Senior Program Manager - Medicare Stars

Company :

Highmark Inc.

Job Description : 

JOB SUMMARY

Performs program planning and design in support of development and implementation of the STAR Program and performs on-going operational program management.  Performs data analysis and reporting in support of STARS Program activities.   Works collaboratively with all departments and external stakeholders to maximize STAR ratings.  Expectations include the ability to lead cross-functional quality improvement initiatives.  The senior program manager will be responsible for program execution, governance, and outcomes measurement for programs.  The individual will facilitate process improvement, change management, and operational enhancements to maximize Star ratings.  Collaboration with measures owners to translates goals into actionable requirements will also be a core responsibility.  

This is a hybrid based role in Pittsburgh, PA - 3 days a week onsite. T, W, Th.

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

Required

• High School / GED

Substitutions

• None

Preferred

• Bachelor's Degree in Business Administration or Technology Management
• Master's Degree in Business Administration or Technology Management

EXPERIENCE

Required

• 10 years in Project Management
• 10 years of delivering business solution using information technology

Preferred

• None

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• PMP or Certification in Project Management

SKILLS

• Project Management
• Familiarity with Cross-functional teams

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

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

Rarely

Lifting: 25 to 50 pounds

Never

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 job 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.

Performs program planning and design in support of development and implementation of the STAR Program and performs on-going operational program management.  Performs data analysis and reporting in support of STARS Program activities.   Works collaboratively with all departments and external stakeholders to maximize STAR ratings.  Expectations include the ability to lead cross-functional quality improvement initiatives.  The senior program manager will be responsible for program execution, governance, and outcomes measurement for programs.  The individual will facilitate process improvement, change management, and operational enhancements to maximize Star ratings.  Collaboration with measures owners to translates goals into actionable requirements will also be a core responsibility.  

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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