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Highmark Inc. is seeking a Program Manager to lead high-stakes, enterprise-scale programs across Medicare, Medicaid, and D-SNP portfolios. You will coordinate clinical, compliance, actuarial, and IT teams to manage interdependencies with strict scope, quality, time, and budget constraints.
You will navigate CMS and state guidelines, manage risk, and partner with procurement and vendors to deliver compliant care to vulnerable populations. Travel is required.
Highmark Inc. Job Description :
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.
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
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