- Highmark Health (Providence, RI)
- …+ Effectively communicates with team members, customers, partners and management , including assisting with or conducting more complex technical walkthroughs, ... of experience as a developer + Experience with Project Management tools + Experience with databases + Experience with...databases + Experience with multiple coding languages **Preferred** + Healthcare experience is strongly preferred + .NET + SQL… more
- Highmark Health (Providence, RI)
- …Inc. **Job Description :** **JOB SUMMARY** This job provides telephonic case management services to members with mental health/substance use and co-morbid chronic ... agreeable short and long-term goals. They support members in developing self- management skills and adopting positive behavior changes; identify and address gaps… more
- Highmark Health (Providence, RI)
- …+ None **Preferred** + Master's Degree in Information Systems, Business Management or Healthcare Administration **EXPERIENCE** **Required** + 5 years ... 2 years of experience with one or more Test management tools + 2 years of experience in working...Strong track record in designing and implementing large scale consumer facing applications + Strong sense of ownership, urgency,… more
- Highmark Health (Providence, RI)
- …range in health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member panel and utilizing data/analytics in ... members in his/her panel that are enrolled in case management . The incumbent conducts outreach to members enrolled in...dialectical behavior therapy (DBT) + Experience working with the healthcare needs of diverse populations + Understanding of the… more
- Highmark Health (Providence, RI)
- …with strategy / management consulting firms or internal strategy groups of healthcare companies **Preferred** + 3 years in the design of complex digital platform ... in a well-defined matrix reporting structure. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities to include, but are not limited to: involved in… more
- Highmark Health (Providence, RI)
- … Healthcare or related field **EXPERIENCE** **Required** + 3 years of Digital Product Management + 2 years in the Healthcare Industry **Preferred** + 3 years ... of new technologies, market trends, and vendor capabilities. References the inventory of existing digital capabilities and determines whether they can solve… more
- CVS Health (Woonsocket, RI)
- …enterprise and is uniquely situated at the center of our retail and healthcare businesses. We are looking for a Senior Manager, Supplemental Benefits and Directed ... client facing responsibilities, data synthesizing and analytics, internal/external stakeholder management , and retail assortment strategies. Furthermore, the ideal individual… more
- Highmark Health (Providence, RI)
- …:** **JOB SUMMARY** This job plays a critical role in digital product management and delivery for Highmark Health's customer and/or clinician facing experiences. The ... **EDUCATION** **Required** . Bachelor's Degree in Business, Science, Technology, Design, Healthcare or related field **Substitutions** . 6 years of related and… more
- Highmark Health (Providence, RI)
- …writing and supporting one or more analytical aspects of the product management lifecycle. Supporting report writing will include working with Business Intelligence ... and healthcare professionals to gather, organize, and present data to...Clarity reports and/or administering EPIC Reporting Workbench. Supporting product management will include using regular judgement and discretion to… more
- Highmark Health (Providence, RI)
- …a variety of technology systems, designing solutions or developing applications in healthcare + 3-5 years experience in Cloud technologies [preferably Google Could ... life cycle, including coding standards, unit testing, code reviews, source control management , build processes, testing, and operations + Strong track record in… more
- Highmark Health (Providence, RI)
- …+ 3 years in the Health Insurance Industry + 3 years in the Healthcare Industry + 1 year supporting product management and/or capability delivery **LICENSES ... supports one or more analytical aspects of the product management lifecycle, within a sub-product scope (one or more...this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of… more
- Highmark Health (Providence, RI)
- …+ 3 years of agile methodologies + 3 years of budgeting and financial management **SKILLS** + Deep understanding of healthcare industry dynamics, strong ... business through effective project delivery, maximizing adoption through change management , and streamlining processes to increase productivity, reduce costs, and… more
- Highmark Health (Providence, RI)
- …**Minimum** + 5 - 10 years of relevant, progressive experience in healthcare , health insurance, and/or product management and development **Preferred** + ... implementation. Responsible for coordination of all aspects of product management including regulatory compliance, legal considerations, operations, communications, marketing,… more
- Highmark Health (Providence, RI)
- …in one or more of the following systems: Workday, Kronos, Salesforce and/or Learning Management Systems, and + 3 years Healthcare or health insurance experience ... business areas and will be accountable to HR Technology Management as well as Enterprise Process Owners for the...this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of… more
- Highmark Health (Providence, RI)
- …**JOB SUMMARY** This job captures all inbound phone inquires for utilization management review from providers and pharmacies. The incumbent assesses the verbal ... coverage, creation of a prior authorization case in Highmark's Utilization Management system for Prior Authorization clinical review, status research, etc. Ensures… more
- Highmark Health (Providence, RI)
- …maintain positive, effective relationships with assigned providers. + Support the management and development of Provider Contract Analysts. + Ensure compliance with ... assigned. **EDUCATION** **Required** + Bachelor's Degree **Substitutions** + 6 years of healthcare experience in lieu of a bachelor's degree **Preferred** + None… more
- Highmark Health (Providence, RI)
- …leadership, problem-solving, data analytics, team development, communication, implementation, and project management . The incumbent often plays a central role in the ... include elements of team leadership, problem-solving, data analysis, project management , communication, and implementation support. Will participate on a portfolio… more
- Highmark Health (Providence, RI)
- …within area of expertise and ability. + As specifically requested by management , conduct research and reporting inclusive of recommendations or alternative proposals ... unit. + Perform miscellaneous job-related duties as assigned. + Project Management for Quality/Patient Safety initiatives. + Preparation of meeting agendas,… more
- Highmark Health (Providence, RI)
- …the patient, and then creates the case (data entry) in Highmark's utilization management system for clinical review. Ensures all accurate information is entered at ... verification of benefit eligibility. Build cases in the utilization management system. + Use knowledge of process and judgement...0 - 1 year of experience working in the Healthcare Industry **Preferred** + 0 - 1 year of… more
- Highmark Health (Providence, RI)
- …and delivers of complex programs that require cross-functional collaboration and management of inter-dependencies between a group of projects and/or related ... activities within the constraint of scope, quality, time and budget. Includes the management of a group of internal exempt and/or matrixed employees and contractors… more