GENERAL OVERVIEW
We are seeking a highly organized, strategic, and analytical Program Manager to support driving improvement in our Medicaid and Medicare (D-SNP) clinical quality measure outcomes. This role will make data-driven decisions to lead the development and execution of strategies to meet state-specific Medicaid quality goals and Medicare Stars targets for our D-SNP population. Responsibilities include managing clinical healthcare quality interventions and overseeing key vendor partnerships, such as those for home screening kits and remote patient monitoring programs, across multiple states and lines of business. The 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. Manages a matrix group of employees and contractors who serve on project teams and/or within interdepartmental 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.
- 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, Technology Management, or Healthcare-related area of study
- MBA or Master’s Degree in Technology Management or Healthcare-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, Certification in Project Management, or CPHQ
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:
$94,200.00Pay Range Maximum:
$151,000.00Base 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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For accommodation requests, please contact HR Services Online at [email protected]
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Skills Required
- High School Diploma or GED
- 7-10 years project management or delivering business solutions using information technology
- Experience improving Medicaid and Medicare (D-SNP) clinical quality measures and clinical interventions
- Experience overseeing vendor partnerships (e.g., home screening kits, remote patient monitoring)
- Ability to lead cross-functional programs, assess risk, and report program financial/operational health to executives
- Knowledge of HIPAA and information security/data privacy requirements
- Bachelor's Degree in Business Administration, Technology Management, or Healthcare-related
- MBA or Master's Degree in Technology Management or Healthcare-related
- PMP, Project Management certification, or CPHQ
Highmark Health Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Highmark Health and has not been reviewed or approved by Highmark Health.
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Healthcare Strength — Medical, prescription, dental, and vision coverage are emphasized alongside 100% coverage for preventive exams, with onsite pharmacy access and fitness center availability at major campuses.
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Retirement Support — An employer‑sponsored 401(k) with a company match is highlighted, with AHN materials illustrating a 100% match on the first 4% plus an additional 1% employer contribution as an example within the enterprise.
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Wellbeing & Lifestyle Benefits — Wellness programs include stress‑management classes, health coaching, incentives for healthy activities, team‑member discounts, and volunteer incentives, with paid volunteer time also noted in the overall package.
Highmark Health Insights
What We Do
Highmark Health, a Pittsburgh, PA based enterprise that employs more than 40,000 people who serve millions of Americans across the country, is the second largest integrated health care delivery and financing network in the nation based on revenue. Highmark Health is the parent company of Highmark Inc., Allegheny Health Network, and HM Health Solutions. Highmark Inc. and its subsidiaries and affiliates provide health insurance to nearly 5 million members in Pennsylvania, West Virginia and Delaware as well as dental insurance, vision care and related health products through a national network of diversified businesses that include United Concordia Companies, HM Insurance Group, and Visionworks. Allegheny Health Network is the parent company of an integrated delivery network that includes eight hospitals, more than 2,800 affiliated physicians, ambulatory surgery centers, an employed physician organization, home and community-based health services, a research institute, a group purchasing organization, and health and wellness pavilions in western Pennsylvania. HM Health Solutions focuses on meeting the information technology platform and other business needs of the Highmark Health enterprise as well as unaffiliated health insurance plans by providing proven business processes, expert knowledge and integrated cloud-based platforms. A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best. Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia and New York, with customers in all 50 states and the District of Columbia. We passionately serve individual consumers and fellow businesses alike. Our companies cover a diversified spectrum of essential health-related needs, including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative technology solutions. We’re also proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.
