Strategic Risk Adjustment Programs Lead

Highmark Health Company; Santa Fe (NM); On-site; USD 120,000 - 160,000; Full time

Job summary

Highmark Inc. is seeking an experienced Senior Project/Program Manager to lead Risk Adjustment programs across health plans and providers. You will drive end-to-end delivery, coordinate resources, and partner with executives, clinicians and IT staff to align on goals and timelines.

The role requires 7–10 years of PM experience, strong leadership, and knowledge of RPM, risk revenue, and strategic planning. PMP certification is preferred.

Qualifications

• Bachelor's degree in Business Administration/Management or Computer and Information Science.
• Six (6) 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.
• 1 -3 years Consulting.
• 1 -3 years Cross-Functional Project Teams.
• Project Management Professional (PMP) certification preferred.

Responsibilities

• Lead day-to-day execution of Strategic Risk Adjustment Program engagements and deliverables.
• Develop engagement scope, staffing and incentive model for RPM engagements with Providers.
• Manage project team members and external consultants; implement changes to achieve goals.
• Coordinate with executive sponsors to ensure alignment on objectives, activities and outcomes.
• Regularly brief executive leadership on program status, strategy, timelines, risks and issues.
• Evaluate risks to risk adjustment program goals and drive continuous improvement.
• Conduct market reviews to identify best practices and improve department methods.
• Perform other duties as assigned.

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

Six (6) years relevant and progressive experience in lieu of Bachelor's degree

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

Job description

Highmark Inc. is seeking an experienced Senior Project/Program Manager to lead Risk Adjustment programs across health plans and providers. You will drive end-to-end delivery, coordinate resources, and partner with executives, clinicians and IT staff to align on goals and timelines.

The role requires 7–10 years of PM experience, strong leadership, and knowledge of RPM, risk revenue, and strategic planning. PMP certification is preferred.