Company. Highmark Inc. Job Description. JOB SUMMARY. This position will serve as the SME for the team they are assigned. This role will support being an escalation point for the production team members, ensuring appropriate level of support to ensure compliance and timeliness. This role will assist the supervisor in monitoring the day to day functions of the production team including running reports to populate production metrics and identifying ...
Company. Highmark Inc. Job Description. JOB SUMMARY. This job manages the enterprise wide Medicare/Medicaid Quality Performance programs which provide oversight and guidance for the enterprise portfolio of programs and projects with the oversight from the Director. Works collaboratively with multiple stakeholders and various cross-functional teams, locations and departments to improve Stars and/or Quality Rating (inclusive of HEDIS, CAHPS, HOS, a...
Company. Highmark Inc. Job Description. JOB SUMMARY. This job oversees one Highmark Direct Retail Store. Will work closely with the Region Manager to monitor sales and operations of a specific store. In addition, this job requires extensive knowledge of all Highmark products, systems, and resources used in stores, including a working knowledge of any necessary Highmark or Highmark-owned ancillary products. This job will serve a leadership role wi...
Company. Highmark Inc. Job Description. JOB SUMMARY. This job is an ASA Certified actuary position that initiates and leads the development of actuarial studies and analyses. Gives direction to less experienced staff and will represent the department's perspectives and needs in cross disciplinary settings. The incumbent applies actuarial techniques and statistical analysis to several functions, including insurance premium and pricing development,...
Company. Highmark Inc. Job Description. JOB SUMMARY. This job manages the enterprise wide Medicare/Medicaid Quality Performance programs which provide oversight and guidance for the enterprise portfolio of programs and projects with the oversight from the Director. Works collaboratively with multiple stakeholders and various cross-functional teams, locations and departments to improve Stars and/or Quality Rating (inclusive of HEDIS, CAHPS, HOS, a...
Company. Highmark Inc. Job Description. GENERAL OVERVIEW. This job is responsible for the successful definition, implementation and delivery of complex programs around the Medicare STARS Program that require cross-functional collaboration and interdependencies between a group of projects and/or related activities within the constraint of scope, quality, time and budget and under circumstances involving multiple moderate-probability, moderate-impa...
Company. Highmark Inc. Job Description. JOB SUMMARY. Work from home - required visits to Harrisburg, PA/Dauphin County area members. This job assures that members with complex medical and/or psychosocial needs have access to high quality, cost-effective health care. Assists in the holistic assessment, planning, arranging, coordinating, monitoring, evaluation of outcomes and activities necessary to facilitate member access to healthcare services....
Company. Highmark Inc. Job Description. Job Summary. Provides assistance, mentoring and resolution, in a non-supervisory capacity, on daily issues to the Service Representatives in the call center. Provides quality customer service in a high-volume contact center to include providing complete, accurate and timely responses to inquiries from internal and external customers. processes and adjusts claims. This is a bargaining unit position. The coll...
Company. Highmark Inc. Job Description. Job Summary. Provides assistance, mentoring and resolution, in a non-supervisory capacity, on daily issues to the Service Representatives in the call center. Provides quality customer service in a high-volume contact center to include providing complete, accurate and timely responses to inquiries from internal and external customers. processes and adjusts claims. This is a bargaining unit position. The coll...
Company. Highmark Inc. Job Description. JOB SUMMARY. This job supervises and coordinates the day to day activities of the various call centers responding to inquiries received by members, providers, or account representatives across all markets. Select, develop and continuously coach staff to the highest levels of performance. Motivate and team build through the creation of a work environment and conditions that contribute to highest levels of ...
Company. Highmark Inc. Job Description. JOB SUMMARY. This job supervises and coordinates the day to day activities of the various call centers responding to inquiries received by members, providers, or account representatives across all markets. Select, develop and continuously coach staff to the highest levels of performance. Motivate and team build through the creation of a work environment and conditions that contribute to highest levels of ...
Company. Highmark Inc. Job Description. JOB SUMMARY. This job is responsible for clerical support of functional groups in accordance with standard procedures, such as copying, preparing and distributing mail, inventory, data entry, filing, faxing and retrieving documents, indexing and scanning/imaging documents. May also include, performing calculations, compiling and maintaining records, posting and verifying information, and resolving question...
