Highmark medical Case Manager Jobs

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Medical Case Manager -Pediatric Private Duty
HighmarkHealth & Medical
Pittsburgh, PA
GENERAL OVERVIEW: The Medical Case Manager will assure that pediatric members with complex medical and/or psychosocial needs have access to high quality, cost-effective health care. Assist in the...
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.com19 days ago
Medical Director - Gateway Health Plan
HighmarkHealth & Medical
Pittsburgh, PA
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 case management.
from highmark.com30+ days ago
Medical Social Worker
HighmarkSocial Services & Mental Health
Pittsburgh, PA
General Overview: The Medical Social Worker is the primary or consultative contact for members across the continuum of health related services. The depth of engagement with the member ranges from coac
from highmark.com30+ 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
Medical Coder
HighmarkHealth & Medical
Pittsburgh, PA
General Overview: The incumbent assigns codes (ICD-9, 10, CPT and HCPCS) which most accurately describe diagnoses, procedures and therapies according to established guidelines. Reviews medical records
from highmark.com29 days ago
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Project Manager
HighmarkTechnology
Pittsburgh, PA
General Overview Provides application development services typically in a defined project. Develops requirements and supplemental specifications for new applications or analyzes change requests/enhanc
from highmark.com5 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
Manager, Advanced Analytics
HighmarkHealthcare Management & Finance
Pittsburgh, PA
General Overview: The Manager of Advanced Analytics -- Enterprise Informatics, Data, and Analytics (EIDA) leads a team of data scientists in the application of advanced analytics to Highmark... large
from highmark.com13 days ago
Care Manager - Utilization Management - Behavioral...
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.com29 days ago

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