Jobs at Highmark Health

Designs, develops, and supports scalable, highly available software applications across digital channels. Responsibilities include architectural design, coding, code reviews, agile Scrum participation, story creation, technical solution evaluation, production monitoring, and mentoring engineers. The role requires full-stack development using React and Python, cloud and distributed systems experience, CI/CD deployment across OpenShift and GCP, database and API expertise, and strong software quality, security, and performance practices.

Develops and supports business intelligence solutions for healthcare users by gathering, analyzing, and presenting data in accessible formats. Creates ad hoc reports, investigates discrepancies, supports migrations and testing, administers analytics systems, monitors performance, coordinates upgrades, maintains documentation, and provides user support and training. Requires experience analyzing business processes, data, and system interfaces, with preferred experience in Epic reporting, EMR systems, accounts receivable systems, and Minitab.

Leads and supports enterprise strategic initiatives involving strategic planning, problem-solving, analytics, project management, communication, implementation, and organizational change. Develops strategic plans, aligns initiatives, resolves complex issues, creates analytics and processes, and supports team and organizational capability development. Works across multiple projects and business areas, with occasional travel of up to 25%.

Owns the strategy, vision, business case, roadmap, backlog, governance, and execution for Highmark’s cost transparency and coverage products. The role manages the member financial experience from cost estimation through payment, financing, and accurate explanations of benefits. Responsibilities include stakeholder alignment, prioritization, metrics-driven improvement, cross-product value creation, and coaching three product managers or analysts in a player-coach model.

Processes and adjudicates paper and electronic healthcare claims by verifying data, resolving edits, determining eligibility and payment levels, and correcting errors. Reviews claims adjustments, inquiries, appeals, audit findings, and other insurance information. Maintains accuracy and productivity standards, researches issues, communicates with internal and external customers, and escalates problems when necessary.

Manages network-wide cost accounting operations and leads analysts producing patient care cost allocations, financial analyses, productivity metrics, and decision-support reporting. Establishes cost accounting methodologies, ensures data credibility through audits and reconciliations, supports reimbursement and capital planning decisions, and collaborates with clinical and hospital leadership. Oversees hiring, coaching, performance management, training, and department operations while using analytical and visualization tools to communicate actionable findings.

Oversee quality and accuracy of corporate tax accounting, compliance, planning, and special-project work. Review tax provisions, returns, transaction impacts, and ASC 740 documentation; lead tax quality assurance for mergers, acquisitions, and divestitures; identify and mitigate tax risks; conduct research; support audits and tax notices; maintain tax procedures and controls; and guide junior staff.

Designs, develops, reviews, and maintains scalable, highly available software applications across digital channels. Responsibilities include creating technical specifications, writing maintainable code, evaluating architectural solutions, participating in Scrum ceremonies, managing user stories and tasks, monitoring development progress, and mentoring junior engineers. The role requires experience with Claude Code or Google Gemini, modern programming languages, web services, cloud platforms, and software architecture.

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.

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.

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.

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.