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1 - 10 of 17 matches in 0.006 seconds
Actuary - Commercial Markets (JC136765881)
Last Updated: 2019-11-17
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…

VP, Executive Medical Director (GHP Clinical Services) (JC141613448)
Last Updated: 2019-11-17
Employer: Highmark Health
Location: Wilmington, DE

Company :

Gateway Health Plan

Job Description :

JOB SUMMARY

This job is accountable for the strategic direction, implementation and effective execution of physician-led functions within Clinical Services including, but not limited to, Utilization Review, Medical Policy, Member and Provider Appeals and Retrospective Review. In addition this leader will have…

Manager - Audit & Advisory Services (Medicaid Government Com (JC150986446)
Last Updated: 2019-11-17
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Inc

Job Description :

GENERAL OVERVIEW:

+ The Medicaid Government Compliance department partners with business units to ensure compliance to rules, regulations, policies, and procedures of governmental and contractual entities. Additionally, Medicaid Government Compliance continuously monitors regulatory requirements and helps the organization to accomplish its objectives…

General Clerk (JC146015601)
Last Updated: 2019-11-17
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Bcbsd Inc.

Job Description :

GENERAL OVERVIEW:

The General Clerk performs clerical support for functional groups in accordance with standard procedures, such as copying, preparing and distributing mail, inventory, data entry, filing, faxing and retrieving documents, indexing and scanning/imaging documents. May also include, performing calculations, compiling…

Data Modeling Analyst (JC147267891)
Last Updated: 2019-11-17
Employer: Highmark Health
Location: Wilmington, DE

Company :

Hm Health Solutions Inc.

Job Description :

Communicate with application developers, end-users, and database analysts to develop, maintain, and gain approval of data models of various levels of abstraction describing the data assets and business rules used by the corporation’s business concepts, business processes, and business applications. Develop…

Provider Contract Negotiator (Hospital) (JC134183133)
Last Updated: 2019-11-17
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 Job Functions :

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

Senior CRM Analyst (JC151056549)
Last Updated: 2019-11-17
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Inc

Job Description :

JOB SUMMARY

This job is responsible for a variety of facets of managing the customer Relationship Management (CRM) Tool and processes used by the Sales team. Ensures Sales Staff is set-up and trained in the use of the CRM tool, and…

VP Finance & CFO HHO Medicaid Market (JC145515616)
Last Updated: 2019-11-17
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Inc

Job Description :

JOB SUMMARY

This job serves in a CFO role capacity for Highmark Health Options, the Health Plan’s company in the Medicaid market within Delaware. It is responsible for oversight of the financial operations of this business segment, including appraisal of operating results in…

Sr IT Infrastructure Engineer (JC145586094)
Last Updated: 2019-11-17
Employer: Highmark Health
Location: Wilmington, DE

Company :

Hm Health Solutions Inc.

Job Description :

GENERAL OVERVIEW:

Takes a lead role in more complex plans to research, evaluate, design and develop IT Infrastructure systems by applying engineering, hardware and software design theories and principles to develop a compatible system infrastructure in line with organizational strategies…

Senior Business Process Analyst (JC150232785)
Last Updated: 2019-11-17
Employer: Highmark Health
Location: Wilmington, DE

Company :

Highmark Inc

Job Description :

JOB SUMMARY

This job provides expertise for moderately to very complex problem solving and complete understanding of system functionality. The incumbent reviews significant amounts of information and analyzes processes to support business unit needs. Troubleshoots errors, conducts impact analyses, and/or solves data rejection…

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