Highmark Health

The Associate Recruiter will own the full-cycle recruitment process, driving high-volume efforts including candidate generation, screening, and selection using the ATS. This role also involves maintaining accurate records, preparing and extending offers, and utilizing technology to enhance the recruitment workflow.

This role involves reviewing inquiries to classify them as grievances or appeals, documenting, investigating, and coordinating their resolution while ensuring compliance with organizational and regulatory requirements. The analyst must also document and summarize investigation results for all involved parties and participate in workgroups focused on process improvement.

This role involves independently developing and proposing strategic modifications to existing contract language for renewals, while also leading high-stakes negotiations with payors to achieve favorable outcomes. The incumbent will collaborate with analytics to create data-driven proposals and manage critical payor relationships, resolving complex issues with internal departments.

Product Owner managing service and analytic products for Highmark Health

Medical Case Manager ensuring members access quality healthcare services

Customer Service Representative for resolving customer inquiries and providing support

Data Solutions Analyst responsible for analytical aspects of business products and services

This role involves working directly with providers to identify members with chronic conditions or care gaps that impact quality and costs, and helping members navigate the healthcare system by recommending and implementing interventions. Responsibilities include conducting member-facing clinical assessments, serving as a subject matter expert for education, and developing/implementing case-specific plans of care.

Senior Actuarial Analyst role at Highmark Health

JOB SUMMARY This role, situated within the Utilization Management team, is responsible for leading and contributing to key strategic initiatives across the organization. The incumbent will leverage their expertise in project management, consulting, and utilization management to d...