Program Manager Risk Adjustment

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?

WORK ENVIRONMENT

Is Travel Required?

Yes - 0-25% local travel

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

$78,900.00

Pay Range Maximum : $146,000.00

$146,000.00

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 ()

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