Strategic Risk Adjustment Programs Lead

Highmark Health Company; Hartford (CT); On-site; USD 100,000 - 130,000; Full time

Job summary

Highmark Inc. is seeking a seasoned leader to manage, deliver, and support Risk Adjustment Programs end-to-end. The role focuses on capability analysis, operating model definition, incentive design, governance, and metrics, while mentoring the program team.

The incumbent will work with senior leadership and clinical/technical staff to prioritize and deliver large-scale projects, advancing care delivery and reporting capabilities across government programs and commercial populations.

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.
• 7-10 years Project / Program Management experience.
• 3-5 years Leadership
• 3-5 years Risk Revenue
• 1-3 years Strategic Planning

Responsibilities

• Lead the day-to-day execution of Strategic Risk Adjustment Program engagements taking ownership of the engagement deliverables, resources, and outcomes.
• Develop the engagement business case, scope, staffing and incentive model for RPM engagement with Providers on internal programs (UDC, Internal Chart Retrieval and RSA).
• Lead and manage project team members and/or external consultants by implementing and managing changes and interventions to ensure project goals are achieved.
• Work closely with executive project sponsors and stakeholders to make communication easy and transparent to ensure ongoing alignment with project objectives, activities, and outcomes.

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

Tools

PMP

Job description

Highmark Inc. is seeking a seasoned leader to manage, deliver, and support Risk Adjustment Programs end-to-end. The role focuses on capability analysis, operating model definition, incentive design, governance, and metrics, while mentoring the program team.

The incumbent will work with senior leadership and clinical/technical staff to prioritize and deliver large-scale projects, advancing care delivery and reporting capabilities across government programs and commercial populations.