Jobs at Highmark Health

The role involves supporting business analysis for system applications, handling inquiries, and coordinating enhancements while ensuring compliance and reporting on system performance.

The Complex Case Manager RN oversees a panel of members, assessing health needs, creating care plans, and coordinating interventions to improve outcomes. They monitor compliance with healthcare regulations while managing a high caseload of enrolled members, providing outreach and support to facilitate care coordination and achieving health goals.

The role involves collecting, validating, and analyzing data to generate reports, resolving technical issues, and developing work plans to meet deadlines.

The Enrollment and Billing Representative handles membership and billing functions, resolves discrepancies, processes data, communicates with clients, and ensures service metrics are met.

Oversee Risk Adjustment and Quality/HEDIS processes, manage staff, ensure compliance, implement improvements, and conduct audits. Lead strategic initiatives for healthcare quality.

This role involves designing, developing, and maintaining data infrastructure, ensuring efficient data movement and transformation, collaborating with stakeholders, and implementing data governance practices.

The OPBAC coordinates benchmarking performance measurement, managing data submissions, supporting department managers, and liaising with vendors in the healthcare sector.

The Manager of Financial Planning and Cost Analysis oversees planning and forecasting cycles, financial reporting, variance analysis, and staff development. This role involves managing departmental operations, providing cost information support, and preparing financial analyses for senior leadership.

The Product Manager defines product value propositions and execution plans, manages product strategy and backlog, and collaborates with stakeholders to drive product value.

Lead strategic transformation of workforce operations at enGen, optimizing resource deployment and financial allocations while driving large-scale business operation improvements.

The Project Manager manages complex programs, coordinates project teams, monitors progress, and ensures alignment with business objectives while building positive customer relationships.

The Senior Decision Support Consultant designs and supports projects and data analysis, providing insights and consultation on Enterprise Informatics, mentoring analysts, and leading complex modeling and project management efforts.

Configure and support Epic Resolute Hospital Billing and Claims application, perform analysis, system design, and problem resolution while guiding end-users.

The Manager Operational Accounting oversees financial reporting, manages a team of accountants and analysts, ensures GAAP compliance, and leads projects for accounting processes and system integrations.

The Complex Case Manager RN manages a panel of members, assessing their health needs, developing care plans, and coordinating resources to improve health outcomes.

The Associate Internal Audit Analyst conducts operational and compliance audits to assess the adequacy of controls and governance processes at Highmark Health. This role involves collaboration with team members, executing control testing, and assisting with audit report development. Effective communication and relationship maintenance are key responsibilities.

The Business Systems Analyst supports claims operations by resolving system issues, managing tickets, and ensuring data integrity through collaboration, testing, and documentation.

The Business Process Analyst reviews information, analyzes processes, coordinates projects, identifies process inefficiencies, and recommends improvements to support business unit needs.

The Pharmacy Benefit Consultant offers strategic insights and consultation to clients, driving growth and retention in pharmacy solutions while focusing on business development, data analysis, and training.

The Pharmacy Analyst works with stakeholders to coordinate activities, manage projects, analyze data, ensure compliance, and improve pharmacy products.