Jobs at Highmark Health

Designs, implements, administers, and supports enterprise cloud platforms, integrations, databases, middleware, and application services. The role develops secure, scalable architectures; automates deployments and administration; supports Oracle Cloud and related technologies; resolves complex platform and integration issues; and leads technical improvements. It also provides architecture guidance, customer consultation, requirements analysis, technical reviews, coaching, and training across the organization.

Administers and configures the Planview ecosystem, including Portfolios, Enterprise Architecture, AgilePlace, and ProjectPlace. Manages workflows, security, integrations, reporting, data governance, environments, releases, and platform quality. Translates business needs into requirements, supports governance and project intake, troubleshoots complex issues, coordinates testing and releases, analyzes risks and impacts, and mentors business systems analysts. Partners with stakeholders on portfolio, resource, financial, and strategic planning processes.

Leads enterprise architecture vision and strategy across multiple domains, aligning complex systems and solutions with business goals. Evaluates technologies, develops architectural standards and documentation, mitigates risks, and influences senior stakeholders. Acts as a subject matter expert while mentoring architects and promoting collaboration, innovation, emerging technologies, and continuous improvement.

Leads enterprise architecture strategy for front-office applications spanning sales, marketing, and digital domains. Develops complex architecture visions, evaluates technologies, manages risks, documents solutions, and aligns architecture with business goals. Advises senior stakeholders, establishes standards, promotes emerging technologies, and mentors architects while driving innovation and continuous improvement.

Lead the architecture and enterprise strategy for scalable, secure AI systems, including data pipelines, model platforms, inference, integrations, MLOps, generative AI, RAG, and AI safety guardrails. Evaluate technology stacks, optimize cloud infrastructure costs, guide legacy modernization, and ensure privacy and compliance. Partner with Data Science, DevOps, Product, business leaders, and customers while leading complex architecture initiatives, technical reviews, mentoring, and executive communication.

Leads the enterprise data protection program and multidisciplinary security team. Owns strategy, architecture, roadmap, operations, and continuous improvement across DLP, data classification, monitoring, encryption, key management, digital rights management, and insider risk. Manages staff, budgets, policies, compliance, projects, and organizational change while communicating security risks and priorities to executive and cross-functional stakeholders.

Designs and engineers secure data solutions across cloud, hybrid, and on-premises environments. The role conducts security architecture assessments, vulnerability analyses, risk assessments, and gap analyses; develops mitigation strategies; and advises teams on data governance, encryption, identity and access management, application security, cloud security, and secure data exchange. Responsibilities also include evaluating security technologies, implementing protective controls, supporting compliance, and mentoring team members.

The Senior Sales Executive is responsible for prospecting new clients, closing sales of health products, and maintaining relationships with brokers. Requires in-depth market knowledge and strategic planning for account acquisition.

Leads the design, development, configuration, integration, administration, upgrades, and support of the Archer GRC platform. Translates business and regulatory requirements into workflows, questionnaires, dashboards, data feeds, and custom solutions. Oversees infrastructure, APIs, databases, security, performance, disaster recovery, and production support across enterprise environments. Partners with stakeholders and vendors, documents technical solutions, manages project activities, conducts training, and ensures compliance with architecture, governance, and service standards.

Configures, implements, tests, upgrades, and supports Epic OpTime and Anesthesia applications for perioperative departments. Analyzes workflows and requirements, translates clinical needs into system solutions, resolves issues, documents processes, trains users, and supports projects and system maintenance. The role collaborates with clinical staff and stakeholders to improve surgical and perioperative efficiency. It is remote-based with 0%–25% travel.

Owns the development and management of service or analytic products by translating strategy into agile execution. Responsibilities include maintaining prioritized backlogs, writing user stories, accepting completed work, defining release plans, managing roadmaps, coordinating stakeholders and vendors, validating testing, and ensuring products deliver business value. The role requires collaboration across product, architecture, business, and development teams in a matrixed organization.

Administer, design, install, configure, and optimize IMS Full Function, HALDB and IMS Fastpath databases in a z/OS Parallel Sysplex. Perform performance tuning, monitoring, backup/recovery, partition management, PSB/DBD/ACB generation, and DBRC operations. Provide expert IMS support, root cause analysis, vendor coordination, application team collaboration, and participate in a 24/7 on-call rotation. Ensure high availability and compliance with data governance.

The Account Executive drives new client acquisition, revenue growth, and market share within print, mail, and digital communications services. Responsibilities include prospecting executive-level contacts, managing sales activity in CRM, developing proposals and business cases, negotiating contracts, onboarding clients, maintaining client satisfaction, forecasting results, reporting sales metrics, and attending industry events. The role requires B2B sales experience, specialized-market knowledge, strong presentation skills, and 40% travel.

Conducts healthcare fraud, waste, and abuse investigations involving providers, members, facilities, pharmacies, and employees. Performs interviews, audits, data analysis, field investigations, payment recovery, and case referrals to regulatory and law enforcement agencies. Develops anti-fraud programs, files regulatory reports, delivers training, supports compliance committees, mentors investigators, and serves as a subject matter expert. Requires strong knowledge of healthcare payment methodology, claims, coding, billing, insurance regulations, and financial analysis.

Owns development and product management for service or analytic products. Translates product strategy into agile execution by prioritizing backlogs, writing user stories, defining acceptance criteria, accepting completed work, and coordinating cross-functional teams, stakeholders, and vendors. Maintains product roadmaps, supports release planning, validates testing, tracks delivery metrics, and communicates product capabilities and status to leadership. Requires strong prioritization, communication, estimation, and requirements translation skills.

Leads program and project managers within a value stream, overseeing project assignments, delivery processes, budgets, risks, communications, schedules, and escalations. Partners with product leaders and stakeholders to resolve issues and improve delivery outcomes. Manages team hiring, coaching, performance, and development while supporting agile product and project delivery, data transformation initiatives, change controls, lessons learned, and project documentation.

Audits medical, dental, vision, FSA, and HRA claims for accuracy, compliance, and timely processing. Reviews plan documents, regulations, coding, and complex claims; records audit results; coaches claims staff; supports training, specialized audits, refund and payment processes, system testing, and workflow monitoring. Provides recommendations and guidance to claims teams while maintaining quality and production standards.

Provides pre-award grants and contracts administration for Principal Investigators, including funding opportunity assessment, proposal submission, budget preparation, financial planning, award negotiation, subagreement and legal document drafting, and liaison work with investigators, accounting, management, and external organizations. Supports annual budgeting and prepares management reports while ensuring compliance with applicable federal regulations, policies, confidentiality requirements, and organizational procedures.

Implements and maintains enterprise compliance and risk programs for assigned healthcare entities. Advises business leaders, conducts risk assessments, audits, investigations, and privacy reviews, and oversees regulatory reporting, training, policies, corrective actions, and risk treatment plans. Serves as the primary liaison for internal stakeholders, legal counsel, regulators, and risk committees while monitoring compliance with federal and state laws, managed care requirements, HIPAA, privacy standards, and information security expectations.

Leads mid-size consulting engagements focused on organizational and operational transformation, including cost reduction, process improvement, automation, and customer or provider experience. Manages project lifecycles, governance, schedules, deliverables, stakeholder requirements, quantitative analyses, financial models, and strategic recommendations. Leads teams, coaches consultants, influences stakeholders across a matrixed organization, and applies emerging technologies such as AI and GenAI to improve business processes.