Program Manager Risk Adjustment - Highmark Health
Frankfort, KY
About the Job
Company :
Highmark Inc.
Job Description :
GENERAL OVERVIEW
This job is responsible for the successful definition, implementation and delivery of complex programs that requires cross-functional collaboration and interdependencies between a group of projects and/or related activities within the constraint of scope, quality, time and budget and under circumstances involving multiple moderate-probability, moderate-impact risk factors. Manages a matrix group of employees and contractors who serve on project teams and/or within departmental work groups to achieve a coordinated benefit.
ESSENTIAL RESPONSIBILITIES
+ Work with management to assemble project teams and work groups to produce deliverables required to achieve the objectives of a defined corporate program. Lead project managers and work group leaders in the development and maintenance of comprehensive plans for a defined corporate program.
+ Organize, direct and coordinate cross-functional activities to focus corporate resources on the successful delivery and implementation of the desired results for a defined corporate program and/or strategic initiative.
+ Work with the executive sponsor of a corporate program (VP or higher), and other management as required to achieve the objectives of a defined corporate program. Acquire detailed understanding of the business objectives for an assigned area.
+ Monitor and evaluate the progress, alignment and financial “health” of a cross-functional group of projects and related activities which together, constitutes a defined corporate program. Direct corrective action as needed to maintain the viability of the program. If required - Report to the executive team/sponsor/steering committee on the progress, business impacts and strategies around the program(s).
+ Assess risks that might jeopardize successful achievement of the desired results of a program, develop risk mitigation strategies and tactics, and implement risk mitigation plans.
+ Assess cross-functional data to inform program strategy development
+ As needed - Partners with procurement to develop and execute strategies related to the service/asset contracts.
+ As needed - Manages the vendor to the responsibilities outlined in the contract and statement of work.
+ Other duties as assigned or requested.
EDUCATION
Minimum
+ High School Diploma / GED
Substitutions
+ None
Preferred
+ Bachelor’s degree in Business Administration or Technology Management-related area of study
+ MBA or Master’s Degree in Technology Management-related area of study
EXPERIENCE
Minimum
+ 7 -10 years of work experience in project management or
+ 7-10 years of work experience delivering business solutions using information technology
Preferred
+ Understanding of government programs – Medicare Advantage, Medicaid, Affordable Care Act
+ Demonstrated knowledge of risk adjustment principals
+ Health Insurance and/or managed care industry experience
+ Provider facing or health system/practice experience
+ Vendor Management experience
SCOPE OF RESPONSIBILITY
Does this role supervise/manage other employees?
No
WORK ENVIRONMENT
Is Travel Required?
Yes - 0-25% local travel
_Disclaimer:_ _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
_Compliance Requirement:_ _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_
Note: Job duties and responsibilities support separation of duties across multiple users
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$78,900.00
Pay Range Maximum:
$146,000.00
_Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( _https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf_ )
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J241301
Highmark Inc.
Job Description :
GENERAL OVERVIEW
This job is responsible for the successful definition, implementation and delivery of complex programs that requires cross-functional collaboration and interdependencies between a group of projects and/or related activities within the constraint of scope, quality, time and budget and under circumstances involving multiple moderate-probability, moderate-impact risk factors. Manages a matrix group of employees and contractors who serve on project teams and/or within departmental work groups to achieve a coordinated benefit.
ESSENTIAL RESPONSIBILITIES
+ Work with management to assemble project teams and work groups to produce deliverables required to achieve the objectives of a defined corporate program. Lead project managers and work group leaders in the development and maintenance of comprehensive plans for a defined corporate program.
+ Organize, direct and coordinate cross-functional activities to focus corporate resources on the successful delivery and implementation of the desired results for a defined corporate program and/or strategic initiative.
+ Work with the executive sponsor of a corporate program (VP or higher), and other management as required to achieve the objectives of a defined corporate program. Acquire detailed understanding of the business objectives for an assigned area.
+ Monitor and evaluate the progress, alignment and financial “health” of a cross-functional group of projects and related activities which together, constitutes a defined corporate program. Direct corrective action as needed to maintain the viability of the program. If required - Report to the executive team/sponsor/steering committee on the progress, business impacts and strategies around the program(s).
+ Assess risks that might jeopardize successful achievement of the desired results of a program, develop risk mitigation strategies and tactics, and implement risk mitigation plans.
+ Assess cross-functional data to inform program strategy development
+ As needed - Partners with procurement to develop and execute strategies related to the service/asset contracts.
+ As needed - Manages the vendor to the responsibilities outlined in the contract and statement of work.
+ Other duties as assigned or requested.
EDUCATION
Minimum
+ High School Diploma / GED
Substitutions
+ None
Preferred
+ Bachelor’s degree in Business Administration or Technology Management-related area of study
+ MBA or Master’s Degree in Technology Management-related area of study
EXPERIENCE
Minimum
+ 7 -10 years of work experience in project management or
+ 7-10 years of work experience delivering business solutions using information technology
Preferred
+ Understanding of government programs – Medicare Advantage, Medicaid, Affordable Care Act
+ Demonstrated knowledge of risk adjustment principals
+ Health Insurance and/or managed care industry experience
+ Provider facing or health system/practice experience
+ Vendor Management experience
SCOPE OF RESPONSIBILITY
Does this role supervise/manage other employees?
No
WORK ENVIRONMENT
Is Travel Required?
Yes - 0-25% local travel
_Disclaimer:_ _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._
_Compliance Requirement:_ _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies_
Note: Job duties and responsibilities support separation of duties across multiple users
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$78,900.00
Pay Range Maximum:
$146,000.00
_Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( _https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf_ )
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
Req ID: J241301
Source : Highmark Health