Highmark Health

Business Intelligence Developer

• The Business Intelligence Analyst plays a critical role in bridging the gap between business needs and technical solutions.
• Elicit, analyze, document, and validate business requirements through interviews, workshops, and existing documentation.
• Extract, transform, and load (ETL) data from various sources, including Salesforce.
• Customize and configure Salesforce to meet specific business needs.
• Serve as a liaison between business users and technical teams.
• Lead process improvement or regular (annual) business processes.

Business Intelligence Analyst

QA Engineer

• Perform a complete review and analysis of transactions as required by all regulatory compliance guidelines
• Manage individual inventory of audit work to meet department quality standards
• Participate in special project work as needed
• Maintain scorecard entries in audit tool accurately and consistently meet all production standards established in departmental protocol
• Share relevant information with the team when received individually through normal work channels

Quality Assurance Analyst

Software Engineer

• Assists in providing less complex application development services
• Assists in analyzing, designing, coding, testing and implementing less complex application enhancements
• Provides general production support
• Collaborates with customers, business analysts, partners, and IT team members to understand business requirements
• Participates on project teams in various project roles based upon level of experience
• Effectively communicates with team members, customers, partners and management

Associate Application Developer

Consultant

• Complete project deliverables under the direction of leadership, including gathering and analyzing qualitative and quantitative information, testing hypotheses, building presentations and reports, helping to facilitate workshops and design sessions, and communicating findings and recommendations to client managers.
• Actively expand consulting and professional skills through project work, client interactions, mentoring, and formal learning.
• Support internal initiatives including learning and development, team gatherings, and continuous improvement efforts.
• Other duties as assigned or requested.

Transformation Consultant

Support Engineer

• Manage clinical applications and supporting infrastructure
• Assist in capturing capability needs
• Collaborate with cross-functional teams
• Support requirements testing
• Communicate with team members and clients

Associate Technical Analyst

Actuary

• Responsible for the overall management and technical oversight of an actuarial staff
• Involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity
• Oversee the preparation of rate filings for large group, small group, direct pay, or senior products
• Work with Underwriting and Rating, Sales and Product Management and Development to develop and implement appropriate rating strategies
• Provide advanced support for the claim reserve process
• Ensure that all new products are financially viable and stable

Director, Actuarial Services

Project Manager

• Responsible for definition, planning and delivery of complex programs that require cross-functional collaboration
• Organizes, plans, and maintains Program roadmap consisting of cross-functional activities/projects
• Work with business and technical organizations to assemble project teams
• Lead Project Managers and Program team in the development and maintenance of comprehensive plans for a defined program
• Monitor, evaluate and report on Program status inclusive of scope, schedule, budget and alignment to Program and strategic goals
• Develop and maintain positive customer relationships

Cloud Engineer

• Advocate for cloud technology
• Analyze, design, code, test and implement technical solutions
• Collaborate with stakeholders to gather requirements
• Monitor work and provide updates
• Document technical processes and procedures
• Mentor associate and intermediate technical engineers
• Stay up-to-date with relevant technologies

Senior Cloud Engineer

Marketing

• Lead the advancement and maturity of the marketing technology stack and AI integration, ensuring it supports current and future marketing strategies and campaign needs
• Manage implementation of marketing technology roadmaps and ongoing platform support, including feature/function enrichment to meet current and future needs of marketing business users
• Serve as primary point of contact and owner for day-to-day vendor relationships, in partnership with many cross-functional areas
• Oversee the development and implementation of marketing operational strategies and plans
• Support budgeting, forecasting, and resource allocation processes for the marketing department
• Develop training and change management programs and services for marketing and experience team members

Marketing Technologist

Analyst

• Support definition, scoping, and prioritization of efforts for solution strategy
• Provide periodic reporting to leadership on assigned project activities
• Drive strong working relationships across matrixed teams and stakeholder groups

Senior Solution Analyst

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

Manager

• 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
• Promote quality and efficiency in the delivery of care management services
• Identify and refer members whose healthcare outcomes might be enhanced by Health Coaching/case management interventions

Care Manager, RN

Financial Planning and Analysis

• Support the monthly close cycle, rolling forecast, and executive reporting
• Own the financial narrative for enGen, including the monthly CFO close presentation
• Collaborate closely with the CFO and senior business leaders
• Advancing the team’s Power BI reporting capabilities and AI-driven automation initiatives
• Perform management responsibilities including hiring, coaching, and performance management

Manager – Financial Planning and Cost Analysis

Director

• Lead and mentor a team responsible for identifying and cultivating strategic relationships with providers in value-based arrangements
• Direct the administration of critical and timely communication to providers through various channels
• Perform management responsibilities to include hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity
• Collaborate closely with the Market Executive to lead the analysis and data-driven decision-making process
• Oversee the team's collaboration with actuary and informatics teams to develop impactful population health tools/reports

Director, Market Provider Engagement

• Develop comprehensive project plans
• Define and manage project scope
• Allocate and manage project resources
• Build and maintain strong relationships with key stakeholders
• Proactively identify, assess, and mitigate project risks and issues
• Prepare and deliver comprehensive project status reports
• Lead and motivate project teams
• Implement quality control measures to ensure projects meet defined quality standards