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Jobs: 1 - 10 of 701

Health Strategy Implementer

Highmark Health. Pittsburgh

Job Description Company : Highmark Inc Job Description : I. GENERAL OVERVIEW: As part of Health Affairs, Health Strategy Implementers are customer facing professionals tasked with implementing individual components of the data driven health...

Country United States
State Pennsylvania (PA)
Job Category Customer Service
Position Type Full Time

SVP, Clinical Transformation

Highmark Health. Pittsburgh

Job Description Company : Highmark Health Job Description : JOB SUMMARY The SVP, Clinical Transformation will be a key member of the CMO/Shared Clinical Services leadership team. The SVP, Clinical Transformation will be accountable to execu...

Country United States
State Pennsylvania (PA)
Job Category Customer Service
Position Type Full Time

Director Transformation Strategy

Highmark Health. Pittsburgh

Job Description Company : Highmark Health Job Description : JOB SUMMARY This job leads the development of the Organization's overall clinical transformation effort with focus on care model design, primary care/community practice redesign, l...

Country United States
State Pennsylvania (PA)
Job Category Customer Service
Position Type Full Time

Vice President, Clinical Services Operations

Highmark Health. Pittsburgh

Job Description Company : Highmark Inc Job Description : JOB SUMMARY This job oversees a multi-disciplinary non-clinical team that provides operational support the Clinical Services clinical functions. The incumbent has ultimate oversight o...

Country United States
State Pennsylvania (PA)
Job Category Customer Service
Position Type Full Time

Associate Medical Director

Highmark Health. Pittsburgh

Job Description Company : Job Description : JOB SUMMARY This job provides clinical support to the Medical Management & Policy team to ensure that utilization management activities are performed in accordance with the highest and most curren...

Country United States
State Pennsylvania (PA)
Job Category Customer Service
Position Type Full Time

Behavioral Health Specialist

Highmark Health. Pittsburgh

Job Description Company : Highmark Inc Job Description : JOB SUMMARY This job is to provide case and condition management services to members with behavioral health concerns. This job uses clinical and motivational interviewing skills to as...

Country United States
State Pennsylvania (PA)
Job Category Customer Service
Position Type Full Time

Senior Care Manager RN

Highmark Health. Pittsburgh

Job Description Company : Highmark Inc Job Description : GENERAL OVERVIEW: Responsible for the implementation of effective utilization management strategies including: review of appropriateness of health care services, application of criter...

Country United States
State Pennsylvania (PA)
Job Category Customer Service
Position Type Full Time

Medical Policy Research Analyst - Program Manager

Highmark Health. Pittsburgh

Job Description Company : Highmark Inc Job Description : JOB SUMMARY This job monitors local, national and federal activity to identify and inform the medical policy clinical leadership team and key decision makers of emerging trends (medic...

Country United States
State Pennsylvania (PA)
Job Category Customer Service
Position Type Full Time

Intake Coordinator

Highmark Health. Pittsburgh

Job Description Company : Highmark Inc Job Description : JOB SUMMARY This job captures all inbound requests for utilization review from providers and pharmacies. The incumbent assesses the request, conducts all necessary research such as ve...

Country United States
State Pennsylvania (PA)
Job Category Customer Service
Position Type Full Time

Manager, Utilization Management

Highmark Health. Pittsburgh

Job Description Company : Highmark Inc Job Description : I. GENERAL OVERVIEW: Expert in the areas of utilization management, continuum of care planning, benefit interpretation, insurance industry regulations as well as personnel management....

Country United States
State Pennsylvania (PA)
Job Category Customer Service
Position Type Full Time
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