Company :Highmark Inc.Job Description : 

JOB SUMMARY

This job defines, plans, implements and successfully delivers readiness and execution activities for all Federal Markets segments. Oversees and manages all activities necessary to maintain efficient business mitigation & control processes, while ensuring adherence to all applicable state and federal regulatory standards. Ensures assigned initiatives are proactively and comprehensively managed; implementing the sales, marketing and product strategies reducing the risk of non-compliance and meeting or exceeding planned revenue. Acts as the primary Business Interface for driving matrixed partner organizations across the enterprise towards strategic delivery. Promotes a risk aware culture; ensure effective risk & compliance management practices by adhering to required standards and processes. The incumbent is primarily responsible for representing all Federal Markets segments in the identification of critical market operations issues, oversight for cross functional issue resolution, resource alignment, assurance for processes or capabilities definition based on business direction, and oversight that monitoring controls are institutionalized. 

ESSENTIAL RESPONSIBILITIES

Coordinate with other senior team members on daily direction of work processes and prioritization with assigned staff monitoring as necessary to ensure accurate & timely go-to-market readiness, risk mitigation and initiative delivery. Ensure operational excellence relative to each segment's readiness and execution and related compliance activities.Assess risks that might jeopardize successful achievement of the desired results, develop risk mitigation strategies and tactics, and implement risk mitigation plans.Prioritize & resolve high impact potential problems collaboratively and effectively using strong judgment, thought leadership and critical thinking.Monitor and evaluate operational performance of processes (e.g., completeness, accuracy, timeliness) along the Federal Markets segments' value streams; direct corrective actions in partnership with functional owners, as needed.  Report to the executive team/sponsor/steering committee on the progress, business impacts and strategies required to ensure proper performance.  Conduct and implement lessons learned to continuously improve the readiness and execution processes, adapting to business needs.Participate in the development and delivery of training for staff and related departments and corporate overviews as necessary to ensure the appropriate level of knowledge to support the Federal Markets' readiness and execution processes. Participate in internal and external audit activities including onsite audits and reporting requests.  Coordinate with senior team members on review of prosepctive policy.Lead and participate in the identification and justification of initiatives that drive value and differentiation of Federal Markets' products to ensure they are planned and executed successfully. Other duties as assigned or requested.

EDUCATION

Required

Bachelor's Degree

Substitutions

6 years of related and progressive experience in lieu of Bachelor's degree

Preferred

Master's Degree

EXPERIENCE

Required

3 years with Strategic Initiatives Delivery, Project Management, Business Analysis, or Business Systems Analysis

Preferred

3 years in the Health Insurance Industry1 year in Audit & ComplianceExperience in external vendor management and leading complex operational initiativesExperience with CHIP, Medicare, or ACA business and operating in the post Health Care Reform environment

LICENSES or CERTIFICATIONS

Required

None

Preferred

Project Management Professional (PMP), (Lean) Six Sigma

​SKILLS

Strong facilitation and cross-functional expertiseComfortable managing uncertainty and ambiguityProject Management Skills with emphasis on Risk ManagementAnalytical SkillsBusiness Process and PlanningProblem Solving and Decision MakingStrategic MindsetQuality Auditing

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

Rarely

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

Rarely

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.

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 their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

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 their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability. 

EEO is The Law

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