Highmark medical Case Manager Jobs

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Medical Director - Medical Management & Policy
HighmarkHealth & Medical
Pittsburgh, PA
most current clinical standards. Responsible to review cases and evaluate the medical necessity and appropriateness of the requested treatment of service. Responsible for compliance to NCQA, URAC, CMS
from highmark.com30+ days ago
Associate Medical Director - Medical Management &...
HighmarkHealth & Medical
Pittsburgh, PA
most current clinical standards. Responsible to review cases and evaluate the medical necessity and appropriateness of the requested treatment of service. Responsible for compliance to NCQA, URAC, CMS
from highmark.com17 days ago
Medical Director-Healthcare Management Services
HighmarkHealth & Medical
Pittsburgh, PA
General Purpose: The Medical Director provides physician oversight into the development, implementation, ongoing monitoring and continuous improvement of the wellness, case management, care... case m
from highmark.com30+ days ago
Care Manager
HighmarkHealthcare Management & Finance
Pittsburgh, PA
appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors and analyzes the deliver
from highmark.com21 days ago
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Manager Utilization Management
HighmarkHealthcare Management & Finance
Pittsburgh, PA
Preferred Qualifications: * Master's degree in health care related profession. * Proficient with MS Office Suite and Outlook Licenses or Certifications: * Certified Case Manager Highmark Health and..
from highmark.com17 days ago
Care Manager
HighmarkHealthcare Management & Finance
Pittsburgh, PA
within the care manager's professional discipline. Effectively functions in accordance with applicable state, federal laws and regulatory compliance. * Implements all care management reviews accordin
from highmark.com7 days ago
Care Manager
HighmarkHealthcare Management & Finance
Wilmington, DE
are within the care manager's professional discipline. Effectively functions in accordance with applicable state, federal laws and regulatory compliance. * Implements all care management reviews acco
from highmark.com24 days ago
Manager, Business Platform
HighmarkBusiness Development
Pittsburgh, PA
entities within Highmark or its strategic business partners. When this is the case, there may be less direct reporting relationships and more matrix relationships demanding extensive relationship mana
from highmark.com3 days ago
Sleep Store Retail Manager
HighmarkRetail
Pittsburgh, PA
Store will be located in East Pittsburgh, location TBD. Hours will be Wed - Fri 9:00-6:30 and Sat 9:30-6:30 for the manager (4 10 hour days). General Overview: The position is responsible for... and
from highmark.com3 days ago
Manager, Care Management
HighmarkHealthcare Management & Finance
Pittsburgh, PA
General Overview: The Manager, Care Management is an expert in the areas of utilization management, continuum of care planning, benefit interpretation, insurance industry regulations as well as... ca
from highmark.com3 days ago

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