Program Manager - Risk Adjustment

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.

Leadership Reporting and Goal Setting/Management Support

Key Responsibilities:

• Preparation of content for leadership review meetings
• Coordination of leadership reviews and revisions to content
• Support facilitation and documentation of strategy sessions to establish and update goals
• Management of leadership dashboards to report on performance related to agreed-upon goals
• Contribute to development and maintenance of operational and project related roadmaps to highlight deliverables, timelines, statuses, and risks

Team Coordination, Initiative Management & Project Support

Key Responsibilities:

• Lead the successful delivery of evolving risk adjustment initiatives and projects, driving outcomes directly aligned with RAAM's strategic plan
• Development of content for monthly team communications (e.g. five things to know, provider news, etc.)
• Coordination of quarterly team building activities (rotational coffee chats, volunteer opportunities, holiday events, etc.)
• Agenda development and facilitation of team meetings

Budget and Spend Management

Key Responsibilities:

• Coordination with finance on spend management
• Purchase order set-up and management
• Facilitation of monthly vendor spend management review with leadership
• Complete month-end and year-end reporting in coordination with accounting
• Management of allocation of spend by line of business factoring in MA/ACA member disruption
• Provider incentive accrual management and reporting with accounting

This role can be hybrid or remote. If you are within 50 miles of an office you are required to be onsite 3 days a week (T, W, Th). Outside of 50 miles you can be remote.

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.
• 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

• None

LICENSES/CERTIFICATIONS

Required

• None

Preferred

• PMP or Certification in Project Management

SCOPE OF RESPONSIBILITY 
Does this role supervise/manage other employees?         

No 

WORK ENVIRONMENT
Is Travel Required?
Yes         
 

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:

Pay Range Maximum:

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 any category protected by applicable federal, state, or local law.

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