Senior Project Manager - Risk Adjustment

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Project Management

Senior Project Manager - Risk Adjustment

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Senior Project Manager - Risk Adjustment

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PA, Working at Home - Pennsylvania

Company :

Highmark Inc.

Job Description :

JOB SUMMARY

The Senior Project Manager will be responsible for leading key projects directly engaging with our provider network around risk adjustment activities. This role demands a professional with excellent communication and interpersonal skills, capable of fostering strong relationships and leading productive discussions with provider groups and clinicians. A crucial aspect of this role involves the ability to identify when and how to effectively engage Highmark clinical teams to support and drive provider education initiatives. A critical eye for detail, superior organizational abilities, and advanced proficiency in Microsoft Excel and PowerPoint are essential for success. The ideal candidate thrives in a fast-paced environment, demonstrating strong decision-making skills, and brings a track record of successful project delivery. While not required, experience in risk adjustment programs (MA, ACA, and/or Medicaid) will be highly valued.

ESSENTIAL RESPONSIBILITIES

• Project Leadership & Management:

• Lead the planning, execution, and successful completion of key projects, particularly those involving direct engagement with provider networks.

• Manage project scope, timelines, and resources to ensure projects are delivered on time and within scope.

• Identify and proactively mitigate project risks, developing contingency plans as necessary.

• Develop and maintain comprehensive project documentation, including project plans, status reports, and stakeholder communications.

• Provider Engagement & Communication:

• Serve as the primary point of contact for provider groups, including clinicians.

• Facilitate and lead productive meetings and discussions with diverse provider stakeholders.

• Build and maintain strong, collaborative relationships with provider partners.

• Translate complex project information into clear and actionable communications for various audiences.

• Clinical Team Collaboration & Provider Education:

• Proactively collaborate with Highmark clinical teams to develop and deliver targeted provider education initiatives.

• Act as a liaison between project teams, providers, and Highmark clinical resources to ensure aligned efforts in education and support.

• Data Analysis & Reporting:

• Utilize advanced proficiency in Microsoft Excel to analyze project-related data, track performance, and identify trends.

• Prepare clear and compelling presentations using Microsoft PowerPoint to report project status, outcomes, and recommendations to stakeholders.

• Decision Making & Problem Solving:

• Demonstrate critical decision-making skills, especially in a fast-paced and dynamic project environment.

• Address project challenges and unforeseen issues effectively and efficiently, seeking optimal solutions.

EDUCATION

Required

• High School Diploma or equivalent

Substitutions

• None

Preferred

• Bachelor"s degree

EXPERIENCE

Required

• 4 years of experience in a project manager role

Preferred

• PMP certification or equivalent training
• Healthcare Insurance industry business and operational knowledge
• Experience managing large, complex projects
• Very good leadership skills
• Very good organizational and planning skills
• Experience with an industry standard software development life-cycle

LICENSES AND CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Experience with customer relationship management
• Presentation skills
• Negotiation skills
• Experience with conflict resolution
• Experience with Risk Mitigation Planning

Language (Other than English)

None

Travel Requirement

0% - 25%

Position Type

Office-based or Remote

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Occasionally

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.

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:

$86,400.00

Pay Range Maximum:

$138,600.00

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

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 the email below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Recruitment Fraud Alert

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Job Details

• Job category Project Management
• Position Type Full Time
• Posted 08/05/2026
• Location(s) PA, Working at Home - Pennsylvania
• Line of Business
• Entity
• Recruiter
• Hiring Manager
• Experience Level
• Job Family Project Management-HM
• Req ID J284893

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Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.

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.

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 the email below.

For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org.

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