Clinical Client Integration Specialist

Highmark Health

Clinical Client Integration Specialist responsible for client clinical support and collaboration across departments at Highmark Health. Manage relationships and data analysis to ensure client success.

Posted 7/10/2026full-timeRemote • Pennsylvania • 🇺🇸 United StatesMid-LevelSenior💰 $86,400 - $138,600 per yearWebsite

About the role

Key responsibilities & impact

Develop collaborative relationships across various departments such as sales, actuary, product, marketing and others, as identified.
Actively collaborate with account managers, clinical sales consultants, and other key stakeholders in preparation for client meetings.
Support sales when prepping for client meetings.
Provide support for sales finalist meetings from a clinical services perspective by providing the clinical insight into value to members and clients.
This is a client-supporting role.
Support the clinical management team to assure that there are clear expectations for Case Managers & Disease Managers as it relates to specific models and client accounts.
Provide new client implementation and ongoing support for clinical teams for buy-up products.
Work with clinical managers to coach nurses on identified opportunities specific to client expectations.
Serve as primary leader in coordination and preparation for client audits and clinical reviews assuring that all requirements established by the client including contractual obligations are met and staff involved in any onsite reviews are adequately prepared and coached.
Work with the Member Listening System (MLS) team to align new cohorts or changes in existing cohorts to maintain contractual agreements.
Liaison between Sales and Clinical teams to field sales and client requests for case management referrals, metrics and case escalations, and success stories.
Analyze, synthesize, and provide clinical detail on High-Cost Claims & Authorization reports leveraging many systems and programs.
Serve as the clinical subject matter expert for RFPs.
Work with the clinical writing team to support the strategy in submissions.
Manage the day-to-day performance operations for all Well 360 Products.
Obtain, monitor and analyze data, monitor the performance of the buy-up models.
Other duties as assigned or requested.

Requirements

What you’ll need

Bachelor’s Degree in Nursing or clinical-related field OR relevant experience and/or education as determined by the company in lieu of bachelor’s degree
5 years of clinical or managed care experience
Preferred: Health insurance experience

Benefits

Comp & perks

Health insurance
401(k) matching
Paid time off
Flexible work arrangements
Professional development opportunities

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Clinical ExperienceManaged Care ExperienceData MonitoringPerformance AnalysisClinical Insight

Soft Skills

CollaborationCoachingCommunicationLeadership

Certifications

Bachelor’s Degree in Nursing