Highmark jobs - Cranberry Township, PA

service development ability to understand Highmark data and talk to internal systems to extract business rules across all channels Supports project manager in working with project... more

Integration Coordinator coordinates the organization wide client integration efforts assessing Supply Chain value, cost reductions, integration, training and contract / service... more

training, etc.: * Familiarity with Highmark's preventative health services programs & services to make referrals as required * Experience in a clinical or health promotion setting... more

* Perform accurate and timely processing of pre-certification requests for authorization of medically necessary health care services at the appropriate level of care, based on the... more

This is a senior level position in a series of classifications for Actuarial Services staff who are pursuing professional designation as Fellow of the Society of Actuaries. more

This is a professional position in a series of classifications for Actuarial Services staff who are pursuing professional designation as Fellow of the Society of Actuaries. more

Ethics and Compliance program across all Highmark business operations, including ... and for incorporating best practices in Highmark's corporate program. o Responsible... more

of processes, technology and people across Highmark's family of companies. Advisory ... services to customers throughout the Highmark family of companies through a... more

As a Associate Counsel III -- Regulatory Compliance you will be primarily responsible for the interpretation and analysis of new federal and state health care laws and... more

This position is responsible for the following: * This position is responsible for providing secretarial and related service to the assigned Executive, as well as for providing... more

This position is required to comply with all Highmark Corporate Policies and ISG ... and business intellegience to help shape the Highmark Information Architecture. * Ability... more

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... more

On Boarding Coordinator Job Description The Highmark Managed Services Organization (MSO) transition process is comprised of many services to enable a practice to operate... more

personal and professional ethics to reflect Highmark's core values, Code of Business ... and to consistently demonstrate support of Highmark's core values, Code of Business... more

I am a recruiting partner with Highmark Inc and our team is working on the Senior Actuarial Analyst opening in PA - Pittsburgh This is a professional position in a series of... more

coaching and case management services to Highmark members * Accountable for daily operation of unit including staffing and scheduling to ensure that member outreach is effective... more

* Complete timely review to determine medically necessary services at the appropriate level of care, utilizing standard criteria and clinical judgment, based on the benefits for... more

an application architecture that adheres to Highmark's Strategic Information System ... and management: internal and external to Highmark including outside vendors regarding... more

As a part-time Associate Counsel V, you will be a key member of the Corporate Law Department. In this position, you will support the activities of the Company and its affiliates... more

f OSCAR claims processing including OCWA, INSINQ, ICIS, OPIS, BlueCard, Major Medical, Credit and Collections, Client Letter, ITS Repository, Cash Management, portals, and... more

systems * A strong understanding of Highmark operations, systems, policies, procedures, and performance requirements * Knowledge of, and experience in the use of, Business Process... more

patients that access services at one of the Highmark and/or WPAHS facilities or sites. This individual will be the service excellence champion for their facility and responsible... more

to explain and encourage participation in Highmark case management programs. * ... * Researching benefit information in Highmark systems * Retrieving messages from... more

This position is responsible for the following: * Manage account relationships with worksite and limited benefit medical plan accounts of all sizes. * Perform renewals and add-on... more

initiatives of critical importance to Highmark in the marketplace, as well as for leading the Audit & Compliance division's involvement in partnership and implementation projects. more

SUMMARY OF JOB RESPONSIBILITIES Performing membership and billing activities for clients and/or members. Duties include verifying enrollment status, making changes to records,... more

with Sales Force.com tool a plus. Prior Highmark experience a plus. CAI is a EOE. Responsible for providing support to technical professionals with regard to a variety of... more

The Expert Technical Integration Architect provides overall direction, guidance and expertise on architecture and solutions for provider business unit to effectively support the... more

strong, value-driven relationships with Highmark business areas through collaboration ... their implications for current and future Highmark business opportunities * Scan the... more

This position is required to comply with all Highmark Corporate Policies and ISG Procedures and Standards. * Provide leadership: o In the analysis, design, programming, testing... more

with professionals external to Highmark (e.g., Pennsylvania Medical Society, ... and support for their handling of Highmark's network providers. (For example,... more

As a Manager, Corporate Travel, Meetings & Events, you will be responsible for overseeing and managing the Corporate Meeting and Event Planning functions, overseeing and managing... more

* 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... more

* With oversight from Director responsible for strategic planning, development, implementation and monitoring of the quality portion of the Quality Improvement/Utilization... more

This position is required to comply with all Highmark Corporate Policies and ISG Procedures and Standards. * Promote a culture of performance excellence departmentally, throughout... more

activities to include: o Using the Highmark Project Lifecycle methodology for writing requirements for: new programs, system enhancements, client database enhancements, reporting,... more

for onboarding physician practices based on Highmark methodologies and standards. The ... monthly reporting capabilities using Highmark reporting and business intelligence... more

leadership and senior leadership throughout Highmark and its Subsidiaries. o Demonstrate ... and apply a thorough understanding of Highmark's complex business processes... more

Tax Management in the representation of Highmark and Subsidiaries; wholly and jointly owned, before applicable government authorities * Keep abreast of changes in tax law at all... more

surgery and hip and knee replacement by Highmark Blue Cross Blue Shield. We are also the official medical provider of the Pittsburgh Pirates. Job Summary: Responsible and... more

Title Enterprise Informatics Undergraduate Intern Location Pittsburgh, PA Description This is for the summer internship. The goal of an internship program is to provide the... more

Ensures deliverables meet / advance Highmark brand. 4) Leads marketing program review monthly meetings to update and align functional stakeholders and share best practices and new... more

As a Director, Human Resources, you will strategically partner with executive leaders and contribute to client strategy and objective setting while influencing HR strategy. more

Tax Management in the representation of Highmark and Subsidiaries; wholly and jointly owned, before applicable government authorities * Keep abreast of changes in tax law at all... more

Highmark is seeking a front-end/UI Web developer to assist in the creation of a best-of-br ... This position is required to comply with all Highmark Corporate Policies and ISG... more

Highmark is seeking application developer in the production support team, providing 24x7x365 production support for an external facing portal application. This position is... more

Title Graphic Design Undergraduate Intern Location Pittsburgh, PA Description This is for a year round internship. The goal of an internship program is to provide the opportunity... more

* Underwriter -- Analyst III has responsibility for revenue growth and improvements in profitability for his/her underwritten stop loss book of business marketed and sold by... more

serves as a primary liaison between Highmark providers and Walgreens Specialty ... targeted payors and providers, including Highmark Physician Network Specialty Pharmacy... more

This position is responsible for the following: * Use Base SAS and SAS BI tools to design and develop reporting and analytic applications * Collaborate closely with end users on... more