Jobs at Highmark Health

Support reimbursement strategy for provider partnerships by performing market research, scenario planning, forecasting, profitability analysis, and competitive intelligence. Lead/participate in strategy projects, develop recommendations and presentations for senior leadership, and collaborate with business owners to define problems and implement cost-containment solutions.

Provide operational support, maintenance, enhancement, and troubleshooting for enterprise content management and information governance applications (Sovera, Datacap, RLDatix, Corepoint). Support system upgrades, integrations, testing, data migration/archiving, metadata mapping, regulatory compliance, and stakeholder communication while assisting senior team members on documentation, QA, and continuous improvement initiatives in a healthcare environment.

Provide sales account support for Stop Loss group accounts: implement and maintain group files, resolve benefit inquiries, coordinate implementations, manage error corrections, support sales cycle tasks, mentor junior colleagues, and manage small-to-medium projects for new business and renewals.

Lead and support enterprise API Gateway platform operations across hybrid environments. Responsible for platform reliability, API security, incident response, infrastructure operations (cloud/Kubernetes), automation, observability, architecture collaboration, operational support, and team leadership including staffing, budgeting, and process improvement.

Administer, support, and enhance Oracle Cloud EPM (primarily Planning/EPBCS) including administration, integrations, business rules (Groovy), metadata, security, Smart View reporting, automated jobs, production support, requirements gathering, testing, documentation, and finance process improvements for planning, forecasting, consolidation, and reconciliation.

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.

Process multi-state payroll (weekly/biweekly/monthly), maintain payroll records, reconcile accounts, handle garnishments and off-cycle payments, perform year-end W-2 tasks, support Workday/Kronos HRIS (EIB loads), create SOPs/training, resolve employee payroll inquiries, ensure regulatory compliance and internal controls, and manage banking/ACH and wire/check requests.

Support Pharmacy Services by assisting in negotiation, development, execution, and management of pharmacy and vendor contracts. Collaborate with internal stakeholders and external vendors, oversee vendor performance, manage contract lifecycle (renewals, amendments, terminations), support RFPs, document compliance, and assist with contract storage and audit responses.

Manage end-to-end pharmacy and vendor contracts including negotiation, renewal, termination, execution, and storage. Collaborate with internal and external legal counsel and stakeholders, support RFPs and audits, resolve post-execution contract issues, and advise Pharmacy Services leadership and analysts on contracting initiatives to maximize value and mitigate risk.

The Director of Product Management will lead efforts in government-focused product development, driving growth, enhancing retention, and optimizing onboarding through strategic vision and cross-functional collaboration.

Lead design, implementation, maintenance, and troubleshooting of enterprise mainframe systems. Ensure high availability, performance, and disaster recovery; mentor junior engineers; collaborate with stakeholders; drive platform improvements, automation, and best practices across a distributed data center environment.

Support and analyze a specific business application set: gather requirements, propose solutions, create deliverables, participate in full project lifecycle, support testing and defect management, run/analyze reports, ensure compliance, and mentor junior staff.

Lead capital forecasting, annual capital budgeting, and business planning for the health network. Manage staff, develop policies and capital committee materials, build financial models and scenario analyses for senior leaders, integrate strategic planning with treasury and risk-adjusted returns, and communicate model outcomes to stakeholders.

Lead planning, execution, and delivery of provider-focused risk-adjustment projects. Manage scope, timelines, risks, and stakeholder communications. Engage provider groups and clinicians, coordinate with clinical teams to deliver provider education, analyze project data using Excel, and present findings in PowerPoint. Drive decisions, resolve issues, and maintain project documentation to ensure successful outcomes.

The Complex Case Manager RN oversees a panel of members, assessing health management needs, creating care plans, and coordinating interventions to improve health outcomes.

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.

Lead implementation, oversight, and continuous improvement of assigned managed-care pharmacy programs. Serve as program SME, monitor outcomes and compliance, produce documentation and reporting, educate stakeholders, identify efficiency opportunities, and collaborate across matrixed teams.

Manage application software development for IT projects, lead and mentor teams, communicate with stakeholders, consult with clients, drive process improvements, oversee budgeting, compliance, and resource planning to deliver Epic ancillary solutions and ensure operational excellence.

Lead design, delivery, and administration of commercial and government insurance products. Drive multi-year product roadmap, cross-functional implementations, regulatory filings, performance management, portfolio simplification, and sales support while ensuring on-time, on-budget delivery and compliance.

The Technical Engineer will manage system administration of the Starburst platform, collaborate on solutions across teams, and ensure efficient operational support.