Company :Highmark Inc. Job Description : JOB SUMMARY This job supervises the Part A and/or Part B Medicare Fee-for-Service appeals unit within the Organizations Medicare Services. Delegates assignments to appeal representatives and technical staff. Manages resources
Company :Highmark Inc. Job Description : JOB SUMMARY This job is responsible for providing comprehensive case management services to members, ensuring quality, cost-effective care delivery, and promoting optimal health outcomes. The Case Manager assesses member needs,
Pay Range: $30.55 to $46.75 Hourly Would you like to have a career that makes a daily difference in people’s lives? Do you want to be part of a caring, respectful, diverse community? If you answered
Company :enGen Job Description : JOB SUMMARY This job will assume responsibility of operational support with vendor relationships, working directly with the vendor client relationship role and to ensure day-to-day oversight and management in meeting performance
Company :Highmark Inc. Job Description : JOB SUMMARY This job serves as a liaison and mediator between members, providers, community -based organizations, and the health plan. Works independently in the community, engaging members within a specific
Are you looking for an opportunity to advance your career while working with an extraordinary team? At Merakey, we put heart and soul into everything we do. We are seeking a full-time Investigation Specialist to join
Company :Highmark Inc. Job Description : JOB SUMMARY This job is responsible for providing comprehensive case management services to members, ensuring quality, cost-effective care delivery, and promoting optimal health outcomes. The Case Manager assesses member needs,
Company :Highmark Health Job Description : JOB SUMMARY This job will lead our Utilization Management product management teams including strategy, roadmap formulation, and value realization. This position will partner closely with UM operations and UM product
Law and Policy Analyst - (26002231) Description Temple Universitys Center for Public Healthy Law Research is searching for a Law and Policy Analyst! Become a part of the Temple family and you will have access to
Flex is a growth-stage, NYC headquartered FinTech company that is creating the best rent payment experience. It’s hard to believe that it’s 2026 and paying rent on time is expensive, inflexible, and difficult. We’re here to
Company :Highmark Health Job Description : JOB SUMMARY This role is part of the Product Performance Measurement (PPM) team within the larger Product and Health Experience (PHE) organization. The Product Evaluation Research Manager partners with Product
Company :Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician
Company :Highmark Inc. Job Description : JOB SUMMARY This job is responsible for the financial reporting of Highmark’s strategic cost of care savings program. The ideal candidate will be comfortable gathering financial data from multiple business
Company :Highmark Inc. Job Description : JOB SUMMARY This job is responsible for requesting and obtaining medical records from healthcare providers to ensure accurate documentation of members’ health conditions and optimize risk adjusted revenue for the
Company :enGen Job Description : JOB SUMMARY This role serves as a thought leader and strategic advisor, shaping and driving the evolution of complex architecture strategies across multiple domains. Responsibilities include the development, implementation, and optimization
Company :enGen Job Description : JOB SUMMARY This job supports one or more analytical aspects of the application product life cycle, including capability enablement with cross-team dependencies within a product scope. Uses significant judgement and discretion
Company :enGen Job Description : JOB SUMMARY *CANDIDATE MUST BE US Citizen (due to contractual/access requirements) * We are seeking a highly motivated and skilled Intermediate Middleware Engineer to join our team. In this role, you
Company :Highmark Health Job Description : JOB SUMMARY This position is responsible for ensuring the quality and accuracy of routine tax assignments and special projects, including those related core tax accounting (insurance and non-insurance) and tax
Company :enGen Job Description : JOB SUMMARY This job will assume responsibility of operational support with vendor relationships, working directly with the vendor client relationship role and to ensure day-to-day oversight and management in meeting performance
Company :Highmark Inc. Job Description : JOB SUMMARY This job is responsible for screening, reviewing, evaluating online entry, correcting errors and/or performing quality control review and final adjudication of paper/electronic claims. Determines whether to return, deny