Regulatory Project Manager - Health Plan Compliance

Highmark Health Company; Frankfort (KY); 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 regulatory initiatives for NCQA, Medicaid, URAC, and CMS programs. The role bridges regulatory mandates with cross-functional execution across Quality Management, Utilization Management, and Credentialing.

This position supports hybrid or remote work; onsite 3 days a week if within 50 miles of an office (T, W, TH).

Qualifications

• 1–3 years experience in a project manager role or project leadership role.
• Regulatory/compliance familiarity (NCQA, URAC, CMS) preferred.
• PMP certification or equivalent is optional but preferred.

Responsibilities

• Drive program strategy and roadmap across cross-functional teams.
• Lead development and maintenance of comprehensive project plans.
• Collaborate with sponsors to achieve program objectives and understand business goals.
• Monitor status including scope, schedule, and budget; escalate as needed.
• Deliver status presentations to stakeholders throughout the project lifecycle.
• Adhere to project management methodologies and audit requirements.

Skills

CRM

Presentation skills

Negotiation

Conflict resolution

Risk mitigation

Team building

Interpersonal skills

Communication skills

Organizational 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 regulatory initiatives for NCQA, Medicaid, URAC, and CMS programs. The role bridges regulatory mandates with cross-functional execution across Quality Management, Utilization Management, and Credentialing.

This position supports hybrid or remote work; onsite 3 days a week if within 50 miles of an office (T, W, TH).