Highmark Health

Clinical Quality and Regulatory Specialist

Highmark Health · Full Time · an hour ago

Highmark Health

🌎 United States 💵 $62700 - $97200 per year ⭐ 2-5 yrs exp 💼 Legal

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.

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Talent Acquisition Coordinator

Highmark Health · Full Time · an hour ago

Highmark Health

🌎 United States 💵 $20.72 - $30.12 per hour ⭐ 0-2 yrs exp 💼 Recruitment

The Talent Acquisition Coordinator manages pre-hire processes, including background checks, health screenings, and documentation to ensure compliance. They also facilitate data integrity for hires and provide administrative support to the talent acquisition team.

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Pega Software Engineer

Highmark Health · Full Time · 2 days ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 5-10 yrs exp 💼 Software Development

The engineer will design, build, and deploy complex, scalable Pega applications within an agile team environment. Responsibilities include writing high-quality code, performing code reviews, and collaborating on technical design and execution.

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Senior Business Systems Analyst

Highmark Health · Full Time · 3 days ago

Highmark Health

🌎 United States 💵 $79300 - $127K per year ⭐ 5-10 yrs exp 💼 Others

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.

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Complex Case Manager RN

Highmark Health · Full Time · 3 days ago

Highmark Health

🌎 United States 💵 $72700 - $116K per year ⭐ 5-10 yrs exp 💼 Healthcare

The incumbent manages a panel of members by assessing health needs, developing personalized care plans, and coordinating clinical interventions. They monitor quality outcomes and ensure all activities comply with regulatory standards and accreditation requirements.

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Senior Account Support Analyst - HMIG

Highmark Health · Full Time · 3 days ago

Highmark Health

🌎 United States 💵 $62700 - $97200 per year ⭐ 5-10 yrs exp 💼 Support

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.

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Senior Medical Stop Loss Underwriter

Highmark Health · Full Time · 4 days ago

Highmark Health

🌎 Azerbaijan, Bermuda, Canada, Cayman Islands, Germany, India, Indonesia, Israel, Tunisia, United States 💵 $79300 - $127K per year ⭐ 5-10 yrs exp 💼 Finance

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.

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Associate Technical Analyst

Highmark Health · Full Time · 4 days ago

Highmark Health

🌎 Azerbaijan, Bermuda, Canada, Cayman Islands, Germany, India, Indonesia, Israel, Tunisia, United States 💵 $58100 - $90000 per year ⭐ 2-5 yrs exp 💼 Others

This role supports the configuration, maintenance, and optimization of the Genesys Cloud environment and its integrations with systems like Epic EHR. The analyst will collaborate with cross-functional teams to implement new capabilities, troubleshoot end-user issues, and ensure platform reliability and compliance.

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Principal Software Engineer

Highmark Health · Full Time · 4 days ago

Highmark Health

🌎 United States 💵 $129K - $214K per year ⭐ 10+ yrs exp 💼 Software Development

The Principal Software Engineer will lead the design and execution of scalable software applications while providing technical leadership and mentorship to the engineering team. They are responsible for driving product roadmaps, ensuring system robustness, and exploring cutting-edge architectural solutions to meet business needs.

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Cloud Database Administrator

Highmark Health · Full Time · 4 days ago

Highmark Health

🌎 United States 💵 $79300 - $127K per year ⭐ 2-5 yrs exp 💼 Software Development

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.

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Care Manager RN

Highmark Health · Full Time · 5 days ago

Highmark Health

🌎 United States 💵 $68400 - $105K per year ⭐ 2-5 yrs exp 💼 Healthcare

The Care Manager RN implements utilization management strategies to ensure appropriate resource use and identifies opportunities for health coaching or case management. They also monitor healthcare delivery, educate providers and members, and analyze data to improve care outcomes and satisfaction.

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Outreach Representative

Highmark Health · Full Time · 5 days ago

Highmark Health

🌎 United States 💵 $19.66 - $27.42 per hour ⭐ 0-2 yrs exp 💼 Others

The Outreach Representative serves as a liaison between members and the health plan, conducting telephonic support to assess needs and provide appointment scheduling assistance. They also initiate outreach for preventive health initiatives and assist members in navigating grievance and appeals processes.

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Senior Director of Underwriting Technology Transformation

Highmark Health · Full Time · 6 days ago

Highmark Health

🌎 Canada, France, Trinidad and Tobago, United Kingdom, United States 💵 $169K - $286K per year ⭐ 10+ yrs exp 💼 Others

The Senior Director leads the enterprise technology transformation of underwriting operating models and decisioning systems to create a scalable, data-driven ecosystem. They collaborate with executive leadership to integrate advanced analytics and automation into workflows, ensuring measurable financial outcomes and improved pricing accuracy.

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Manager Strategic Program Delivery and Operations

Highmark Health · Full Time · 6 days ago

Highmark Health

🌎 United States 💵 $118K - $196K per year ⭐ 5-10 yrs exp 💼 Others

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.

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Manager Client Project Management

Highmark Health · Full Time · 6 days ago

Highmark Health

🌎 United States ⭐ 5-10 yrs exp 💼 Product

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.

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Principal Information Security Architect - Data Security

Highmark Health · Full Time · 6 days ago

Highmark Health

🌎 United States 💵 $129K - $214K per year ⭐ 10+ yrs exp 💼 Software Development

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.

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Lead Architect

Highmark Health · Full Time · 6 days ago

Highmark Health

🌎 Azerbaijan, Bermuda, Canada, Cayman Islands, Germany, India, Indonesia, Israel, Tunisia, United States 💵 $118K - $196K per year ⭐ 5-10 yrs exp 💼 Software Development

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.

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Client Project Manager

Highmark Health · Full Time · 7 days ago

Highmark Health

🌎 Azerbaijan, Bermuda, Canada, Cayman Islands, Germany, India, Indonesia, Israel, Tunisia, United States ⭐ 2-5 yrs exp 💼 Product

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.

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Senior Client Project Manager

Highmark Health · Full Time · 7 days ago

Highmark Health

🌎 United States ⭐ 5-10 yrs exp 💼 Product

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.

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Mainframe Senior Architect – Performance & Capacity Management

Highmark Health · Full Time · 7 days ago

Highmark Health

🌎 United States 💵 $102K - $164K per year ⭐ 10+ yrs exp 💼 Software Development

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.

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Senior Clinical Informaticist

Highmark Health · Full Time · 7 days ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 5-10 yrs exp 💼 Healthcare

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.

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Strategy Consultant - Utilization Management and Medical Policy

Highmark Health · Full Time · 7 days ago

Highmark Health

🌎 United States 💵 $108K - $180K per year ⭐ 5-10 yrs exp 💼 Healthcare

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.

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Transformation Consultant

Highmark Health · Full Time · 9 days ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 2-5 yrs exp 💼 Others

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.

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Senior Financial Systems Analyst

Highmark Health · Full Time · 10 days ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 5-10 yrs exp 💼 Finance

The role involves designing, implementing, and maintaining complex computerized finance systems while collaborating with IT and finance teams. It requires leading large-scale enterprise transformation programs and managing deliverables such as business vision, testing plans, and user interface designs.

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Information Risk Consultant

Highmark Health · Full Time · 10 days ago

Highmark Health

🌎 United States 💵 $79300 - $127K per year ⭐ 5-10 yrs exp 💼 Finance

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.

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Manager Information Security & Risk Management - Cloud Security Manager

Highmark Health · Full Time · 11 days ago

Highmark Health

🌎 United States 💵 $129K - $214K per year ⭐ 10+ yrs exp 💼 Software Development

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.

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Associate Document Implementation Analyst

Highmark Health · Full Time · 11 days ago

Highmark Health

🌎 Azerbaijan, Bermuda, Canada, Cayman Islands, Germany, India, Indonesia, Israel, Tunisia, United States 💵 $53800 - $83300 per year ⭐ 0-2 yrs exp 💼 Others

Responsible for the development, production, and maintenance of state and federally regulated documents ensuring accuracy and compliance. The role involves supporting cross-functional collaboration and improving operational workflows using digital tools and AI.

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Senior Product Manager

Highmark Health · Full Time · 12 days ago

Highmark Health

🌎 United States 💵 $102K - $164K per year ⭐ 5-10 yrs exp 💼 Product

Lead the strategic vision and execution of Payer/Provider Interoperability products to improve health outcomes and reduce administrative burden. Manage the product roadmap, backlog, and cross-functional delivery while mentoring junior product team members.

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Supervisor Case Management - (Remote) Delaware

Highmark Health · Full Time · 13 days ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 5-10 yrs exp 💼 Others

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.

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Director Strategy - Risk Adjustment

Highmark Health · Full Time · 13 days ago

Highmark Health

🌎 United States 💵 $142K - $236K per year ⭐ 5-10 yrs exp 💼 Others

The Director of Strategy for Risk Adjustment leads strategic planning, operational efficiency, and programmatic execution within the RAAM department. This includes managing budgets, overseeing cross-functional projects, and optimizing risk adjustment accuracy to achieve organizational goals.

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Clinical Pharmacy Technician - Remote

Highmark Health · Full Time · 14 days ago

Highmark Health

🌎 Cuba, Finland, France, Germany, United States 💵 $19.66 - $27.42 per hour ⭐ 2-5 yrs exp 💼 Healthcare

Coordinates member and provider outreach to gather non-clinical information, including benefits investigations and formulary research. Acts as a liaison between members, providers, and pharmacy teams to ensure accurate documentation and timely case processing.

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Community Health Worker

Highmark Health · Full Time · 17 days ago

Highmark Health

🌎 United States 💵 $20.72 - $30.12 per hour ⭐ 0-2 yrs exp 💼 Healthcare

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.

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Revenue Cycle Operations Analyst

Highmark Health · Full Time · 18 days ago

Highmark Health

🌎 United States 💵 $31.02 - $48.54 per hour ⭐ 2-5 yrs exp 💼 Sales

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.

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Senior IT Pharmacy Analyst

Highmark Health · Full Time · 18 days ago

Highmark Health

🌎 United States 💵 $102K - $164K per year ⭐ 2-5 yrs exp 💼 Healthcare

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.

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Supervisor Coding

Highmark Health · Full Time · 19 days ago

Highmark Health

🌎 United States 💵 $31.02 - $48.54 per hour ⭐ 5-10 yrs exp 💼 Others

Assists the Coding Manager in supervising daily operational processes, including work assignments, timekeeping, and staff productivity. Responsible for analyzing coding data, resolving claim issues, and implementing process improvements to enhance revenue results.

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Underwriter

Highmark Health · Full Time · 19 days ago

Highmark Health

🌎 United States 💵 $62700 - $97200 per year ⭐ 2-5 yrs exp 💼 Finance

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.

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Supervisor Strategic Risk Adjustment and Quality

Highmark Health · Full Time · 20 days ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 5-10 yrs exp 💼 Others

The Supervisor is responsible for developing plans and managing activities related to Risk Adjustment and Quality/HEDIS, overseeing daily operations and staff performance. They also implement strategic improvements and ensure compliance with regulatory standards.

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Associate Technical Engineer

Highmark Health · Full Time · 21 days ago

Highmark Health

🌎 United States 💵 $68400 - $105K per year ⭐ 2-5 yrs exp 💼 Software Development

Responsible for analyzing, designing, coding, and implementing technical solutions while providing production monitoring and support. Collaborates with cross-functional teams to align technical solutions with enterprise goals and organizational needs.

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Data Governance Consultant

Highmark Health · Full Time · 21 days ago

Highmark Health

🌎 United States 💵 $68400 - $105K per year ⭐ 2-5 yrs exp 💼 Others

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.

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Senior Data Scientist - AI Services and Platforms

Highmark Health · Full Time · 21 days ago

Highmark Health

🌎 United States 💵 $102K - $164K per year ⭐ 2-5 yrs exp 💼 Software Development

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.

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Category Manager

Highmark Health · Full Time · 24 days ago

Highmark Health

🌎 United States 💵 $94200 - $151K per year ⭐ 5-10 yrs exp 💼 Others

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.

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Business Planning Analyst

Highmark Health · Full Time · 25 days ago

Highmark Health

🌎 United States 💵 $79300 - $127K per year ⭐ 5-10 yrs exp 💼 Others

Acts as a strategic partner to the Senior Dental Director to drive enterprise priorities, organizational effectiveness, and transformational initiatives. Responsibilities include coordinating strategic planning, monitoring business performance via KPIs, and leading change management and executive communications.

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Account Executive II - United Concordia Dental

Highmark Health · Full Time · 25 days ago

Highmark Health

🌎 United States 💵 $64000 - $96000 per year ⭐ 2-5 yrs exp 💼 Sales

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.

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Client Advising Consultant

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $72700 - $116K per year ⭐ 2-5 yrs exp 💼 Others

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.

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Associate Client Advising Consultant

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $62700 - $97200 per year ⭐ 2-5 yrs exp 💼 Others

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.

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Associate Client Advising Consultant

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $62700 - $97200 per year ⭐ 2-5 yrs exp 💼 Others

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.

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Associate Client Advising Consultant

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $62700 - $97200 per year ⭐ 2-5 yrs exp 💼 Others

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.

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Client Advising Consultant

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $72700 - $116K per year ⭐ 2-5 yrs exp 💼 Others

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.

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Senior Clinical & Population Health Analyst

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $79300 - $127K per year ⭐ 5-10 yrs exp 💼 Healthcare

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.

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VP AI Strategy & Enablement

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $209K - $372K per year ⭐ 10+ yrs exp 💼 Software Development

Define and execute the strategic AI roadmap for enGen and the Highmark enterprise to drive innovation and operational efficiency. Lead the commercialization of AI capabilities to generate new revenue streams and foster cross-enterprise collaboration.

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Epic Clindoc Systems Analyst

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $68400 - $105K per year ⭐ 2-5 yrs exp 💼 Others

Responsible for configuring, implementing, and supporting the Epic Clinical Documentation (Clindoc) application. This includes performing workflow analysis, resolving system issues, and providing guidance to end-users to optimize software use.

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Associate Technical Analyst

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $58100 - $90000 per year ⭐ 0-2 yrs exp 💼 Others

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.

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Senior Product Manager - Network Product

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $102K - $164K per year ⭐ 5-10 yrs exp 💼 Product

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.

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Associate Managed Care Analyst

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $34.29 - $54.25 per hour ⭐ 2-5 yrs exp 💼 Others

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.

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Strategy Analyst - Product and Experience Operations

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 2-5 yrs exp 💼 Others

Drive operational excellence across the Product Development Management Lifecycle by defining standards, workflows, and outcome-based performance metrics. Coordinate departmental momentum through internal communications, roadmap tracking, and workforce transformation initiatives.

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Actuary

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $102K - $164K per year ⭐ 5-10 yrs exp 💼 Finance

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.

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Senior Transformation Consultant

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $108K - $180K per year ⭐ 5-10 yrs exp 💼 Others

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.

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Medical Stop Loss Underwriting Consultant

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $94200 - $151K per year ⭐ 10+ yrs exp 💼 Healthcare

Manage a block of stop loss business and case level underwriting to achieve P/L and renewal metrics. Collaborate with Sales and Clinical teams to develop pricing strategies and provide leadership and training to other underwriters.

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Hierarchical Condition Category (HCC) Coding Specialist

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $27.02 - $41.85 per hour ⭐ 2-5 yrs exp 💼 Others

Perform HCC coding for Medicare Advantage, ACA, and ESRD projects to ensure accurate risk adjustment. Collaborate with physicians and internal partners to improve documentation and comply with CMS requirements.

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Associate IT Audit Analyst

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $58100 - $90000 per year ⭐ 0-2 yrs exp 💼 Others

Execute audit activities related to IT security, system implementations, and data privacy to ensure risk management and governance processes are functioning. Develop recommendations for business process improvements and maintain high-quality audit work papers.

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Business Analyst - Sponsored Programs Financial Services - Clinical Trials

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $25.87 - $40.48 per hour ⭐ 2-5 yrs exp 💼 Software Development

Responsible for post-award financial management, including award set-up, transaction processing, and compliance review for grants and clinical trials. The role involves managing invoicing, month-end close processes, and preparing complex financial reports to facilitate business decisions.

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Strategic Analytics Consultant - UM Transformation

Highmark Health · Full Time · a month ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 5-10 yrs exp 💼 Software Development

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.

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Pharmacy Coordinator

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $19.39 - $24.19 per hour ⭐ 2-5 yrs exp 💼 Healthcare

Provides guidance to front-line staff and ensures efficient delivery of pharmacy call center services. Reviews medication exception requests and manages prior authorizations in adherence to state and federal drug benefit designs.

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Associate Technical Engineer

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $68400 - $105K per year ⭐ 2-5 yrs exp 💼 Software Development

The role involves supporting the design, development, and maintenance of technical solutions across infrastructure, systems, and networks. Key duties include collaborating with stakeholders to gather requirements and documenting technical processes to ensure alignment with enterprise goals.

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Senior Mainframe Technical Engineer

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $94200 - $151K per year ⭐ 10+ yrs exp 💼 Software Development

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.

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Identity Access Management Security Engineer

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 5-10 yrs exp 💼 Software Development

Develop, implement, and integrate Identity and Access Management (IAM) systems to protect information resources from unauthorized access. Monitor IAM systems, troubleshoot complex access issues, and provide training on IAM capabilities and standards.

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Senior Technical Engineer - Senior Cloud Engineer

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $94200 - $151K per year ⭐ 5-10 yrs exp 💼 Software Development

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.

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Healthcare .NET Senior Application Developer - HNAS

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 5-10 yrs exp 💼 Software Development

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.

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Marketing Technologist

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 5-10 yrs exp 💼 Marketing

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.

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Manager Financial Planning and Cost Analysis

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $102K - $164K per year ⭐ 5-10 yrs exp 💼 Finance

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.

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Coder - Outpatient

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $21.97 - $34.39 per hour ⭐ 2-5 yrs exp 💼 Software Development

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.

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Associate Actuary

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 2-5 yrs exp 💼 Finance

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.

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Senior Actuarial Analyst

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $72700 - $116K per year ⭐ 2-5 yrs exp 💼 Finance

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.

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VP Reserving Forecasting & Trend

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $209K - $372K per year ⭐ 10+ yrs exp 💼 Finance

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.

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Director, Product Management - Government Segment

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $142K - $236K per year ⭐ 10+ yrs exp 💼 Product

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.

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Medical Director - Behavioral Health (Medicaid)

Highmark Health · Full Time · 2 months ago

Highmark Health

🌎 United States 💵 $227K - $385K per year ⭐ 10+ yrs exp 💼 Healthcare

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.

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Lead Financial Analyst

Highmark Health · Full Time · 3 months ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 5-10 yrs exp 💼 Finance

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.

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Medical Director

Highmark Health · Full Time · 3 months ago

Highmark Health

🌎 United States 💵 $227K - $385K per year ⭐ 5-10 yrs exp 💼 Healthcare

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.

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Service Rep OPL / OPEIU

Highmark Health · Full Time · 3 months ago

Highmark Health

🌎 United States ⭐ 0-2 yrs exp 💼 Others

Provide high-volume customer service to subscribers and providers while processing and adjusting insurance claims. Research eligibility, handle COB investigations, and resolve inquiries via phone, email, and chat.

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Functional Product Analyst

Highmark Health · Full Time · 3 months ago

Highmark Health

🌎 United States ⭐ 2-5 yrs exp 💼 Product

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.

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HRIS Consultant

Highmark Health · Full Time · 3 months ago

Highmark Health

🌎 United States 💵 $108K - $180K per year ⭐ 5-10 yrs exp 💼 Others

The incumbent will provide consultative leadership to design, configure, and deploy HCM and payroll solutions while managing stakeholder expectations and project timelines. They are responsible for identifying system improvement opportunities, developing requirements, and ensuring high customer satisfaction through effective communication and process design.

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Manager IT - Data Governance

Highmark Health · Full Time · 3 months ago

Highmark Health

🌎 United States 💵 $118K - $196K per year ⭐ 5-10 yrs exp 💼 Others

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.

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Advanced Practice Provider - Pittsburgh, PA

Highmark Health · Full Time · 3 months ago

Highmark Health

🌎 United States 💵 $102K - $164K per year ⭐ 2-5 yrs exp 💼 Healthcare

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.

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Complex Case Manager RN - (Remote)

Highmark Health · Full Time · 3 months ago

Highmark Health

🌎 United States 💵 $72700 - $116K per year ⭐ 5-10 yrs exp 💼 Healthcare

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.

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Epic Systems Analyst - Willow Ambulatory

Highmark Health · Full Time · 4 months ago

Highmark Health

🌎 United States 💵 $68400 - $105K per year ⭐ 2-5 yrs exp 💼 Others

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.

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RN Registered Nurse (part-time) - AHN Home Infusion - Pittsburgh and Surrounding Areas (territory-based travel)

Highmark Health · Full Time · 4 months ago

Highmark Health

🌎 United States 💵 $32 - $50.75 per hour ⭐ 0-2 yrs exp 💼 Healthcare

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.

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Clinical Transformation Consultant - Central PA/Lehigh Valley

Highmark Health · Full Time · 4 months ago

Highmark Health

🌎 United States 💵 $79300 - $127K per year ⭐ 5-10 yrs exp 💼 Healthcare

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.

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Senior Stop Loss Claims Analyst

Highmark Health · Full Time · 4 months ago

Highmark Health

🌎 United States 💵 $23.16 - $35.88 per hour ⭐ 5-10 yrs exp 💼 Finance

The analyst reviews, evaluates, and processes complex Stop Loss claims while ensuring compliance with policy provisions and regulatory guidelines. They also provide client counseling, monitor claim losses, and assist leadership in evaluating client performance and system efficiency.

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Senior Cyber Incident Responder

Highmark Health · Full Time · 4 months ago

Highmark Health

🌎 United States 💵 $86400 - $138K per year ⭐ 5-10 yrs exp 💼 Others

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.

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Full Stack Angular/Oracle/GCP Developer

Highmark Health · Full Time · 4 months ago

Highmark Health

🌎 United States 💵 $78900 - $147K per year ⭐ 5-10 yrs exp 💼 Software Development

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.

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Imaging Institute - Neuroradiologist - Remote

Highmark Health · Full Time · 5 months ago

Highmark Health

🌎 United States 💵 $420K - $1100K per year ⭐ 5-10 yrs exp 💼 Others

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.

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Imaging Institute - Cardiothoracic Physician - Remote

Highmark Health · Full Time · 5 months ago

Highmark Health

🌎 United States 💵 $420K - $1100K per year ⭐ 10+ yrs exp 💼 Healthcare

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).

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Imaging Institute - Musculoskeletal Radiologist - Remote, Evening

Highmark Health · Full Time · 5 months ago

Highmark Health

🌎 United States 💵 $420K - $1100K per year ⭐ 5-10 yrs exp 💼 Healthcare

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.

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Infusion RN Registered Nurse - AHN Pediatric Home Infusion - Pittsburgh and Surrounding Areas (TRAVEL)

Highmark Health · · 5 months ago

Highmark Health

🌎 United States 💵 $32 - $50.75 per hour ⭐ 0-2 yrs exp 💼 Healthcare

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.

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Epic Healthy Planet Systems Analyst

Highmark Health · Full Time · 6 months ago

Highmark Health

🌎 United States 💵 $57700 - $107K per year ⭐ 2-5 yrs exp 💼 Others

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.

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Mainframe Systems Programmer – CICS/MQ

Highmark Health · Full Time · 6 months ago

Highmark Health

🌎 United States 💵 $67500 - $126K per year ⭐ 2-5 yrs exp 💼 Software Development

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.

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Senior Sales Executive - HNAS

Highmark Health · Full Time · 6 months ago

Highmark Health

🌎 United States 💵 $72000 - $108K per year ⭐ 5-10 yrs exp 💼 Sales

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.

insurance security product-development communication training organization negotiation

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Account Executive II - United Concordia Dental

Highmark Health · Full Time · 7 months ago

Highmark Health

🌎 United States 💵 $64000 - $96000 per year ⭐ 2-5 yrs exp 💼 Sales

The Account Executive II is responsible for the retention, growth, and profitability of an assigned customer base, focusing on medium, large, and key accounts. This includes negotiating financial renewals, managing client issues, and implementing business strategies.

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Senior Digital Marketing Analyst

Highmark Health · Full Time · 8 months ago

Highmark Health

🌎 United States 💵 $57700 - $107K per year ⭐ 5-10 yrs exp 💼 Marketing

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.

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Principal Data Architect: Data Movement, Enrichment, and Orchestration

Highmark Health · Full Time · 8 months ago

Highmark Health

🌎 United States 💵 $108K - $201K per year ⭐ 10+ yrs exp 💼 Software Development

Lead the development and articulation of complex architecture vision and strategy, ensuring alignment with business goals. Champion the adoption of best practices and emerging technologies while collaborating with senior stakeholders across the organization.

trading insurance cloud security architecture training mentoring

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Coder - Inpatient

Highmark Health · Full Time · 8 months ago

Highmark Health

🌎 United States 💵 $23.03 - $35.7 per hour ⭐ 0-2 yrs exp 💼 Software Development

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.

insurance security medical training

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Sales Executive

Highmark Health · Full Time · 9 months ago

Highmark Health

🌎 United States ⭐ 2-5 yrs exp 💼 Sales

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.

insurance security product-development communication training negotiation

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Part-Time Weekend Medical Director (Remote)

Highmark Health · Full Time · 9 months ago

Highmark Health

🌎 United States 💵 $170K - $352K per year ⭐ 5-10 yrs exp 💼 Healthcare

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.

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