Highmark medical Case Manager Jobs

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Medical Director-Medical Management & Policy
HighmarkHealth & Medical
Pittsburgh, PA
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, DOH, and DOL regulat
from highmark.com25 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.com9 days ago
Sr Medical Policy Analyst
HighmarkHealth & Medical
Camp Hill, PA
Summary of Job Responsibilities: The Sr Medical Policy Analyst is responsible for: * Medical research and developing utilization management pre-certification criteria for medical policies to be used b
from highmark.com25 days ago
Medical Director- Clinical Client Relations
HighmarkHealth & Medical
Pittsburgh, PA
continuum. The Medical Director presents customized clinical direction to Clients, based on their specific risk profile, and facilitates interventions that optimize the health status of employee popul
from highmark.com25 days ago
Sr Care Manager - Behavioral Health Utilization...
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.com19 days ago
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Manager, Advertising
HighmarkAdvertising
Pittsburgh, PA
campaigns, presenting campaigns concepts to management, creating business case and seeks approval for changes to budget as needed. Will also preside over broadcast productions. * Other duties as assi
from highmark.com11 days ago
Manager Business Platform
HighmarkBusiness Development
Pittsburgh, PA
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 management sk
from highmark.com25 days ago
Manager Business Platform
HighmarkBusiness Development
Pittsburgh, PA
strategic business partners. When this is the case, there may be less direct reporting relationships and more matrix relationships demanding extensive relationship management skills. These types of
from highmark.com25 days ago
Manager Care Management
HighmarkHealthcare Management & Finance
Wilmington, DE
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 personnel management....
from highmark.com25 days ago
Manager Quality & Customer Reporting
HighmarkTech Quality Assurance
Pittsburgh, PA
in first dollar Medical Claims adjudication and benefit determinations Highmark is an Affirmative Action/Equal Employment Opportunity (AA/EEO) employer. Highmark Health and its affiliates prohibit
from highmark.com25 days ago

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