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 Case Management Representative
HighmarkHealth & Medical
Pittsburgh, PA
General Overview Coordinates the Workers' Compensation or disability medical management process from the time of case receipt through closure utilizing critical thinking skills to achieve physician...
from highmark.com30+ days ago
Psychiatric Medical Director
HighmarkHealth & Medical
Pittsburgh, PA
communications and monitoring of services utilized. As such, the Medical Director's role is to provide clinical input into health care management services' activities including for example, care and c
from highmark.comToday
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
Medical Review Analyst
HighmarkHealth & Medical
Wilmington, DE
of both medical documentation and claims data to assure appropriate resource utilization, identification of opportunities for Case Management, identify issues which can be used for education of networ
from highmark.com3 days ago
Senior Project Manager - Medical Management & Policy
HighmarkTechnology
Pittsburgh, PA
Project Managers and Program team in the development and maintenance of comprehensive plans for a defined program. * Work with Executive Sponsor and Business Owner of a Program, and other management
from highmark.com16 days ago
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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
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.com30+ days ago
Care Manager
HighmarkHealthcare Management & Finance
Charleston, WV
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.com22 days ago
Manager Provider Experience
HighmarkHealthcare Management & Finance
Camp Hill, PA
General Overview: The Manager Provider Experience (Manager Customer Service) manages staff to produce high quality work output and throughput and selects, develops and continuously coaches staff to...
from highmark.com30+ days ago

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