Strategic Risk Adjustment Programs Lead

Highmark Health Company; Montpelier (VT); On-site; USD 120,000 - 165,000; Full time

Job summary

Highmark Inc. is seeking a senior project/program leader to manage end-to-end Risk Adjustment Programs across Health Plan initiatives, delivering value to beneficiaries and stakeholders. You will guide capability analysis, operating models, incentive design, and governance to drive program success.

You will coordinate with executive leadership and providers, oversee teams, and mentor staff while ensuring alignment with strategic objectives and continuous improvement across the portfolio.

Qualifications

• Bachelor’s degree required in business/IT fields or related experience with progressive responsibilities.
• Minimum 7–10 years in project/program management with leadership exposure.
• Preferred PMP certification.

Responsibilities

• Lead and manage Risk Adjustment Program engagements, delivering outcomes on scope, time, and budget.
• Collaborate with senior leadership and stakeholders to align project objectives with strategic goals.
• Develop engagement business cases, scope, staffing, and incentive models for RPM engagements.
• Oversee project teams and external consultants, guiding changes to meet project goals.
• Provide clear communication to executive sponsors on status, risks, and issues.
• Monitor risks to program goals and drive continuous improvement in practices.
• Perform hiring decisions, coaching, and staff development as part of leadership responsibilities.

Skills

Excellent multi-tasking

Analytical reasoning

Information Technology

Enterprise systems

Financial statements

Education

Bachelor’s Degree in Business Administration/Management or Computer & Information Science

Six years relevant experience in lieu of degree

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

Job description

Highmark Inc. is seeking a senior project/program leader to manage end-to-end Risk Adjustment Programs across Health Plan initiatives, delivering value to beneficiaries and stakeholders. You will guide capability analysis, operating models, incentive design, and governance to drive program success.

You will coordinate with executive leadership and providers, oversee teams, and mentor staff while ensuring alignment with strategic objectives and continuous improvement across the portfolio.