Strategic Risk Adjustment Programs Lead

Highmark Health; Cheyenne (WY); On-site; USD 100,000 - 140,000; Full time

Job summary

Highmark Inc. in Cheyenne is seeking an experienced Project/Program Manager to lead end-to-end Risk Adjustment programs for government plans. You will collaborate with senior leadership, physicians and IT staff to deliver value and enhance patient care documentation and reporting.

The role requires 7–10 years of PM experience, leadership in risk revenue, and expertise in strategic planning within healthcare. A PMP is preferred; a bachelor's is required and a master’s is favored.

Qualifications

• Bachelor's Degree in Business Administration/Management or Computer and Information Science.
• Six years relevant and progressive experience in lieu of Bachelor's degree.
• Master's Degree in Business Administration/Management or Mental Health Services.
• 7 - 10 years Project / Program Management.
• 3 - 5 years Leadership.
• 3 - 5 years Risk Revenue.
• 1 - 3 years Strategic Planning.
• 3 - 5 years Healthcare Industry.
• 1 -3 years Consulting.
• 1 -3 years Cross-Functional Project Teams.
• Preferred: PMP certification.

Responsibilities

• Plan, organize, staff, direct and control day-to-day operations; develop policies and programs; may have budgetary responsibility.
• Lead the day-to-day execution of Strategic Risk Adjustment Program engagements with providers.
• Develop engagement business case, scope, staffing and incentive model for RPM engagements.
• Lead and manage project team members and external consultants; manage changes to achieve goals.
• Communicate with executive sponsors to ensure alignment on strategy, activities and outcomes.
• Brief executive leadership on project status, strategy, timelines, risks and issues.
• Evaluate risks to risk adjustment program goals and drive continuous improvement.
• Other duties as assigned.

Skills

Leadership

Risk revenue

Strategic planning

Healthcare industry

Consulting

Cross-functional teams

Multi-tasking

Analytical thinking

Information Technology

Enterprise systems

Financial statements

Education

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

Six years relevant experience in lieu of Bachelor's degree

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

Job description

Highmark Inc. in Cheyenne is seeking an experienced Project/Program Manager to lead end-to-end Risk Adjustment programs for government plans. You will collaborate with senior leadership, physicians and IT staff to deliver value and enhance patient care documentation and reporting.

The role requires 7–10 years of PM experience, leadership in risk revenue, and expertise in strategic planning within healthcare. A PMP is preferred; a bachelor's is required and a master’s is favored.