Strategic Risk Adjustment Programs Lead

Highmark Health; Juneau (AK); In loco; USD 120.000 - 160.000; Tempo pieno

Descrizione del lavoro

Highmark Inc. seeks an experienced leader to manage, deliver and support Risk Adjustment Programs end-to-end, working with Health Plan beneficiaries under MA and ACA.

You will coordinate capability analysis, operating models, governance and metrics design, while mentoring program teams. This role requires leading engagement delivery, building business cases, staffing models, and coordinating with executive sponsors and providers.

Competenze

• 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 experience.
• 3-5 years Leadership experience.
• 3-5 years Risk Revenue experience.
• 1-3 years Strategic Planning.
• 3-5 years Healthcare Industry experience.
• 1-3 years Consulting experience.
• 1-3 years Cross-Functional Project Teams experience.
• Project Management Professional (PMP) certification preferred.

Mansioni

• Hire, coach, develop staff; manage performance and productivity.
• Lead day-to-day execution of Strategic Risk Adjustment Program engagements with responsibility for deliverables, resources and outcomes.
• Develop engagement business case, scope, staffing and incentive model for RPM engagements with Providers.
• Lead and manage project team members and external consultants by implementing changes to meet goals.
• Communicate with executive sponsors to ensure alignment on objectives, activities and outcomes.
• Regularly brief Enterprise leadership including CFO, EVP, Chief Actuary, and VP on status and strategy.
• Evaluate risks to risk adjustment program goals and elevate as needed.
• Conduct periodic market reviews to drive continuous improvement in department approaches.
• Other duties as assigned.

Conoscenze

Multi-tasking

Analytical thinking

Information Tech

Enterprise systems

Financial statements

Formazione

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

Descrizione del lavoro

Highmark Inc. seeks an experienced leader to manage, deliver and support Risk Adjustment Programs end-to-end, working with Health Plan beneficiaries under MA and ACA.

You will coordinate capability analysis, operating models, governance and metrics design, while mentoring program teams. This role requires leading engagement delivery, building business cases, staffing models, and coordinating with executive sponsors and providers.