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1 - 9 of 9 matches in 0.014 seconds
Medicaid Compliance Officer (Director) - Delaware (JC134184042)
Last Updated: 2019-03-20
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Inc

Job Description :

JOB SUMMARY

This job oversees the Government Compliance Medicaid Team. Government Compliance is responsible for the implementation of the Medicaid Compliance program. The incumbent ensures the business is properly following the growing number of laws, regulations and other requirements set for by the…

Pediatric Clinical Care Coordinator (JC135571852)
Last Updated: 2019-03-20
Employer: Highmark Health
Location: Wilmington, DE

Company :

Gateway Health Plan

Job Description :

I. GENERAL OVERVIEW:

This position is responsible for working directly with pediatric medical providers in a hospital setting to appropriately identify members with chronic conditions and/or gaps in care that can be positively impacted related to quality and care costs. The…

Actuary - Commercial Markets (JC136765881)
Last Updated: 2019-03-20
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Inc

Job Description :

General Overview:

This job is an ASA Certified actuary position that initiates and leads the development of actuarial studies and analyses. Gives direction to less experienced staff and will represent the department’s perspectives and needs in cross disciplinary settings. The incumbent applies actuarial…

IT Infrastructure Analyst - Data Networks and Voice (JC136882247)
Last Updated: 2019-03-20
Employer: Highmark Health
Location: Wilmington, DE

Company :

Hm Health Solutions Inc.

Job Description :

1. Responsible for the physical delivery and ongoing support of products/services, applications, network systems and overall solutions.

2. Performs tasks including, but not limited to, systems software upgrades, workstation setups and server configurations.

3. Maintains software and hardware inventories.

4. Provides…

Chief Medical Officer (Delaware) - Gateway Health Plan (JC134184157)
Last Updated: 2019-03-20
Employer: Highmark Health
Location: Wilmington, DE

Company :

Gateway Health Plan

Job Description :

JOB SUMMARY

This job plays a crucial role in the corporation’s success and works closely with all divisions and departments within the corporate structure to provide clinical consultation and support with regard to program development, compliance with accepted medical standards, and practitioner/provider…

Provider Contract Negotiator (JC134183133)
Last Updated: 2019-03-20
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Bcbsd Inc.

Job Description :

GENERAL OVERVIEW:

Serve in a leadership role for all activities and develop strategies for contract negotiations that support departmental initiatives as well as Highmark’s corporate mission and objectives.

ESSENTIAL RESPONSIBILITIES:

1.Lead negotiations of provider payment and contractual terms, with responsibility…

Senior Provider Contract Analyst (JC135389029)
Last Updated: 2019-03-20
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Bcbsd Inc.

Job Description :

General Overview :

This position works within the Provider Contracting department and provides analytical and other support for provider contracting, contract administration, and departmental initiatives and projects. The incumbent supports the data and analytical needs of those leading provider negotiations. They monitor…

Senior Client Manager-Large Group (JC137365215)
Last Updated: 2019-03-20
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Bcbsd Inc.

Job Description :

I. GENERAL OVERVIEW:

Responsible for managing a book of business and the business relationship as a strategic consultant for existing accounts directly or through intermediaries. Responsible for renewing accounts and selling new products and services to existing accounts to ensure retention…

Manager Clinical Care Coordination - UM Behavioral Health (JC138195428)
Last Updated: 2019-03-20
Employer: Highmark Health
Location: Wilmington, DE

Company :

Gateway Health Plan

Job Description :

JOB SUMMARY

This job manages and coordinates the supervisory staff that has accountability for the case management, medical review, utilization review, quality management and/or health education team and programs. Monitors and evaluates the operational performance of overall departmental direction, leveraging analytics, regional…

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