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Highmark Health Senior Program Manager - ISRM in Helena, Montana

Company :

enGen

Job Description :

JOB SUMMARY

This position requires proactive engagement with internal stakeholders to establish strong relationships for identifying and accessing relevant data sources crucial for analytics-driven fraud detection in the healthcare domain. The Program Manager will lead efforts to build collaborative partnerships across departments to gather comprehensive datasets necessary for detecting anomalous activities and potential malicious trends. They will leverage these relationships to ensure access to critical information while adhering to security and compliance protocols. In addition to building internal relationships for data access, this role encompasses the establishment of new reporting structures and key performance indicator (KPI) criteria vital for effective fraud detection within the healthcare sector. The Program Manager will lead the development and implementation of comprehensive reporting mechanisms and KPI frameworks tailored to monitor and assess fraud detection effectiveness. They will collaborate with stakeholders to define meaningful metrics, dashboards, and scorecards that align with organizational objectives and regulatory requirements. The Program Manager will spearhead initiatives to enhance data-sharing practices and foster a culture of information transparency to strengthen fraud detection capabilities within the organization and use those capabilities to advertise differentiation from other health care plans to our customers.

ESSENTIAL RESPONSIBILITIES

  • Cross-functional collaboration and interdependency management between a group of projects, products/technologies, functions and/or customers.

  • Work with the executive sponsor of a corporate program 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.

  • Ensure clear lines of communication including but not limited to; transparency to the business on upcoming security initiatives, identifying impact to the business and to consumers, helping shape remediation, and developing external and internal communications

  • Measure program effectiveness and report accordingly on progress.

  • Work with Executive Sponsor and Business Owner of a Program, and other management as required, to achieve the Program objectives.

  • Measure program effectiveness and report accordingly on progress.

  • Utilize change management methodologies to mitigate identified security risks.

  • Other duties as assigned or requested.

EDUCATION

Required

  • Bachelor's Degree in Business Education, Marketing or Information Systems

Substitutions

  • Six (6) years relevant, progressive experience

Preferred

  • Master's Degree in Business Administration or Business Management

EXPERIENCE

Required

  • 7 years in IS/IT or IT Security

Preferred

  • 5 years of Project/Program Management

  • Analytics experience, preferably within an Information Technology/ Information Security organization

LICENSES or CERTIFICATIONS

Required

  • None

Preferred

  • PMP

  • CISSP

SKILLS

  • Change Management

  • Presentation Delivery

  • Prioritizing

  • Analytical and Logical Reasoning/Thinking

  • Communication Skills

  • Experience with Conflict Resolution

  • Experience with Risk Mitigation Planning

  • Customer Relationship Management

  • Customer Relationship Management Skills

  • Strong Interpersonal and Leadership Skills

  • Solid Organizational and Planning Skills

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Frequently

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

No

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

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.

Pay Range Minimum:

$78,900.00

Pay Range Maximum:

$146,000.00

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 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

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled/Sexual Orientation/Gender Identity ( https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf )

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 number below.

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

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J241050

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