Manager Strategic Risk Adjustment Programs (Healthcare)

Location: Remote from Pennsylvania, United States; travel requirement 0%–25%; physical work site required.

Company

hirify.global operates healthcare and health plan programs serving beneficiaries enrolled in government risk-adjusted programs.

What you will do

• Manage the day-to-day operations of the department, including staffing, coaching, development, performance management, productivity, policies, programs, and potential budget responsibilities.
• Lead Strategic Risk Adjustment Program engagements, owning deliverables, resources, outcomes, business cases, scope, staffing, and incentive models for provider programs.
• Lead project teams and external consultants while managing changes and interventions to achieve project goals.
• Partner with executive sponsors, physicians, technical staff, strategic hospital partners, and other stakeholders to maintain alignment on objectives, timelines, risks, and outcomes.
• Brief Highmark and hirify.global executive leadership, including the CFO, EVP, Chief Actuary, and Vice President, on strategy and performance.
• Evaluate program risks, conduct market reviews, and drive continuous improvement in risk adjustment methods, tools, capabilities, and organizational awareness.

Requirements

• Bachelor’s degree in Business Administration, Management, Computer Science, or Information Science, or six years of relevant and progressive experience in lieu of the degree.
• 7–10 years of project or program management experience.
• 3–5 years of leadership experience and 3–5 years of risk revenue experience.
• 1–3 years of strategic planning experience.
• 3–5 years of healthcare industry experience.
• 1–3 years of consulting experience and 1–3 years working with cross-functional project teams.
• Excellent multitasking, analytical and logical reasoning, information technology, enterprise systems, and financial statement skills.

Nice to have

• Master’s degree in Business Administration, Management, or Mental Health Services.
• Project Management Professional (PMP) certification.

Culture & Benefits

• Remote work arrangement from Pennsylvania with 0%–25% travel.
• Regularly teaches and trains others.
• Work includes compliance with HIPAA, privacy, information security, confidentiality, and company conduct requirements.
• Base pay is determined by qualifications, experience, expected contributions, internal equity, market, business considerations, and applicable geographic differentials.