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Senior Decision Support Analyst (Medical Benefits Consulting)

Highmark Health - Pittsburgh, PA
**Company :** Highmark Inc **Job Description :** **General Overview** The Senior Decision Support Analyst will report to the Manager, Market-Facing Analytics and will serves as the client's primary point of contact into the Advanced Analytics... - Jan 16

Medical Director-MM&P

Highmark Health - Wilmington, DE
... **Job Description :** **General Overview:** Physician who provides clinical support to the Medical Management - Policy team to ensure that utilization management activities are performed in accordance with the highest and most current clinical ... - Jan 16

Associate Principal Consultant - Provider Reimbursement Programs

Highmark Health - Pittsburgh, PA
... **Associate Principle Consultant - Provider Analytics** Experience analyzing medical cost data and the tools available to evaluate provider performance. Prefer background in implementing analytical solutions and tools. **Essential Job Functions:** + ... - Jan 16

Clinical Quality Management Analyst

Highmark Health - WV
... Review, researches and responds to customer complaints relating to quality of medical care and service. Recommends and/or implements process improvements related to the potential of quality medical care and service. Serves as a resource regarding ... - Jan 16

clinical quality managment consultant

Highmark Health - Pittsburgh, PA
... Reviews, researches and responds to clinical data relating to quality of medical care. Recommends and/or implements interventions related to the improvement of medical care and costs. Serves as a corporate resource regarding related accreditation ... - Jan 16

Mgr Care Management

Highmark Health - Pittsburgh, PA
... Responsible for appropriate application of Medical Policy and criteria. Communicating and executing corporate initiatives. Management and control of departmental expenditures defined by cost center allocation. II. ESSENTIAL RESPONSIBILITIES: 1. ... - Jan 16

HCS - Medical Economics Consultant

Highmark Health - Pittsburgh, PA
... This job is responsible for the development, coordination and management of medical economics analysis, models, health outcome studies, forecasting and actual results, and related dashboards for the portfolio of activities that are focused on ... - Jan 16

Medical Coder

Highmark Health - Pittsburgh, PA
... Reviews ambulatory and inpatient medical charts in EPIC EHR for prospective and retrospective coding of chronic conditions which map to HCCs, educate providers on Risk Adjustment Coding and Documentation Guidelines and necessary quality of care ... - Jan 16

Product Consultant

Highmark Health - Pittsburgh, PA
... Products and programs may include but are not limited to medical, pharmacy, clinically based, and wellness and prevention offerings, and non-medical based offerings. Manage initiatives involving internal and external constituents (e.g. vendors, IDN, ... - Jan 16

Care Manager - RN

Highmark Health - Charleston, WV
... + Implement all care management reviews according to accepted and established criteria, as well as other approved guidelines and medical policies. + Promote quality and efficiency in the delivery of care management services. + Respect the member’s ... - Jan 16
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