Senior Program Manager - Medicare Stars

Highmark; Pittsburgh (Allegheny County); Hybrid; USD 110,000 - 160,000; Full time

Job summary

Highmark is seeking a Senior Program Manager to lead the STAR Program, overseeing governance, execution, and outcomes measurement. You will drive cross‑functional quality initiatives, collaborate with stakeholders, and ensure delivery of program benefits.

The role requires strong program management, change management, and ability to translate goals into actionable requirements. Hybrid role based in Pittsburgh, PA with on-site three days per week.

Qualifications

• High School / GED is required.
• Bachelor's Degree in Business Administration or Technology Management preferred.
• Master's Degree in Business Administration or Technology Management preferred.

Responsibilities

• Assemble project teams and work groups to deliver program objectives.
• Direct and coordinate cross-functional activities to achieve program results.
• Collaborate with executive sponsors to align business objectives and program scope.
• Monitor progress and financial health of projects; report to executives as needed.
• Identify and mitigate risks; develop and implement risk management plans.
• Manage vendor relationships and contract obligations as required.
• Perform additional duties as assigned.

Skills

Project Management

Cross-functional teams

Education

High School / GED

Bachelor's Degree in Business Administration or Technology Management

Master's Degree in Business Administration or Technology Management

Job description

Job Summary

Performs program planning and design in support of development and implementation of the STAR Program and performs on-going operational program management. Performs data analysis and reporting in support of STARS Program activities. Works collaboratively with all departments and external stakeholders to maximize STAR ratings. Expectations include the ability to lead cross-functional quality improvement initiatives. The senior program manager will be responsible for program execution, governance, and outcomes measurement for programs. The individual will facilitate process improvement, change management, and operational enhancements to maximize Star ratings. Collaboration with measures owners to translates goals into actionable requirements will also be a core responsibility.

Company

Highmark Inc.

Job Description

Performs program planning and design in support of development and implementation of the STAR Program and performs on-going operational program management. Performs data analysis and reporting in support of STARS Program activities. Works collaboratively with all departments and external stakeholders to maximize STAR ratings. Expectations include the ability to lead cross-functional quality improvement initiatives. The senior program manager will be responsible for program execution, governance, and outcomes measurement for programs. The individual will facilitate process improvement, change management, and operational enhancements to maximize Star ratings. Collaboration with measures owners to translates goals into actionable requirements will also be a core responsibility.

This is a hybrid based role in Pittsburgh, PA - 3 days a week onsite. T, W, Th.

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

Required

• High School / GED

Preferred

• Bachelor's Degree in Business Administration or Technology Management
• Master's Degree in Business Administration or Technology Management

Experience

Required

• 10 years in Project Management
• 10 years of delivering business solution using information technology

Preferred

• None

Licenses or Certifications

Required

• None

Preferred

• PMP or Certification in Project Management

Skills

• Project Management
• Familiarity with Cross-functional teams

Language (Other Than English)

None

Travel Requirement

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

• Position Type Office-based
• Teaches / trains others regularly
• Occasionally
• Travel regularly from the office to various work sites or from site-to-site
• Occasionally
• Works primarily out-of-the office selling products/services (sales employees)
• Never
• Physical work site required
• Yes
• Lifting up to 10 pounds
• Constantly
• Lifting 10 to 25 pounds
• Rarely
• Lifting 25 to 50 pounds
• Never

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 job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. 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.

Repetition

Performs program planning and design in support of development and implementation of the STAR Program and performs on-going operational program management. Performs data analysis and reporting in support of STARS Program activities. Works collaboratively with all departments and external stakeholders to maximize STAR ratings. Expectations include the ability to lead cross-functional quality improvement initiatives. The senior program manager will be responsible for program execution, governance, and outcomes measurement for programs. The individual will facilitate process improvement, change management, and operational enhancements to maximize Star ratings. Collaboration with measures owners to translates goals into actionable requirements will also be a core responsibility.

Equal Opportunity

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.

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