Highmark medical Case Manager Jobs

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Case Manager - Pediatric
HighmarkNursing
Pittsburgh, PA
General Overview: * Primary nurse providing both case management services to members across the continuum of health ranging from health promotion to end-of-life * Uses clinical and motivational... e
from highmark.com12 days ago
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.com6 days ago
Supervisor, Medical Management & Policy Clinical
HighmarkHealth & Medical
Pittsburgh, PA
General Overview: The Supervisor, Medical Management and Policy - Clinical is responsible for managing a team of clinicians charged with promoting quality member outcomes, to optimize member benefits,
from highmark.com30+ days ago
Care Manager - Utilization Management RN
HighmarkNursing
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.com30+ days ago
Care Manager
HighmarkHealthcare Management & Finance
Wilmington, DE
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.com30+ days ago
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Manager Business Platform
HighmarkBusiness Development
Pittsburgh, PA
initiatives. These could include managing complex matrix relationships across business units or even business entities within Highmark or its strategic business partners. When this is the case, there
from highmark.com18 days ago
Manager, Integration Consultant
HighmarkManagement Consulting
Pittsburgh, PA
and drive solutions to achieve strategic vision by participating in the business case development and project portfolio management. Identifies people, process and technology solutions to achieve... W
from highmark.com30+ days ago
Care Manager - Post Acute
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.com30+ days ago
Manager Clinical Performance Measures - HEDIS
HighmarkHealth & Medical
Pittsburgh, PA
initiatives to enhance reliance on the Plan's databases in preference to medical record reviews * Works with multidisciplinary groups of individuals throughout the organization to develop interventio
from highmark.com16 days ago
Program Manager
HighmarkHealthcare Management & Finance
Pittsburgh, PA
assemble project teams and work groups to produce deliverables required to achieve the objectives of a defined corporate program. Lead project managers and work group leaders in the development and...
from highmark.com27 days ago

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