Company : Highmark Inc. Job Description : JOB SUMMARY This job captures all inbound inquires for utilization management review from providers and pharmacies. The incumbent assesses the request, conducts all necessary research such as ...
Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: We are currently seeking a highly organized and detail-oriented Coordinator Staffing for the Anesthesia Institute at Allegheny Health Network. This position will b...
Company : Highmark Inc. Job Description : JOB SUMMARY The job works directly with network providers to champion provider practice transformation in support of various Organization endorsed strategic care delivery models. Leads the day...
Company : Highmark Inc. Job Description : JOB SUMMARY This job manages and coordinates the supervisory staff that has accountability for the case management, medical review, utilization review, quality management and/or health education t...
Company : Highmark Inc. Job Description : JOB SUMMARY This job is responsible for the claims invoicing and accounts receivable activities for the non-risk self-insured population of clients supporting all medical, buy-up, shared savin...
Company : Highmark Inc. Job Description : GENERAL OVERVIEW: The Appeals Analyst reviews inquiries to determine if they meet the definition of a grievance/appeal;documents, investigates, refers and coordinates grievances and appeals;...
Company : enGen Job Description : JOB SUMMARY ***CANDIDATE MUST BE US Citizen (due to contractual/access requirements)*** This role provides Information Security and Risk Management services for the organization with a primary focus...
Company : Highmark Health Job Description : JOB SUMMARY Work Location Policy: This role offers a hybrid work model. Candidates residing within 50 miles of a Highmark office will be required to work on-site Tuesday through Thursday. Al...
Company : enGen Job Description : JOB SUMMARY ***CANDIDATE MUST BE US Citizen (due to contractual/access requirements)*** As a Senior Data Engineer, you will design and operate real‑time and analytical data pipelines that power ente...
Company : enGen Job Description : JOB SUMMARY This role is responsible for leading and developing a team of Business Relationship Managers who serve as the primary liaison between business stakeholders and IT. The manager ensures cons...