The role involves collaborating with cross-functional teams to gather data requirements, create analytical reports, and develop data sets. It also requires supporting the data delivery lifecycle through testing, defect management, and ensuring quality compliance.
The Senior Program Manager is responsible for the definition, implementation, and delivery of complex, cross-functional programs within scope, quality, and budget constraints. They lead matrixed teams, manage technology roadmaps, and utilize change management methodologies to ensure security behavior engagement and risk mitigation.
The Senior Data Engineer will design, develop, and maintain robust data infrastructure and pipelines to ensure efficient data movement and transformation. They will also collaborate with cross-functional teams to implement data governance, security, and business intelligence solutions.
The incumbent serves as the primary liaison between Highmark and the Blue Cross Blue Shield Association, managing operational compliance and strategic initiatives. They are responsible for negotiating Inter-Plan program policies, overseeing financial reimbursement structures, and providing expert testimony in legal matters related to national business operations.
Design, build, and maintain scalable data engineering solutions including ingestion pipelines, transformations, and delivery frameworks. Collaborate with cross-functional teams to support operational and analytic platforms while ensuring data quality and governance standards.
The Senior Architect leads the design, development, and implementation of complex architecture strategies to meet business needs. They provide strategic consultation, mentor team members, and ensure the integrity and practicality of enterprise business solutions.
The architect designs, develops, and optimizes architecture strategies to meet business needs while ensuring the integrity and practicality of enterprise solutions. They provide strategic consultation to business customers and lead improvement programs to enhance organizational processes and systems.
The Lead Business Analyst manages clinical trial agreements, negotiates budgets, and ensures billing compliance through Medicare Coverage Analysis. They also provide functional leadership, mentoring staff and driving strategic process improvements within the Office of Sponsored Research.
The Platform Engineer designs, implements, and supports enterprise cloud platforms and integrations to deliver secure and scalable solutions. This includes providing strategic consultation to business customers and leading system architecture improvements.
The role is responsible for the development, production, and maintenance of state and federally regulated documents with a focus on accuracy and compliance. It also involves supporting cross-functional collaboration and identifying opportunities to improve workflows and coding practices.
The analyst supports the product management lifecycle by collaborating with stakeholders to define business requirements and translate them into actionable product capabilities. They also manage the product backlog, perform root cause analysis, and ensure quality delivery of solutions through Agile methodologies.
The incumbent manages a complex portfolio of sponsored programs, overseeing financial activities from project activation to close-out. They are responsible for ensuring compliance with regulations, performing advanced financial analysis, and providing mentorship to junior analysts.
This leadership role oversees underwriting operations, managing team performance and strategic initiatives to support customer acquisition and retention. The incumbent collaborates with sales leadership to develop book management strategies and ensures adherence to internal and governmental regulations.
The Senior Security Engineer will lead the integration of security controls into the software development lifecycle and drive vulnerability risk reduction across the enterprise. They will also serve as a security advisor to engineering teams, mentor staff, and automate security toolchains to ensure high-fidelity detection.
The senior research statistician leads statistical support for scholarly research, including data cleaning, analysis, and protocol development. They serve as the primary contact for investigators and contribute to the preparation of manuscripts for peer-reviewed journals.
The supervisor manages the Medicare Fee-for-Service appeals unit, delegating assignments and ensuring compliance with CMS thresholds and internal standards. They provide direct oversight to staff, handle high-profile provider issues, and monitor departmental performance against budget and quality goals.
The incumbent manages a book of business for existing accounts, acting as a strategic consultant to ensure retention and growth. Responsibilities include conducting service calls, managing senior-level relationships, and leading internal partners to deliver client strategy.
The Pediatric Shift Care Case Manager acts as a central point of contact for pediatric members, managing caseloads and coordinating in-home nursing services. They are responsible for developing individualized care plans, monitoring member progress, and ensuring compliance with regulatory and company standards.
The incumbent will support, maintain, and optimize cloud technologies through engineering and automation builds. They will collaborate with cross-functional teams to design, test, and implement technical solutions that meet organizational goals.
The investigator is responsible for developing anti-fraud programs and conducting investigations into alleged fraud, waste, and abuse by providers and members. They must also prepare cases for legal referral, testify in court, and coordinate the recovery of misappropriated funds.
The incumbent partners with Client Managers to maintain and grow existing business while ensuring positive account relationships. They serve as the primary liaison for problem resolution and assist in the preparation of proposals, financial reports, and implementation specifications.
The dietitian directs and provides nutrition care to patients through assessment, planning, implementation, and monitoring. They also provide nutrition education to patients and staff while maintaining accurate documentation and reports.
The Strategy Analyst supports leadership by designing and executing analytics for cost containment and developing strategic impact packages. They work with business owners to identify key issues, apply analytical frameworks, and represent findings to stakeholders.
The Care Manager implements utilization management strategies, including reviewing the appropriateness of healthcare services and applying medical policies. They also monitor service delivery, educate providers and members, and identify opportunities for case management interventions.
The incumbent facilitates the implementation and administration of group accounts by managing stop loss sales cycle tasks and resolving issues related to underwriting and account service. They also act as a primary point of contact for producers and clients while coordinating new business and renewal activities.
The Identity & Access Management Security Engineer participates in the development, testing, implementation, and integration of IAM systems and solutions. This role focuses on supporting identity solutions, troubleshooting access issues, and ensuring the security of information resources.
The Payroll Administration Specialist is responsible for executing accurate multi-state payroll processing and maintaining HR information systems. They also provide Tier Two support for payroll-related inquiries and ensure compliance with federal, state, and local regulations.
The specialist analyzes and programs pacemakers, ICDs, and implantable loop recorders while supporting the telemonitoring program. They are also responsible for maintaining patient follow-up appointments and conducting patient education regarding device care.
The Senior Oracle Cloud EPM Analyst will administer, maintain, and enhance Oracle Cloud EPM applications, with a primary focus on Planning and EPBCS. They will also partner with Finance, Accounting, and IT teams to translate business requirements into scalable technical solutions and provide production support.
The Producer Analyst is responsible for managing producer compliance, monitoring licensure, and ensuring accurate commission payments. They also coordinate appointment renewals and maintain system agreements for sales personnel.
The consultant manages a block of stop loss business, overseeing new business and renewal pricing, risk analysis, and financial performance. They collaborate with sales, clinical, and underwriting teams to develop creative solutions and provide leadership and training to staff.
The specialist manages department activities to ensure compliance with regulatory guidelines such as NCQA, CMS, and DPW. They also oversee case management policies, conduct internal audits, and facilitate process improvements across the organization.
The Senior Business Systems Analyst supports the application product life cycle by translating business needs into detailed requirements and driving quality solutions. They lead project teams, manage cross-functional dependencies, and act as a subject matter expert to ensure successful delivery of business capabilities.
This role provides critical sales account support for the Stop Loss Business Unit, managing complex sales cycle tasks and facilitating account implementation. The incumbent acts as a primary point of contact for resolving issues related to RFP intake, underwriting, and ongoing group account service.
The incumbent analyzes risk factors and sets rates for self-funded plans while ensuring profitability and growth for a book of business. They also provide technical guidance to lower-level underwriters and influence sales and external partners regarding risk solutions.
The Database Administrator will manage the day-to-day operations, maintenance, and performance tuning of cloud-based database systems. They are also responsible for implementing backup and recovery strategies, ensuring high availability, and collaborating with application teams on database design and troubleshooting.
The manager will lead strategic program delivery and cloud operations, overseeing ERP implementations and technology initiatives across Finance and Supply Chain. They are responsible for managing staff performance, defining operational KPIs, and ensuring alignment with organizational strategic goals.
The manager provides leadership oversight to a group of project managers, ensuring delivery processes are followed and obstacles are removed. They are responsible for staff development, budget management, and resolving cross-domain scheduling conflicts.
The Principal Information Security Architect leads the design and advancement of enterprise data security architectures to protect sensitive information across its lifecycle. They collaborate with cross-functional teams to establish secure solutions for modern data platforms, analytics environments, and cloud infrastructure.
The Lead Enterprise Architect will drive technology strategy and innovation by designing comprehensive architecture roadmaps and leading AI solution strategies. This role involves providing strategic consultation to business customers and mentoring team members to ensure cohesive, scalable, and cost-effective enterprise solutions.
Lead the full project lifecycle from concept to delivery for mid-to-large initiatives, ensuring they are completed on time and within budget. Manage resources, mitigate risks, and maintain strong communication with stakeholders through detailed reporting and documentation.
Lead the full project lifecycle for large to extra-large initiatives, ensuring delivery on time, within budget, and to quality standards. Manage resources, mitigate risks, and maintain strong communication with stakeholders through detailed reporting and documentation.
The role is responsible for the performance and capacity management of the IBM zEnterprise mainframe environment to ensure system efficiency and cost-effectiveness. Key duties include capacity forecasting, performance tuning of middleware, and cross-functional collaboration with DevOps teams.
The role involves designing and developing research databases and analytic solutions to address clinical and financial healthcare challenges. The informaticist serves as a liaison between physicians and research staff to translate data needs into actionable insights.
Drive change within Utilization Management and Medical Policy operations by bridging clinical decision-making and operational finance. Develop robust financial and operational data models to quantify the impact of medical policies and track administrative costs.
Supports Enterprise Transformation project teams by analyzing qualitative and quantitative data to identify insights and shape recommendations. Responsible for owning deliverables from start to finish, including building presentations and facilitating design sessions for clients.
Conduct information risk assessments and formulate risk scoring to identify business threats and vulnerabilities. Partner with technical teams to integrate security architecture requirements and ensure compliance with standards like HITRUST and ISO 27001.
Manage Information Security and Risk Management services, overseeing personnel, budgets, and the implementation of security technology products. Lead strategic planning, ensure corporate policy compliance, and develop security awareness training programs.
Manage a team of clinicians to optimize member outcomes and ensure care is medically appropriate and cost-effective. Oversee department processes, ensure regulatory compliance with NCQA and CMS, and lead staff development and performance evaluations.
Acts as a liaison between members and healthcare providers to improve health outcomes through community outreach and education. Assists members in navigating the healthcare system, closing care gaps, and connecting with community resources.
Responsible for the configuration, rollout, and support of Revenue Cycle applications, specifically focusing on Epic systems. The role involves business analysis, system design, and collaborating with stakeholders to optimize revenue cycle workflows.
Develops and maintains clinical information systems and medication orders to ensure patient safety and operational efficiency. Collaborates with clinical and IT teams to design EMR solutions and manage interfaces with pharmacy applications.
The role involves analyzing industry data and financial conditions to assess risk for small and mid-sized clients. The underwriter collaborates with sales teams to deliver quotes and provide strategic risk management recommendations.
Design and implement end-to-end data management solutions to ensure data integrity, quality, and consistent flows across the enterprise. Perform data cleansing, audits, and root-cause analysis to troubleshoot system issues and implement process improvements.
Develop innovative generative and predictive AI solutions to solve complex business challenges for enterprise stakeholders. Design and implement end-to-end evaluation pipelines and R&D work for scalable, responsible AI agents.
Develops and executes strategic business plans for contract categories and manages high-dollar bids and GPO operational activities. Builds strategic relationships with supplier partners and presents business cases to senior leadership.
Responsible for the retention, growth, and profitability of medium to large customer accounts through strategic renewal negotiations and contract management. The role involves collaborating with internal teams to deliver product solutions and managing client issues to resolution.
Drive the adoption of innovative health products by partnering with sales and marketing to deliver consultative client presentations. Manage a book of business and develop client-specific marketing plans for key accounts to meet their specific needs.
The role focuses on driving the adoption of innovative health products through consultative selling and client presentations in partnership with sales and marketing. It involves managing a book of business, developing client-specific marketing plans, and serving as a product expert for implementation and problem resolution.
Drive the adoption of innovative health products by partnering with sales and marketing to deliver consultative client presentations. Manage a book of business and develop client-specific marketing plans to meet the needs of large key accounts.
The role focuses on driving the adoption of innovative health products through consultative selling and client presentations. It involves managing a book of business and developing client-specific marketing plans for key accounts.
Partner with sales and marketing to drive the adoption of innovative healthcare products through consultative client advising and presentations. Manage a book of business and develop client-specific marketing plans for key accounts to meet their strategic needs.
The role focuses on creating data-driven insights and reporting solutions to improve healthcare costs, outcomes, and patient experiences. The analyst serves as a technical expert, leading the design and execution of clinical and population health analyses for internal and external stakeholders.
Responsible for onboarding new clinical applications, providing technical support, and managing the lifecycle of servers and applications. The role involves collaborating with cross-functional teams to ensure secure, compliant, and highly available systems for patient care.
Lead the development and evolution of network products by defining the value proposition, vision, and multi-year strategy. Oversee the entire product lifecycle from ideation to optimization while collaborating with internal strategy and operations teams.
The role focuses on building and maintaining hospital, professional, and ASC contracts within the Epic system. It also involves managing underpayment accounts and collaborating with Finance and Revenue Cycle teams on reimbursement analysis.
Lead the development of actuarial studies and analyses focusing on insurance pricing, claim trends, and profitability. Provide technical guidance to junior staff and represent the department's needs in cross-disciplinary settings.
Drive project delivery to improve key performance metrics through capability analysis, operating model definition, and process transformation. Manage full workstreams from start to finish, including data analysis, hypothesis testing, and presenting recommendations to executives.
Lead complex strategic initiatives to optimize clinical programs and improve health outcomes through data-driven analysis. Translate analytical findings into actionable business cases and strategic recommendations for senior management.
Lead the design, implementation, and maintenance of critical mainframe systems including z/OS, DB2, and CICS. The role involves driving platform improvements, troubleshooting critical issues, and mentoring junior engineers in a geographically dispersed environment.
The role focuses on adopting, maintaining, and optimizing cloud technologies and automation builds across the organization. Responsibilities include designing and implementing technical solutions, collaborating with stakeholders, and mentoring junior engineers.
Lead the analysis, design, coding, and implementation of complex application enhancements and provide general production support. Collaborate with business analysts and IT teams to deliver innovative technical solutions that adhere to company standards.
Lead the advancement and integration of the marketing technology stack and AI to scale marketing efforts. Manage vendor relationships, operational strategies, and the delivery of platform roadmaps in collaboration with IT and other stakeholders.
Lead the financial narrative for enGen by managing the monthly close cycle, rolling forecasts, and executive reporting for the CFO and board. Oversee the finance team's daily operations, including staff development and the implementation of AI-driven automation and Power BI reporting.
Perform thorough medical record reviews to abstract data and apply ICD and CPT codes for diagnoses and procedures. Manage unbilled coding reports to ensure efficient cash flow and maintain up-to-date knowledge of coding guidelines.
Lead the development of actuarial studies and analyses to inform management decisions across various insurance functions. Guide and mentor junior staff while implementing efficient processes for pricing, claim trends, and profitability analysis.
The role involves applying actuarial techniques and statistical analysis to functions such as pricing, claim trends, and profitability. The analyst is responsible for developing data queries, creating studies for decision-makers, and participating in the Actuarial Executive Development Program.
Lead a team of actuarial and analytics professionals to manage claims reserving, financial forecasting, and trend analytics. Provide strategic guidance to senior leadership to ensure financial stability and regulatory compliance across the enterprise.
Lead product management for the Acquisition & Onboarding portfolio within the Government segment, focusing on Medicare and ACA membership growth. Define product visions, execute multi-year roadmaps, and manage the full product lifecycle from ideation to launch.
Provides clinical consultation and utilization management reviews for behavioral health and addiction services within Medicaid and Medicare programs. Collaborates with leadership to develop strategic directions, ensure compliance with medical standards, and manage provider networks.
Perform financial and business research, including the preparation of forecasts, trend analysis, and financial reports. Lead special projects by gathering data, documenting findings, and presenting results to management to improve business outcomes.
The Medical Director performs utilization management reviews to evaluate the medical necessity and appropriateness of treatments based on clinical standards. They also serve as the physician expert within a multidisciplinary team for case and disease management.
The role focuses on the product management lifecycle for Provider Data Exchange, translating business needs into detailed requirements. It involves collaborating with stakeholders to manage product backlogs, roadmaps, and ensuring quality delivery through Agile methodologies.
The Manager of IT Data Governance provides operational leadership for the data governance team to support IT projects and enterprise data standards. They are responsible for managing data owners, facilitating governance councils, and ensuring continuous process improvement across the organization.
Conduct comprehensive in-home, virtual, and telephonic clinical assessments for patients with chronic health conditions. Manage palliative care, facilitate advance care planning, and coordinate with interdisciplinary teams to ensure optimal health outcomes.
The incumbent manages a panel of members by assessing health needs, developing care plans, and coordinating clinical interventions to improve health outcomes. They also monitor quality metrics and ensure all activities comply with regulatory standards and accreditation requirements.
This role involves the design, build, implementation, and support of Epic Willow Ambulatory applications for retail and outpatient pharmacy operations. The analyst will partner with pharmacy leadership and IT teams to optimize medication workflows, ensure system stability, and manage retail pharmacy integrations.
The Registered Nurse is responsible for assessing patient needs, planning and implementing nursing care, and administering infusion therapy in home settings. They must maintain accurate medical records, coordinate with interdisciplinary teams, and ensure adherence to safety and quality standards.
The consultant leads provider practice transformation initiatives to improve clinical operations and patient outcomes across various healthcare settings. They facilitate change through baseline analysis, gap assessments, and the implementation of evidence-based best practices.
The Senior Cyber Incident Responder leads complex cyber investigations and coordinates incident response efforts within the Cyber Fusion Center. They are responsible for analyzing threat data, performing forensic collections, and providing expert technical guidance to ensure enterprise-wide security.
This role involves instructing, directing, and checking the work of other analysts and programmers while formulating complex system scope and objectives for assigned projects. Responsibilities include providing complex architecture and technical designs, managing the entire application life cycle, and ensuring adherence to project schedules.
The Imaging Institute is expanding services and locations, recruiting radiologists for musculoskeletal imaging roles. Positions are available as part-time or full-time, with options for onsite, hybrid, or remote work arrangements.
Physicians will provide a full range of diagnostic neuroradiology services across various AHN facilities, including trauma centers and stroke centers, utilizing state-of-the-art imaging technologies. Involvement in clinical and didactic teaching for residents and medical students, along with active participation in multidisciplinary conferences, is also expected.
The role involves reading chest imaging exclusively or a combination of chest and cardiac imaging, with options for body imaging interpretation available. Responsibilities include providing diagnostic services across plain film, various CT modalities (including cardiac CT), and MR imaging (including cardiac MRI).
The Registered Nurse assesses human responses and plans, implements, and evaluates nursing care for individuals or families, assuring safe delivery of nursing services in alternative care settings like home infusion visits to administer therapy. Responsibilities include active participation in interdisciplinary communication, directing ancillary care, accurate documentation, and timely implementation and evaluation of physician orders.
This role involves configuring, deploying, and supporting assigned Epic application(s), including performing business/systems analysis, defining requirements, designing systems, and resolving problems for end-users. The analyst will plan, build, test, implement, and maintain Epic software environments to meet user needs and manage small to medium projects independently.
The Mainframe Systems Programmer will install, upgrade, and manage CICS/MQ environments, ensuring the health and stability of the mainframe system. They will also participate in disaster recovery exercises and troubleshoot issues to determine root causes.
This role involves identifying and cultivating prospects and clients for the profitable sale of core and supplemental HNAS products within an assigned region, directly or through intermediaries. The incumbent will lead new business meetings, close sales for groups generally spanning 1,000-10,000 members, and manage complex account needs.
The Senior Marketing Analytics Analyst transforms customer and campaign data into insights to improve marketing effectiveness. This role involves developing digital strategies, building performance dashboards, and evaluating campaign ROI.
The coder performs thorough medical record reviews to abstract medical and demographic data and applies appropriate ICD codes for diagnoses and procedures. They also ensure efficient management of medical information and assist in decreasing average accounts receivable days.
The Sales Executive actively prospects for new clients and manages relationships with existing accounts to ensure retention and growth. They are responsible for selling core and supplemental products while acting as a strategic consultant for clients.
The Medical Director ensures that utilization management responsibilities are performed according to clinical standards by reviewing escalated cases and determining medical necessity. They also participate in multidisciplinary teams for case and disease management, advising on high-risk cases and managing special projects.
