Highmark Health

AI Engineer

• Design the entire ecosystem for AI solutions
• Define end-to-end architecture for AI systems, ensuring scalability and integration
• Establish best practices for MLOps
• Lead cross-functional collaboration with Data Science, DevOps, and Product teams
• Mentor senior engineers and present architectural decisions to executive leadership

Lead AI Architect

Business Analyst

• Support analytical aspects of business products and services life cycle
• Collaborate with customers on complex data and reporting issues
• Create data sets, operational reports, and analytical deliverables
• Analyze data to determine business problems, trends, or opportunities
• Provide root cause analysis and corrective action plans
• Ensure quality delivery on project needs
• Mentor Associate and Intermediate Data Analysts
• Resolve complex issues considering regulatory risk exposure

Senior Data Solutions Analyst – Medicaid Growth Reporting

• Support analytical aspects of the business products and services life cycle.
• Collaborate with customers to understand data, reporting, and analytical needs.
• Create data sets, operational reports, and analytical deliverables.
• Analyze data for business trends or opportunities for process improvements.
• Work with senior team members to capture capability needs.

Associate Data Solutions Analyst – Medicaid Clinical Reporting

Manager

• Maintain oversight over specified panel of members
• Create care plans to address members’ identified needs
• Ensure targeted percentage of patient goal achievement
• Monitor, improve, and maintain quality outcomes for the specified panel of members

Complex Case Manager RN – Oncology

Billing Specialist

• Under general supervision, responsible for enrollment and billing activities for the membership, enrollment & billing department.
• Performing membership and billing activities for clients and/or members.
• Duties include verifying enrollment status, making changes to records, addressing enrollment questions or concerns, resolving membership and billing issues, and accessing/updating enrollment and billing databases.
• Communicate effectively with internal and external contacts to promptly resolve discrepancies in membership and billing information and to promptly provide accurate responses to written, telephone and online inquiries.
• Process and maintain membership data.
• Manage multiple production oriented tasks and responsibilities.
• Perform various billing, accounts receivable, and reconciliation activities.
• Create and distribute membership/billing materials and communications to clients/members.
• Ensures acceptable service levels, metrics, and/or other performance guarantees are met.
• Conduct research to ensure issue resolution.
• Other duties as assigned or requested.

Associate Enrollment and Billing Representative

Project Manager

• Develop comprehensive project plans, including detailed schedules, resource allocation, budget management, and risk assessments.
• Proactively identify and mitigate potential project roadblocks.
• Define and manage project scope, ensuring all deliverables align with business objectives.
• Allocate and manage project resources (human, financial, and material) effectively to optimize performance and meet project deadlines.
• Build and maintain strong relationships with key stakeholders, communicating project progress, addressing concerns, and managing expectations.
• Proactively identify, assess, and mitigate project risks and issues, implementing appropriate corrective actions.
• Prepare and deliver comprehensive project status reports, maintaining meticulous documentation, including project plans, meeting minutes, project artifacts, and approvals.
• Lead and motivate project teams, fostering a collaborative and productive work environment.
• Implement quality control measures to ensure projects meet defined quality standards.

Systems Engineer

• Collaborate with customers, Software Engineers, and Architects to define capability needs and deliver high-quality business solutions.
• Create and maintain deliverables such as business vision, requirements, and user interface designs.
• Actively participate in the full software development lifecycle within Agile scrum teams.
• Support comprehensive requirements testing to minimize production issues.
• Ensure adherence to organizational standards and secure necessary approvals throughout the project lifecycle.
• Communicate effectively with team members, customers, and management.

Business Systems Analyst

Analyst

• Execute operational, regulatory and compliance audits
• Collaborate with team members for engagement planning
• Execute testing of entity level controls
• Assist in finalizing audits and projects

Associate Internal Audit Analyst

Engineer

• Support design, development, and maintenance of technical solutions
• Collaborate with stakeholders to gather requirements and provide technical solutions
• Monitor production schedule and report issues to leadership
• Document technical processes and participate in technical reviews

Technical Engineer

Accountant

• Perform professional accounting work involving compilation, consolidation, and analysis of accounting and finance information for the production of financial statements and reports.
• Applies accounting techniques and standard practices to the classification and recording of financial transactions.
• Prepares financial and business-related analysis.
• Classifies, examines, and analyzes accounting records and prepares related financial reports and statements.
• May serve on or lead project teams for special projects.

Senior Accountant

DevOps Engineer

• This job is responsible for the reliability, availability, and performance of critical healthcare IT systems
• Proactively identifies and mitigates potential disruptions to maintain the highest standards of care and operational efficiency
• Works cross-functionally with AHN site leaders and teams
• Fosters a culture of automation, continuous improvement, collaboration, and patient safety
• Develops core metrics for monitoring and maintaining system health for SRE practitioners
• Performs management responsibilities including hiring, coaching and development, performance management, and staff productivity

Manager, Site Reliability Engineering

Claims Specialist

• Receives and processes claims including entering/verifying claims data; determines if claim information is complete and correct.
• Resolves claim edits, reviews history records and determines benefit eligibility for service.
• Reviews payment levels to arrive at final payment determination; elevates issues to next level of supervision, as appropriate.
• Meets all production and quality standards, ensuring timeliness and accuracy of all work.
• Maintains accurate records including timekeeping records.
• Attends all required training classes.

Claims Processor

Compliance

• Support risk and compliance assessment activities across frameworks including NIST, HITRUST, and HIPAA
• Conduct risk assessment activities to identify and address financial, information security, privacy, and other areas of risk
• Prepare management reporting deliverables and ensure audit quality standards are met
• Collaborate with teams to align risk management objectives and facilitate communication of findings
• Maintain risk management reporting dashboards and ensure completion of risk questionnaires

Senior Risk and Compliance Analyst

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Research Business Analyst – Sponsored Research

Risk

• Provide operational leadership for the data governance team in support of data and application software development management
• Create plans and manage activities, within assigned unit/area
• Assess viability of current direction/projects/operations and recommend strategies and tactics
• Lead team in scheduling, direction, future planning and standard practices
• Monitor and control quality while seeking opportunities for improvement