• As needed - Partners with procurement to develop and execute strategies related to the service/asset contracts.
• As needed - Manages the vendor to the responsibilities outlined in the contract and statement of work.
• Other duties as assigned or requested.

EDUCATION

Minimum High School Diploma / GED Substitutions None Preferred Bachelor’s degree in Business Administration or Technology Management-related area of study MBA or Master’s Degree in Technology Management-related area of study

EXPERIENCE

Minimum 7 -10 years of work experience in project management or 7-10 years of work experience delivering business solutions using information technology Preferred None

LICENSES/CERTIFICATIONS

Required None Preferred PMP or Certification in Project Management

SCOPE OF RESPONSIBILITY

Does this role supervise/manage other employees? No

WORK ENVIRONMENT

Is Travel Required? Yes

DISCLAIMER / COMPLIANCE

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 Note: Job duties and responsibilities support separation of duties across multiple users 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: $94,200.00 Pay Range Maximum: $151,000.00 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

Highmark Health is a national, blended health organization that includes one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network. Based in Pittsburgh, Pa., Highmark Health’s 35,000 employees serve millions of customers nationwide through the nonprofit organization’s affiliated businesses, which include Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, HM Health Solutions and HM Home & Community Services. Highmark Health’s businesses proudly serve a broad spectrum of health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions.