Highmark Health Jobs in the United States
Highmark Health
Wexford, PA
Certification Requirements: + Employees who have: graduated from a medical assistant program within five years OR proof of one year of work experience as a medical assistant in the last three years must complete certification training and/or attempt testing within 30 days of hire and must obtain certification within 120 days of hire. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._.
Highmark Health
Olympia, WA
Communicate effectively with all levels of the organization: facilitate meetings; plan, design and provide presentations; represent HM Health Solutions with outside entities; prepare divisional procedures, policies, reports and correspondence; spread awareness of new and existing security threats; provide oversight regarding metrics, funding, budgets and resources. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $108,000.00 **Pay Range Maximum:** $201,800.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.
Highmark Health
Erie, PA
Shares knowledge and skills with peers and colleagues and cultivates a work environment that promotes positive employees attitudes, effective communications, trust, and collaboration. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._.
Highmark Health
Atlanta, GA
To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Highmark Health
Concord, NH
To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Highmark Health
Juneau, AK
To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Highmark Health
Pittsburgh, PA
GENERAL OVERVIEW: Completes one or more of the following processes (scheduling, pre-registration, financial clearance, authorization and referral validation and pre-serviceability estimations and collections) within Patient Access and creates the first impression of AHN's services to patients and families and other external customers. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._.
Highmark Health
Pittsburgh, PA
Shares knowledge and skills with peers and colleagues and cultivates a work environment that promotes positive employees attitudes, effective communications, trust, and collaboration. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._.
Highmark Health
Topeka, KS
To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Highmark Health
Cheyenne, WY
To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Highmark Health
Honolulu, HI
To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Highmark Health
West Mifflin, PA
Transcribes reports, notes and correspondence; answers phones and take appropriate actions; files patient information in the medical record and prepares charts; performs general office tasks. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._.
Highmark Health
Phoenix, AZ
To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Highmark Health
Carson City, NV
To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Highmark Health
Dover, DE
To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Highmark Health
Cheyenne, WY
In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._. + Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards.
Highmark Health
Montgomery, AL
Demonstrated ability to work with minimal supervision with a high degree of organization and attention to detail; manage multiple simultaneous tasks, assignments, deadlines, and produce results, and be results-oriented team player who leads by example, holds self-accountable for performance, takes ownership, and champions all aspects product initiatives. + Ability to lead and influence others within a matrixed organization, and leads with a true sense of urgency with the ability to engage the workforce to do the right thing every time for our customers and clinicians; Leads with a customer and clinician-centric lens and advocates for a combined customer and clinician view in all interactions.
Highmark Health
Pittsburgh, PA
Monitors and operates the switchboard including answering and directing incoming calls, placing outgoing calls, overhead paging and emergency response communication. + Answers and directs all telephone calls and overhead paging inquiries for the efficient and timely operation of hospital communications.
Highmark Health
Atlanta, GA
In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._. + Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards.
Highmark Health
Boston, MA
To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Highmark Health
Austin, TX
To that end, the program will provide hands-on training and experience in the business line, expose the various career opportunities in the business line and related areas, and prepare participants for positions in the business. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Highmark Health
Trenton, NJ
Communicate effectively with physicians and pharmacy network providers to ensure that the needs of the provider and plan member are addressed in a courteous, helpful and timely manner. This role involves a high volume of daily contacts with members, physicians, and pharmacies to address medication-related issues, promote adherence, and ensure appropriate medication utilization.
Highmark Health
Jackson, MS
Successful definition, implementation and delivery of complex programs that requires cross-functional collaboration and inter-dependencies between a group of projects and/or related activities within the constraint of scope, quality, time and budget and under circumstances involving multiple moderate-probability, moderate-impact risk factors. + Organize, direct and coordinate cross-functional activities to focus corporate resources on the successful delivery and implementation of the desired results for a defined corporate program and/or strategic initiative.
Highmark Health
Harrisburg, PA
The incumbent is responsible for implementation and execution of various post-award and financial management activities for grants, contracts and/or clinical trials within the Sponsored Programs Financial Services (SPFS) supporting Allegheny-Singer Research Institute and Allegheny Health Network. Maintain compliance with allowable costs, period of performance, subrecipient monitoring, tracking cost share and program income, effort reporting, reporting, other special test provisions, cash management invoicing, and clinical trial billing compliance.
Highmark Health
Boise, ID
In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._. _Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.
Highmark Health
Indianapolis, IN
Responsible for ongoing maintenance, adequacy and support of existing networks, including strategic business rule changes, network audit support, network adequacy/provider gap fill support, understanding tools used to provider network adequacy (Quest), answering network inquiries from both internal and external customers, ensuring marketing brochures are accurate, and maintaining internal documents that support the business (product and network matrix; hospital tiering document). + Apply a broad knowledge of concepts and principles to develop analytical frameworks, approach and methodology best practices to analyze complex strategy issues, often applying ingenuity and originality to develop unique solutions.
Highmark Health
Raleigh, NC
Communicate effectively with physicians and pharmacy network providers to ensure that the needs of the provider and plan member are addressed in a courteous, helpful and timely manner. This role involves a high volume of daily contacts with members, physicians, and pharmacies to address medication-related issues, promote adherence, and ensure appropriate medication utilization.
Highmark Health
Montpelier, VT
Responsible for ongoing maintenance, adequacy and support of existing networks, including strategic business rule changes, network audit support, network adequacy/provider gap fill support, understanding tools used to provider network adequacy (Quest), answering network inquiries from both internal and external customers, ensuring marketing brochures are accurate, and maintaining internal documents that support the business (product and network matrix; hospital tiering document). + Apply a broad knowledge of concepts and principles to develop analytical frameworks, approach and methodology best practices to analyze complex strategy issues, often applying ingenuity and originality to develop unique solutions.
Highmark Health
Boston, MA
Successful definition, implementation and delivery of complex programs that requires cross-functional collaboration and inter-dependencies between a group of projects and/or related activities within the constraint of scope, quality, time and budget and under circumstances involving multiple moderate-probability, moderate-impact risk factors. + Organize, direct and coordinate cross-functional activities to focus corporate resources on the successful delivery and implementation of the desired results for a defined corporate program and/or strategic initiative.
Highmark Health
Phoenix, AZ
Provide feedback to Government Markets sales leadership and applicable departments related to sales opportunities, market trends and customer experience to help establish best practices and process improvements across business unit and matrixed organization. The incumbent meets and/or exceeds established quotas in terms of total calls, prospects sent to meetings, and contracts sold as well as predetermined enrollment targets.
Highmark Health
Lansing, MI
Support various aspects of business analysis, business requirements definition and documentation, business user testing, business requirement traceability, and full product capability delivery (e.g., user acceptance testing plans, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts. + Participate in the full product management delivery life cycle by actively participating with business and IT delivery teams using modern product management delivery practices and methodologies, such as Agile / Scrum, Kanban, etc. to manage product requirements, delivery plans, business product backlog & prioritization, testing, prototyping, and defining customer/user acceptance criteria.
Highmark Health
Concord, NH
The incumbent is responsible for implementation and execution of various post-award and financial management activities for grants, contracts and/or clinical trials within the Sponsored Programs Financial Services (SPFS) supporting Allegheny-Singer Research Institute and Allegheny Health Network. Maintain compliance with allowable costs, period of performance, subrecipient monitoring, tracking cost share and program income, effort reporting, reporting, other special test provisions, cash management invoicing, and clinical trial billing compliance.
Highmark Health
Concord, NH
Communicate effectively with physicians and pharmacy network providers to ensure that the needs of the provider and plan member are addressed in a courteous, helpful and timely manner. This role involves a high volume of daily contacts with members, physicians, and pharmacies to address medication-related issues, promote adherence, and ensure appropriate medication utilization.
Highmark Health
Madison, WI
Support various aspects of business analysis, business requirements definition and documentation, business user testing, business requirement traceability, and full product capability delivery (e.g., user acceptance testing plans, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts. + Participate in the full product management delivery life cycle by actively participating with business and IT delivery teams using modern product management delivery practices and methodologies, such as Agile / Scrum, Kanban, etc. to manage product requirements, delivery plans, business product backlog & prioritization, testing, prototyping, and defining customer/user acceptance criteria.
Highmark Health
Tallahassee, FL
Responsible for ongoing maintenance, adequacy and support of existing networks, including strategic business rule changes, network audit support, network adequacy/provider gap fill support, understanding tools used to provider network adequacy (Quest), answering network inquiries from both internal and external customers, ensuring marketing brochures are accurate, and maintaining internal documents that support the business (product and network matrix; hospital tiering document). + Apply a broad knowledge of concepts and principles to develop analytical frameworks, approach and methodology best practices to analyze complex strategy issues, often applying ingenuity and originality to develop unique solutions.
Highmark Health
Raleigh, NC
Responsible for ongoing maintenance, adequacy and support of existing networks, including strategic business rule changes, network audit support, network adequacy/provider gap fill support, understanding tools used to provider network adequacy (Quest), answering network inquiries from both internal and external customers, ensuring marketing brochures are accurate, and maintaining internal documents that support the business (product and network matrix; hospital tiering document). + Apply a broad knowledge of concepts and principles to develop analytical frameworks, approach and methodology best practices to analyze complex strategy issues, often applying ingenuity and originality to develop unique solutions.
Highmark Health
Albany, NY
Participate in the full software development life cycle by actively taking a lead role on agile scrum teams in various roles, including, but not limited to, Scrum Master, Business Technical Analyst, User Interface designer, Capability Manager, or Tester, based upon experience and need. + Communicate in an exemplary manner with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
Highmark Health
Salt Lake City, UT
Participate in the full software development life cycle by actively taking a lead role on agile scrum teams in various roles, including, but not limited to, Scrum Master, Business Technical Analyst, User Interface designer, Capability Manager, or Tester, based upon experience and need. + Communicate in an exemplary manner with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
Highmark Health
Springfield, IL
Demonstrated ability to work with minimal supervision with a high degree of organization and attention to detail; manage multiple simultaneous tasks, assignments, deadlines, and produce results, and be results-oriented team player who leads by example, holds self-accountable for performance, takes ownership, and champions all aspects product initiatives. + Ability to lead and influence others within a matrixed organization, and leads with a true sense of urgency with the ability to engage the workforce to do the right thing every time for our customers and clinicians; Leads with a customer and clinician-centric lens and advocates for a combined customer and clinician view in all interactions.
Highmark Health
Oklahoma City, OK
Duties include verifying enrollment status, making changes to records, addressing enrollment questions or concerns, resolving membership and billing issues, and accessing/updating enrollment and billing databases. + Communicate effectively with internal and external contacts to promptly resolve discrepancies in membership and billing information and to promptly provide accurate responses to written, telephone and online inquiries.
Highmark Health
Madison, WI
Duties include verifying enrollment status, making changes to records, addressing enrollment questions or concerns, resolving membership and billing issues, and accessing/updating enrollment and billing databases. + Communicate effectively with internal and external contacts to promptly resolve discrepancies in membership and billing information and to promptly provide accurate responses to written, telephone and online inquiries.
Highmark Health
Honolulu, HI
Support various aspects of business analysis, business requirements definition and documentation, business user testing, business requirement traceability, and full product capability delivery (e.g., user acceptance testing plans, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts. + Participate in the full product management delivery life cycle by actively participating with business and IT delivery teams using modern product management delivery practices and methodologies, such as Agile / Scrum, Kanban, etc. to manage product requirements, delivery plans, business product backlog & prioritization, testing, prototyping, and defining customer/user acceptance criteria.
Highmark Health
Montpelier, VT
Leveraging your profound expertise in graph databases (e.g., Neo4j, ArangoDB, Amazon Neptune, Ontotext GraphDB), distributed graph processing frameworks (e.g., Apache Spark GraphX, Dask-Graph), and leading GML libraries (e.g., PyTorch Geometric, DGL, Spektral), you will conduct in-depth research, construct sophisticated predictive, prescriptive, and diagnostic models directly on graph structures. You will proactively identify opportunities to construct and leverage comprehensive healthcare knowledge graphs, integrating diverse patient, provider, claims, and clinical data to uncover hidden patterns, propagate insights through networks, and develop groundbreaking analytical solutions that exploit the rich, multi-modal structures within healthcare.
Highmark Health
Pierre, SD
Support various aspects of business analysis, business requirements definition and documentation, business user testing, business requirement traceability, and full product capability delivery (e.g., user acceptance testing plans, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts. + Participate in the full product management delivery life cycle by actively participating with business and IT delivery teams using modern product management delivery practices and methodologies, such as Agile / Scrum, Kanban, etc. to manage product requirements, delivery plans, business product backlog & prioritization, testing, prototyping, and defining customer/user acceptance criteria.
Highmark Health
Austin, TX
This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to ensure appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy._.
Highmark Health
Nashville, TN
Duties include verifying enrollment status, making changes to records, addressing enrollment questions or concerns, resolving membership and billing issues, and accessing/updating enrollment and billing databases. + Communicate effectively with internal and external contacts to promptly resolve discrepancies in membership and billing information and to promptly provide accurate responses to written, telephone and online inquiries.
Highmark Health
Denver, CO
Demonstrated ability to work with minimal supervision with a high degree of organization and attention to detail; manage multiple simultaneous tasks, assignments, deadlines, and produce results, and be results-oriented team player who leads by example, holds self-accountable for performance, takes ownership, and champions all aspects product initiatives. + Ability to lead and influence others within a matrixed organization, and leads with a true sense of urgency with the ability to engage the workforce to do the right thing every time for our customers and clinicians; Leads with a customer and clinician-centric lens and advocates for a combined customer and clinician view in all interactions.
Highmark Health
Cheyenne, WY
Contribute to the definition, planning, and delivery of multiple product and technology projects, working with the executive sponsor (Director or higher) and other management as required to ensure achievement of the defined project goals. This requires a commitment to on-time/on-budget delivery, promoting a culture of collaboration among all project stakeholders, thinking and planning strategically in areas of risk mitigation and overall project direction, and a dedicated focus on bringing value to our customers.
Highmark Health
Topeka, KS
Provide required business and/or subject matter expertise for both project and production related activities on complex issues, including new strategic programs or initiatives impacting current and existing systems. testing plan, testing scenarios, testing schedule, testing outcomes, user task analysis, documentation, defect management, results analysis) to ensure minimal production defects are realized.
Highmark Health
Washington, DC
Contribute to the definition, planning, and delivery of multiple product and technology projects, working with the executive sponsor (Director or higher) and other management as required to ensure achievement of the defined project goals. This requires a commitment to on-time/on-budget delivery, promoting a culture of collaboration among all project stakeholders, thinking and planning strategically in areas of risk mitigation and overall project direction, and a dedicated focus on bringing value to our customers.