Program Manager - Risk Adjustment

Company :

Highmark Inc.

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…