Company : Highmark Inc. Job Description : JOB SUMMARY This job is responsible for the overall pre-payment high dollar claims review process for Highmark including the review of itemized bills for saving on outlier claims. This require...
Company : Highmark Inc. Job Description : JOB SUMMARY This job assists in the creation, execution, and oversight of the Medicare sales and distribution strategy through partnering with sales leadership and other matrix partners. The i...
Company : Highmark Inc. Job Description : JOB SUMMARY This job provides expertise for moderately to very complex problem solving and complete understanding of system functionality. The incumbent reviews significant amounts of informat...
Company : Highmark Inc. Job Description : JOB SUMMARY This job leads and/or participates in the development and execution of key strategic initiatives for Pharmacy Services. The incumbent engages in multiple cross-functional projects ...
Company : Highmark Inc. Job Description : JOB SUMMARY This job is responsible for providing comprehensive case management services to members, ensuring quality, cost-effective care delivery, and promoting optimal health outcomes. The ...
Company : enGen Job Description : JOB SUMMARY This role focuses on supporting the application product lifecycle, with a particular emphasis on claims processing and related application components. The Business Technical Analyst collab...
Company : Endorsed Job Description : JOB SUMMARY This role is integral to the organization's comprehensive care delivery system. The incumbent delivers high-quality, patient-centered care through in-home, virtual, and telephonic compr...
Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical ...
Company : Highmark Health Job Description : JOB SUMMARY The HRIS Consultant is a senior individual contributor who serves as the functional architect and implementation lead for Workday and its connected HR technology ecosystem. This ...
Company : enGen Job Description : JOB SUMMARY We are seeking a highly skilled and experienced Senior Enterprise Solution Architect to lead the design and implementation of innovative, robust, and scalable solutions that address comple...