Senior Manager, Risk Adjustment Strategy

Highmark Health; Lansing (MI); On-site; USD 120,000 - 150,000; Full time

Job summary

Highmark Inc. seeks an experienced Program/Project Manager to oversee end-to-end Risk Adjustment programs, delivering value to the Health Plan and beneficiaries enrolled in MA and ACA.

You will work with executive leadership, physicians, and technical staff to define operating models, governance, and incentive structures while driving continuous improvement in risk adjustment documentation and reporting capabilities.

Qualifications

• Bachelor's degree in Business Administration/Management or Computer and Information Science; substitutions possible with 6 years of experience.
• 7-10 years of Project/Program Management experience.
• PMP certification preferred.
• Strong leadership, strategic planning and cross-functional collaboration skills.

Responsibilities

• Lead day-to-day operations and manage engagement deliverables, resources and outcomes.
• Develop engagement business case, scope, staffing and incentive model for RPM engagements.
• Manage project teams and external consultants to achieve goals and milestones.
• Brief executive leadership on project status, strategy, timelines, risks and issues.

Skills

Excellent Multi-Tasker

Analytical and Logical Reasoning/Think

Information Technology

Enterprise Systems

Financial Statements

Education

Bachelor's Degree in Business Administration/Management or Computer and Information Science

Six (6) years relevant and progressive experience in lieu of Bachelor's degree

Master's Degree in Business Administration/Management or Mental Health Services

Job description

Highmark Inc. seeks an experienced Program/Project Manager to oversee end-to-end Risk Adjustment programs, delivering value to the Health Plan and beneficiaries enrolled in MA and ACA.

You will work with executive leadership, physicians, and technical staff to define operating models, governance, and incentive structures while driving continuous improvement in risk adjustment documentation and reporting capabilities.