Highmark Health jobs

Quality Analytics Specialist, REMOTE – Military Veterans

MILITARY VETERANS

**Company :**

Allegheny Health Network

**Job Description :**

**GENERAL OVERVIEW:**

Responsible for translating data into actionable information (information is critical to improve processes and achieve outcomes encompassing quality, safety and financial initiatives) and providing decision support for clinicians and operations associates.

**ESSENTIAL RESPONSIBILITIES:**

+ Utilizes quality measurement co...

Clinical Study Manager – Military Veterans

MILITARY VETERANS

**Company :**

Highmark Health

**Job Description :**

**JOB SUMMARY**

We are making a seismic shift away from trying to fix health care, to creating a new model of health that is dynamic, perpetual and focused on individuals and their health journey. We call it Living Health. Living Health is built on providers and payers care and coverage working together in service of customers and clinicians. The model has two part...

Care Manager RN – Appeals and Grievance (Remote) – Military Veterans

MILITARY VETERANS

**Company :**

Highmark Wholecare

**Job Description :**

**JOB SUMMARY**

This job implements effective utilization management strategies including: review of appropriateness of health care services, application of criteria to assure appropriate resource utilization, identification of opportunities for referral to a Health Coach/case management, and identification and resolution of quality issues. Monitors and analyzes...

Category Manager – Remote – Military Veterans

MILITARY VETERANS

**Company :**

Allegheny Health Network

**Job Description :**

**JOB SUMMARY**

This job creates strategies around assigned contract categories, functions, and commodities. Develops business plans for broad contract areas. Negotiates all contracts (client and GPO) and manages related GPO operational activities. Provides guidance and coaching to Contract Managers, Sourcing Specialists, and other key department resources...

Licensed Practical Nurse – Outpatient Cardiology Clinic – Moon Township – Full Time

**Company :**Allegheny Health Network**Job Description :**GENERAL OVERVIEW:This job provides quality care to patients and families to promote health and prevent disease under the direction of a registered nurse or physician.ESSENTIAL RESPONSIBILITIES:+ Performs general nursing care in accordance with nursing practice standards. (30%)+ Assists with the preparation of equipment and assists the physician/clinical provider during treatment, examination and testing of patients. (20%)+ Collects ...

Pediatric Complex Case Manager RN

**Company :**
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
This job has primary ownership and oversight over a specified panel of pediatric members that range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical intervention for each member. The incumbent will be supported by a multi-disciplin...

Pediatric Complex Case Manager RN

**Company :**
Highmark Inc.
**Job Description :**
**JOB SUMMARY**
This job has primary ownership and oversight over a specified panel of pediatric members that range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical intervention for each member. The incumbent will be supported by a multi-disciplin...

Clinical Transformation Director, Delivery System Transformation Team

Company :
Highmark Wholecare
Job Description :
JOB SUMMARY
The Clinical Transformation Director supports clinical transformational work and allows for expansion of the DSTT model to additional APEX and key provider partners by leading clinical efforts both internally and with provider partners to create, drive, and maintain Highmark Wholecares Virtual Integrated Delivery Model, including but not limited to, onboarding new provider partners to the established framework and opera...

Clinical Manager – Pain Management – Bloomfield WPH

**Company :**Allegheny Health Network**Job Description :****GENERAL OVERVIEW:**Manages the daily operations related to clinical activities for designated sites.**ESSENTIAL RESPONSIBILITIES:**+ Responsible for the clinical professional services for designated sites.+ Manage the day-to-day operations and office functions.+ Supervises staff, resolves problems and implements approved disciplinary action.+ Interviews, hires, trains and conducts performance evaluations.+ Manages and monitors key...

Senior Clinical Informaticist

**Company :**Highmark Health**Job Description :****JOB SUMMARY*******Entirely Remote Work From Anywhere Role!*****At Highmark Health, data, analytics, and technology are at the heart of our strategy. Leveraging our unique position as a payor and a provider, the Enterprise Data and Analytics team implements advanced solutions that generate differentiated insights that pave the way for everyone to embrace health. We lead cutting-edge cloud technology solutions, are funded to pursue bold idea...

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