Highmark · 11 hours ago
Manager Strategic Risk Adjustment Programs
PA
Full-time
Onsite
Mid, Senior Level
$92K/yr - $172K/yr
7+ years expHighmark Inc. is a healthcare company dedicated to providing innovative solutions in health management. They are seeking a Manager of Strategic Risk Adjustment Programs to oversee and support risk adjustment initiatives, ensuring alignment with business objectives and enhancing patient care delivery. The role involves leading project teams, managing stakeholder communication, and driving continuous improvement efforts.
Health CareHealth InsuranceInsuranceWellness
Responsibilities
Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity. Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority
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
Regularly brief the executive leadership of the Enterprise (both Highmark and Highmark Health), including CFO, EVP, Chief Actuary, and Vice President, on project status including program strategy, performance, timelines, risks, and issues
Evaluate risks to risk adjustment programs goals and objectives and escalate as appropriate
Conduct periodic market review to understand industry leading practices and drive continuous improvement in department approaches, methods, and tools and organizational awareness of department capabilities
Other duties as assigned or requested
Qualification
Required
Bachelor's Degree in Business Administration/Management or Computer and Information Science
7 - 10 years Project / Program Management
3 - 5 years Leadership
3 - 5 years Risk Revenue
1 - 3 years Strategic Planning
None
Preferred
Master's Degree in Business Administration/Management or Mental Health Services
3 - 5 years Healthcare Industry
1 -3 years Consulting
1 -3 years Cross-Functional Project Teams
Project Management Professional (PMP)
Company
Highmark
Highmark provides health insurance plans for individuals and businesses.
10001+ employees
H1B Sponsorship
Highmark has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (11)
2024 (7)
2023 (19)
2022 (21)
2021 (18)
2020 (23)
Funding
Current Stage
Late StageTotal Funding
$27.3M2018-04-06Grant· $25M
2014-08-07Grant· $2.3M
Leadership Team
Deborah Rice-Johnson
CEO, Diversified Businesses at Highmark Inc. and Chief Growth Officer
Paul Sikora
CTO Provider Services
Recent News
2025-12-11
Company data provided by crunchbase