Nurse Supervisor, Medical Policy
Highmark - Harrisburg, PA
Company Description: Our history of helping families and companies with their health insurance needs dates to the 1930s, when our predecessor companies were established to help Pennsylvania's residents pay for health care. Highmark was created in 1996 by the consolidation of two ...
Highmark - Camp Hill, PA
Incumbent will be part of the Benefit Platform Client Market Facing business team. Acting in the role of an individual contributor and/or project lead on moderate to complex projects, this position is responsible for the following: Track, trend, forecast and analyze data to ident...
Highmark - Parkersburg, WV
As a Medical Underwriting Analyst, you will be responsible for making complex decisions regarding all medical underwriting liabilities and the development and implementation of all health underwriting policies and procedures. This position is the entry level position for Medical ...
Highmark - Camp Hill, PA
As an Accounting Clerk II, you will be responsible for the following: * Under general supervision assigns codes, identifies accounts, and prepares data transaction sheets. Analyzes and audits various accounts. * Posts, checks, and proofs entries to general ledger and accounts. * ...
Highmark - Pittsburgh, PA
Participate in the analysis of data and business processes, production support activities, routine table maintenance, and interfaces to support the Health Plan Operations area(s) taking into consideration impacts to the business environment. Utilize project management methodologi...
Highmark - Pittsburgh, PA
This position is responsible for: * Planning and managing all activities within an assigned business unit/area. This includes multiple application development, maintenance, and enhancement projects utilizing various new computing architectures (e.g., client/server, intranet, Web)...
Senior, Quality Improvement Consultant (Nursing)
Highmark - Pittsburgh, PA
* Assists Quality Improvement (QI) management, in the training of staff and distribution of work to assure completion of QI initiatives and program goals* Develops and/or oversees development of clinical and preventive guidelines and studies, analysis of data and identifies assoc...
Care Delivery Support Spec-HEP
Highmark - Pittsburgh, PA
SUMMARY OF JOB RESPONSIBILITIES This position is responsible for the following: * Enrolling new referrals in the clinical information system, confirming member eligibility and benefit information, ensuring the presence of member/family contact information, closing cases not requi...
Highmark - Pittsburgh, PA
This position is responsible for the following: * Perform software development Life Cycle tool analysis and design solutions to meet user, architecture, and infrastructure requirements.* Design and develop utilities to assist in implementation of tool solutions.* Identify and eva...
Highmark - Pittsburgh, PA
As an Accountant II, you will be a part of the Shared Financial Services department. In this role, you will be responsible moderately complex accounting activities related to bank reconciliations. Responsibilities include: * Under general supervision, responsible for moderately c...
Highmark - Camp Hill, PA
Analyze processes to support Health Plan Operations areas by conducting impact analysis to aid in decision making. * Utilize project management methodologies, as an individual contributor and/or project lead, to produce project deliverables on medium-sized projects. Coach, consul...
Highmark - Pittsburgh, PA
* Assure that members with complex medical and/or psychosocial needs have access to high quality, cost-effective health care.* Assist in the holistic assessment, planning, arranging, coordinating, monitoring, evaluation of outcomes and activities necessary to facilitate member ac...
Highmark - Pittsburgh, PA
This position is responsible for the following: * This position will aide in the development and maintenance of the network strategies for the Workers' Compensation product. * The incumbent will analyze and review provider data and work to resolve issues with internal and externa...
Highmark - Pittsburgh, PA
Business Tech Analyst - 2Acting in the role of an individual contributor, this position is responsible for the following: Provide business and technical expertise for the HPO website; Design, develop and maintain website content that is both engaging and effective in presenting r...
Highmark - Pittsburgh, PA
This position is responsible for the following working independently and potentially with more complex incidents * As the incident owner, for the identification, tracking, escalation, management, and documentation for all enterprise production outages. * Providing technical, admi...
Highmark - Camp Hill, PA
Provides consultation and analytical expertise in the development and support of various projects and data analysis of a moderately complex nature. Consultation and analysis would include: provider data and extracts, health care cost and utilization trends, clinical and condition...
Enterprise Datawarehouse Information Architect
Highmark - Pittsburgh, PA
This position is responsible for the following: *Defining the foundation components of the information architecture and contributing to the establishment and maintenance of the Enterprise Architecture.*Defining and implementing methodologies and tools to implement and support the...
Highmark - Camp Hill, PA
This position is responsible for the following: * Lead and mentor application staff in the development and/or support of systems applications, typically in support of simple to moderate business functional areas. * Work with staff and management to provide simple to complex techn...
Highmark - Camp Hill, PA
SUMMARY OF JOB RESPONSIBILITIES Acting in the role of Project Lead and/or high-level individual contributor on complex projects, this position is responsible for the following: * Analyze complex processes to support operational business areas by making decisions on the integratio...
Highmark - Pittsburgh, PA
Summary of Responsibilities: The Care Manager holds a pivotal position in the medical management area. This position is responsible for the implementation of effective utilization management strategies, including: Review of appropriateness of health care services. Application of ...