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Supervisor Member Services

Highmark Inc.
West Virginia
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Company : Highmark Inc. Job Description : JOB SUMMARY This job is ...
Details
Summary
About the job:
responsible for supervising member service call center and ensuring timely, professional, and courteous responses to all customer inquiries and complaints, appropriately referring inquiries to other areas as necessary for resolution. Investigate escalated member inquiries. The incumbent may be required to make routine medical approval decisions. This role requires you to reside within the state of West Virginia. ESSENTIAL RESPONSIBILITIES - Manage the departmental operations and day-to-day functions. - Handle escalated calls...
Location:
West Virginia
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Highmark Inc.
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

VP Enterprise Effectiveness Strategy & Delivery

Highmark Health
Pittsburgh, PA
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Company : Highmark Health Job Description : JOB SUMMARY The VP Enterprise ...
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Summary
About the job:
Effectiveness will provide day-to-day leadership and oversight of the Enterprise Effectiveness internal consulting group, research and development team, and the Agile Center of Excellence in support of Highmark Health’s overall transformation to improve and innovate work across the enterprise called thinkUP. This will include working to set the overall strategy for the group, identifying and scoping projects, delivering projects, and helping the business plan for implementation and value realization. Projects can span a...
Location:
Pittsburgh, PA
Job Type:
Full-Time
Permanent
Occupation:
General and Operations Managers
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Highmark Health
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Financial Project Accountant

Highmark Health
Camp Hill, PA
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Company : Highmark Health Job Description : General Overview: This position ...
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Summary
About the job:
will perform professional accounting work involving compilation, consolidation, and analysis of accounting and finance information. The incumbent will apply accounting techniques and standard practices to the classification and recording of financial transactions. This role will be responsible for the accounting of internally developed software and cloud computing arrangements in accordance with ASC 350. This incumbent will perform the month end capitalization process and reporting. Essential Job Functions: - Manage...
Location:
Camp Hill, PA
Job Type:
Full-Time
Permanent
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Highmark Health
Certifications / Licenses:
Certified Public Accountant
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Provider Contract Analyst

Highmark Inc.
Pittsburgh, PA
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Company : Highmark Inc. Job Description : JOB SUMMARY This job manages ...
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Summary
About the job:
contracts including negotiations, contract development, contract renewal, and financial reimbursement. Acts as the intermediary between the organization and outside entity. Responds to contractual and payment issues both internally and externally. Ensures compliance with contractual terms. ESSENTIAL RESPONSIBILITIES - Monitor activities by tracking the specific terms of each contract and maintaining some mechanism for monitoring and documenting compliance with those terms. Perform special studies/audits, coordinating...
Location:
Pittsburgh, PA
Job Type:
Full-Time
Contract
Occupation:
Accountants and Auditors
Career Level / Education:
Bachelor's degree
Salary:
High Income Jobs ($80K-$99K)
From:
Highmark Inc.
Certifications / Licenses:
Certified Public Accountant
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Medical Records Associate - AHN Home Infusion - Meadville Pharmacy

Highmark Health
Located in Ohio
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data-type="string"> Description : **Company :** Allegheny Health Network ...
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Summary
About the job:
**Job Description :** **GENERAL OVERVIEW:** Responsible for processing, filing/retrieval of medical records, transcription duties, and release of information requests. Assists customers with requests. **ESSENTIAL RESPONSIBILITIES:** + Files, retrieves, and processes medical records which may include reports. (35%) + Creates medical record files for new patients, including labeling and indexing. Processes files and disseminates reports, mails/faxes and/or performs transcription duties. (35%) + Assists and responds to...
Location:
Located in Ohio
Job Type:
Full-Time
Permanent
Occupation:
Medical Records Specialists
Career Level / Education:
Postsecondary nondegree award
Salary:
Middle Income Jobs ($30K-$49K)
From:
De jobs
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Senior Program Manager - Federal and Government Markets

Highmark Health
Saint Paul, MN
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Company : Highmark Inc. Job Description : JOB SUMMARY Successful definition, ...
Details
Summary
About the job:
implementation and delivery of complex programs that requires cross-functional collaboration and inter-dependencies between a group of projects and/or related activities within the constraint of scope, quality, time and budget and under circumstances involving multiple moderate-probability, moderate-impact risk factors. Manages a matrix group of employees and contractors who serve on project teams and/or within departmental work groups to achieve a coordinated benefit. ESSENTIAL RESPONSIBILITIES - Work with...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Project Management Specialists
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Career Force
Certifications / Licenses:
Project Management Professional
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Associate Provider Data Analyst

Highmark Health
Saint Paul, MN
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Company : Highmark Health Job Description : JOB SUMMARY The incumbent works ...
Details
Summary
About the job:
closely with internal customers responsible for the design and operations of enterprise value based reimbursement programs. Has an understanding of key provider reimbursement concepts and the ability to communicate those concepts effectively. Delivers analytics and insights to key decision-makers to help guide and design programs and initiatives. Through close collaboration with business stakeholders, works to create and maintain documentation supporting business processes as well as the development and submission of...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Management Analysts
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Career Force
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Pharmacy Coordinator

Highmark Health
Saint Paul, MN
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Company : Highmark Inc. Job Description : JOB SUMMARY This job provides ...
Details
Summary
About the job:
front line staff guidance, ensures effective and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings. The incumbent responds to physician and pharmacy network provider inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Pharmacy Technicians
Career Level / Education:
High school diploma or equivalent
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Career Force
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Customer Service Representative

Highmark Health
Saint Paul, MN
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Company : Highmark Inc. Job Description : JOB SUMMARY This job resolves ...
Details
Summary
About the job:
standard and occasional non-standard customer inquiries, comments, and concerns by applying a seamless and positive customer experience gained through many recurring cycles of on the job work engagement. ESSENTIAL RESPONSIBILITIES - Engages with customers in a confident and compelling manner, performing the full range of customer service duties and responsibilities, as assigned. - Strives to resolve customer concerns in a single interaction via telephone, written, or face to face communication. - Responds to a diverse set...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Customer Service Representatives
Career Level / Education:
High school diploma or equivalent
Salary:
Middle Income Jobs ($30K-$49K)
From:
Career Force
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information

Associate Product Owner

Highmark Health
Saint Paul, MN
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Company : enGen Job Description : JOB SUMMARY **CANDIDATE MUST BE US Citizen ...
Details
Summary
About the job:
(due to contractual/access requirements) ** This job is responsible for the development and product management of a service and or analytic product within the organization with a unique focus on the applicable business unit. The incumbent is the primary point of contact to agile, large cross-functional teams on behalf of the customer to identify the product requirements for development. The incumbent contributes to ensuring the product's ability to produce business value by focusing on the translation of strategy to...
Location:
Saint Paul, MN
Job Type:
Full-Time
Permanent
Occupation:
Project Management Specialists
Career Level / Education:
Bachelor's degree
Salary:
Upper Middle Income Jobs ($50K-$79K)
From:
Career Force
Certifications / Licenses:
N/A
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
apply
Detailed Job Information
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