Highmark Health

Financial Planning and Analysis

• Lead a team of financial analysts responsible for providing critical financial insights and support to various Institutes
• Analyze monthly financial results, monitor key metrics for performance management, budget management, and special project support
• Perform management responsibilities to include hiring and termination decisions, coaching and development, rewards and recognition
• Communicate effectively within the team, amongst peers, and upwards to senior leadership
• Oversee the review and analysis of monthly financial results for various products, identifying variances from performance plans
• Develop and present clear, concise, and actionable reports to stakeholders
• Conduct ad-hoc analyses and provide recommendations to support decision making
• Support the annual budget process
• Team management and development: manage and mentor the team, provide technical guidance, training, and performance feedback

Manager, Finance

Vice President

• Guide a high-performing team of actuarial and analytics professionals
• Drive strategic, tactical, and operational excellence in claims reserving
• Serve as a trusted advisor to Senior Management and cross-functional teams
• Lead the comprehensive financial forecasting process
• Provide expert consultative services

VP Reserving Forecasting – Trend

Security Engineer

• Secures AI/ML, Generative AI, and agentic systems across the enterprise
• Designs, tests, and operates controls to protect systems at scale
• Advises engineering and security leadership on emerging AI threats
• Develops security controls for AI/ML, GenAI, and agentic systems
• Engineers guardrails to mitigate data leakage and insecure workflows
• Analyzes agent logic and identifies systemic security weaknesses
• Builds monitoring, logging, and alerting for AI systems
• Partners with AI platform and data engineering teams for security integration

Senior AI Security Engineer

Actuary

• Participate in Highmark’s Actuarial Executive Development Program
• Develop efficient and transparent queries to obtain data
• Create studies, analyses, and presentation materials needed
• Proactively ensure internal and external consistency of all work

Senior Actuarial Analyst

Billing Specialist

• Communicate effectively to resolve discrepancies
• Process and maintain membership data
• Perform billing and accounts receivable activities
• Create and distribute membership materials

Enrollment and Billing Representative

Artificial Intelligence

• Collaborate with Sr. Consultant and business partners to identify AI opportunities.
• Work with technical teams to explore solutions to business problems through research and applying human centered design methods.
• Work across teams to facilitate the design of a proof of concept and testing plan.
• Ensure alignment around the problem statement and the measures that would determine whether the solution is viable.
• Support translating proof of concept into scaled use and value creation using change management and project management best practices.
• Serve as an advisor and partner for change execution.
• Work with the Sr. AI Consultant and business partners to create and groom portfolios of AI opportunities.
• Support reporting, ongoing prioritization, and facilitating value capture tactics.
• Other duties as assigned or requested.

Artificial Intelligence Consultant

Product Manager

• Development and product management of a service and or analytic product
• Primary point of contact to agile, large cross-functional teams
• Identify the product requirements for development
• Oversee priority, scope and the validation of work
• Collaborate with stakeholders to breakdown features into user stories
• Maintain a well groomed and prioritized backlog
• Recommend resolution paths to domain leadership
• Collaborate with external vendors to align roadmaps
• Track and provide status to leadership

Product Owner

• Manage all facets of the planning/forecasting cycles for the Organization.
• Perform management responsibilities including hiring and termination decisions, coaching and development, rewards and recognition.
• Plan, organize, staff, direct and control the day-to-day operations of the department.
• Direct the completion of revenue, claim and administrative expense components of the forecast.

Manager, Financial Planning and Cost Analysis

Data Engineer

• Design, develop, and maintain robust data processes and solutions to ensure the efficient movement and transformation of data across multiple systems
• Develop and maintain data models, databases, and data warehouses to support business intelligence and analytics needs
• Collaborate with stakeholders across IT, product, analytics, and business teams to gather requirements and provide data solutions that meet organizational needs
• Monitor work against production schedule, provide progress updates, and report any issues or technical difficulties to lead developers regularly
• Implement and manage data governance practices, ensuring data quality, integrity, and compliance with relevant regulations.
• Collaborate on the design and implementation of data security measures, including access controls, encryption, and data masking
• Mentor other associate and intermediate data engineers as needed
• Perform data analysis and provide insights to support decision-making across various departments
• Stay current with industry trends and emerging technologies in data engineering, recommending new tools and best practices as needed

Senior Data Engineer – Cloud Data Products, Analytic Enablement

Medical Billing and Coding

• Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. ( 65%)
• Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. ( 15%)
• Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. ( 10%)
• Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these updates in daily work. ( 5%)
• Performs other duties as assigned or required. (5%)

Coder – Outpatient, Part-Time

Manager

• Directly supervise and lead all staff for student, residency and fellowship programs.
• Advise Departmental and Administrative leadership in all matters of hiring and managing educational program staff.
• Coordinate with the institutional GME and local Dean’s offices to maintain and implement policies that ensure efficient operations and compliance with all accreditation and organizational requirements.
• Work directly with educational and administrative leadership to create and promote opportunities for staff’s skill and career development.
• Coordinate with administrative leadership including Administrative Director, Program leadership, Chair and the finance committee to determine the total departmental education budget and identify funding sources.
• Advise the Program Directors and Chair in distribution of staff support of the various education programs to ensure that all education programs are well supported.

Manager, Medicine Education

• Deliver value to the Health Plan and its beneficiaries enrolled in risk-adjusted government programs through HCC coding, medical coding, clinical terminology and anatomy/physiology
• Conduct quality assurance (QA) review of internal coding team members
• Provide coding education to team
• Evaluate HCC coding questions and independently renders guidance on appropriate coding determinations
• Supports RADV audits
• Specializes in performing second level review of HCC validation
• Prepares documentation and coversheets for upload to regulatory body and/or independent auditor
• Analyzes results
• Develop presentations to improve provider documentation and accuracy
• Conducts Quality Assurance (QA) reviews on internal coders
• Guides coding decision making adhering to CMS Guidelines for Coding and Highmark’s Policy and Procedures

Lead HCC Coding Specialist

Customer Support

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Associate Customer Service Representative

• Implement care management review processes that are consistent with established industry and corporate standards
• Function in accordance with applicable state, federal laws and regulatory compliance
• Identify and refer members whose healthcare outcomes might be enhanced by Health Coaching/case management interventions

Care Manager, RN

• Collaborate with Sr. Consultant and business partners to identify AI opportunities
• Support translating proof of concept into scaled use and value creation using change management and project management best practices
• Work with the Sr. AI Consultant and business partners to create and groom portfolios of AI opportunities
• Facilitate the design of a proof of concept and testing plan
• Serve as an advisor and partner for change execution