Applications Analyst jobs at Highmark - 27 jobs

This job supports one or more analytical aspects of the application product life cycle, within a sub-product scope (one or more application components). Uses regular judgement and discretion to collaborate with customers in order to: Understand capability needs; Gather project specifications; Create business cases; Translate high-level business needs into detailed requirements for new capabilities (and change request/enhancements on existing capabilities); Analyze data to determine business problems, trends, or opportunities for process improvements; Create/execute test cases; Provide root cause analysis and corrective action plans; Verify delivery of customer needs, and Ensure quality delivery. The incumbent identifies, documents, and resolves risks, defects and issues. Analyzes market trends for competitive insight to correlate into business value statements. Builds organizational and platform knowledge in one or more disciplines to advance professional track career. Uses functional and organizational knowledge to mentor junior resources. Requires thorough understanding of end systems impact of changes across multiple systems, clinical disease process, and healthcare data. As a **Clinical Business Systems Analyst** , you will play a critical role in shaping the digital healthcare strategy for the organization and our clients. You will be responsible for fostering strong partnerships with stakeholders, providing expert consultation on the design and feasibility of our clinical digital healthcare products, implementing large scale data exchange initiatives, and providing development and operations support. This role involves translating intricate clinical requirements into clear, actionable plans for product and technical teams. Our products are designed for clinical identification and stratification and facilitating precise member routing to in-person, telephonic, and digital outreach programs. Your contributions will directly impact our ability to deliver impactful member outreach. **ESSENTIAL RESPONSIBILITIES** + Work with customers, Software Engineers, Architects, Capability Managers, and other team members to capture capability needs and drive quality business solutions. Create and maintain deliverables such as business vision, requirements and personalization to different clients, and user interface design. + Participate in the full software development life cycle by actively participating on Agile scrum teams in various roles, including, but not limited to, Scrum Master, Business Technical Analyst, User Interface designer, Capability Manager, or Tester, based upon experience and need. + Support various aspects of requirements testing (e.g. testing plan, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts. + Ensure compliance for required standards and all necessary approvals have been obtained throughout the project lifecycle. + Effectively communicate with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation. + Other duties as assigned. **EDUCATION** **Minimum** + Bachelor's Degree in Business Management, Information Systems, or closely related field **Substitutions** + Degree in Nursing, Informatics, Business Management, Health Administration, Public Health or related field **Preferred** + None **EXPERIENCE** **Minimum** + 3 - 5 years in IS/IT or Healthcare **Preferred** + 1 - 3 years in Lean/Six Sigma experience + 1 - 3 years in the Health Insurance Industry + 1 - 3 years in the Healthcare industry **LICENSES OR CERTIFICATIONS** **Required** + None **Preferred** + Six Sigma + Project Management Professional (PMP) + Clinical License **SKILLS** + Analytical Skills + Problem-Solving + Communication Skills + Report Writing + SQL + Agile Methodolgy + Agile Project Management + Manage Multiple projects concurrently + Proven ability to effectively juggle multiple competing projects + Strong planning and execution + Data Exchange **Language Requirements (other than English)** None **Travel Required** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Remote Teaches / trains others regularly Rarely Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Rarely Lifting: 10 to 25 pounds Rarely Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement:_** _This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $57,700.00 **Pay Range Maximum:** $107,800.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J270367

**Become a part of our caring community and help us put health first** We are seeking a skilled and motivated P2 CyberSecurity Defense Operations Analyst to strengthen our Cybersecurity Operations Center (CSOC). This role is ideal for a cybersecurity professional with proven experience in monitoring, triaging, and responding to complex security alerts. In this role you will have the opportunity to work directly with other members of the CSOSC, partner with the Digital Forensics and Incident Response team, utilize a comprehensive tool stack, and have a direct impact on our mission of safeguarding the Humana environment. The CyberSecurity Defense Operations Analyst 2 documents and logs cyber defense incidents from initial detection through final resolution or escalation and ensures information is appropriately catalogued, analyzed, and reported on for root-cause analysis identification. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. **Use your skills to make an impact** **Required Qualifications:** + 1-3 years of experience in a security operations center or similar environment + Proficiency with security tools such as SIEM and EDR + Ability to investigate and respond to security alerts + Strong communication, documentation, and collaboration skills **Preferred Qualifications:** + Related Security Certification + Bach Degree in a technology related concentration Remote/WAH requirements: + WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. + A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. + Satellite and Wireless Internet service is NOT allowed for this role. + A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $80,900 - $110,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-19-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

UPMC Health Plan has an exciting opportunity for a Clinical Auditor/Analyst Intermediate! The Clinical Auditor/Analyst Intermediate is an integral part of the Special Investigations Unit (SIU) and is responsible for conducting clinical audits and reviews regarding the analysis of care and services related to clinical guidelines, coding requirements, regulatory requirements, and resource utilization. This role also acts as a SME for the department in representing management in meetings, training new staff and auditing peers. Collects program data to monitor/ensure compliance requirements and establishes and revises better best practice within the department. The Clinical Auditor/Analyst Intermediate creates, maintains and analyzes auditing reports related to their assigned work plan and communicates the results with management. Other responsibilities include but are not limited to analysis of controlled substance prescribing and utilization to identify potential clinical care issues; prepayment review of claims, and prepayment review of unlisted codes. Claims analysis and the use of fraud and abuse detection software tools will be an integral part of the function of this position. Responsibilities will involve working in collaboration with appropriate Health Plan departments including Quality Improvement, Legal, and Medical Management to facilitate the resolution of issue or cases. Responsibilities may involve multiple line of business focused reviews, or ad hoc reviews as needed; analysis of billing by providers/physicians, and providing trending, analysis and reporting of auditing data. The Clinical Auditor/Analyst Intermediate will routinely interact with providers, law enforcement and/or regulatory entities in the course of their duties. Responsibilities: + Respond to fraud, waste, and abuse referrals and/or complete data analysis and related audits as assigned. + Utilize fraud detection software to assess and monitor for potential FWA. + Review and analyze claims, medical records and associated processes related to the appropriateness of coding, clinical care, documentation, and health plan business rules. + Provide a clinical opinion for special projects or various issues including appropriate utilization of controlled substances, prescribing of controlled substances, or medically appropriate services. + Query medical and/or pharmacy claims and conduct a risk assessment by performing data analysis and applying applicable coding guidelines, Health Plan policies and any applicable National Coverage Determination (NCD) or Local Coverage Determination (LCD). + Evaluate referrals from Pharmacy Benefit Manager (PBM) by analyzing medical and pharmacy claims and associated clinical documentation in HealthPlaNET, Mars, Epic and/or Cerner. + Complete audits by utilizing standard coding guidelines and principles and coding clinics to verify that the appropriate CPT codes/DRGs were assigned and supported in the medical record documentation. + Attend in person or virtual recipient restriction hearings. + Review Medical Pended Queue claims to understand and resolve claim referral issues through research and interaction with other Health Plan Departments including Medical Management, Medical Directors, various committees, and other appropriate Health Plan departments. + As necessary, assist in the development of new policies concerning future Health Plan payment of identified issue. + Assess, investigate and resolve complex issues. + Write concise written reports including statistical data for communication to other areas of UPMC Health Plan and to communicate with department heads for identification of various problem issues, how they affect the Health Plan, and to make recommendations for resolution of the issue. + Identify error trends to determine appropriate training needs and suggest modifications to company policies and procedures. + Conduct provider education, as necessary, regarding audit results. Communicate effectively with Medical Directors and ancillary departments as necessary to address issues and concerns. + Participate as needed in special projects and other auditing activities. Provide assistance to other departments as requested. + Understand customers including internal Health Plan Departments (i.e. Claims staff, Customer Service, Marketing, etc.) and external customers (i.e. Health System Internal Audit, Client Audit teams) to understand issues, identify solutions and facilitate resolution. + Serve as an SIU representative at internal and external meetings, document and present findings to SIU Staff and document as appropriate in the SIU FWA Case Management Database. + Assist in the development and revision of SIU policies and procedures. Identify trends for improvements internally, such as claims payment, to determine appropriate training needs and suggest modification to company policies and procedures. + Perform audit peer reviews for Clinical Auditor/Analysts. + Provide new-hire training to Clinical Auditor/Analysts. Performing administrative appeals/preparing medical necessity appeals for Medical Directors for second level appeals. Participate in training programs to develop a thorough understanding of the materials presented. + Obtain CPE or CEUs to maintain nursing license, and/or professional designations. + Design and maintain reports, auditing tools and related documentation. Maintain or exceed designated quality and production goals. Maintain employee/insured confidentiality. Registered Nurse (RN). Bachelor of Science in Nursing (BSN) or the equivalent combination of education, professional training and work experience. Five years of clinical experience. Three years of fraud & abuse, auditing, case management, quality review or chart auditing experience required. Ability to analyze data, maintain designated production standards, and organize multiple projects and tasks. In-depth knowledge of medical terminology, ICD-10 and CPT-4 coding. Knowledge of health insurance products and various lines of business. Detail-oriented individual with excellent organizational skills. Keyboard dexterity and accuracy. High level of oral and written communication skills. Proficiency with Microsoft Office products (Excel, Access, OneDrive, OneNote and Word). Licensure, Certifications, and Clearances: AAPC or AHIMA Certified (CPC, CPMA, CIC, CCA, CCS, CCS-P) or AHFI designation required. + Registered Nurse (RN) + Act 33 with renewal + Act 34 with renewal + Act 73 FBI Clearance with renewal *Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state. UPMC is an Equal Opportunity Employer/Disability/Veteran

Become a part of our caring community and help us put health first We are seeking a skilled and motivated P2 CyberSecurity Defense Operations Analyst to strengthen our Cybersecurity Operations Center (CSOC). This role is ideal for a cybersecurity professional with proven experience in monitoring, triaging, and responding to complex security alerts. In this role you will have the opportunity to work directly with other members of the CSOSC, partner with the Digital Forensics and Incident Response team, utilize a comprehensive tool stack, and have a direct impact on our mission of safeguarding the Humana environment.The CyberSecurity Defense Operations Analyst 2 documents and logs cyber defense incidents from initial detection through final resolution or escalation and ensures information is appropriately catalogued, analyzed, and reported on for root-cause analysis identification. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Use your skills to make an impact Required Qualifications: 1-3 years of experience in a security operations center or similar environment Proficiency with security tools such as SIEM and EDR Ability to investigate and respond to security alerts Strong communication, documentation, and collaboration skills Preferred Qualifications: Related Security Certification Bach Degree in a technology related concentration Remote/WAH requirements: WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $80,900 - $110,300 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 01-19-2026 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

This pivotal role drives the full lifecycle of medical policies, from initial development and evidence-based criteria writing to publication, maintenance, and assisting with impact assessment through data analysis. The incumbent will act as a primary owner of assigned medical policies, ensuring their accuracy, clinical soundness, and operational feasibility. A core responsibility of this position is to leverage advanced data analytics to generate critical insights, identify actionable opportunities, and develop sophisticated reporting solutions. These data-driven contributions will directly inform and influence medical policy decisions, ensuring alignment with the Quadruple Aim of Healthcare: lower per capita health care costs, improved outcomes and quality of care received, and optimal member/patient and provider experiences with care delivery. The incumbent will also act as a clinical lead and expert on various workgroups, ensuring policies are grounded in strong clinical evidence and operational realities. + **Full-Cycle Medical Policy Ownership:** Own the development, revision, and maintenance of a portfolio of commercial medical policies, encompassing both internally developed and vendor-sourced criteria. This includes proactive monitoring, review, and timely updates in response to new evidence, regulatory changes, or escalated inquiries. + **Evidence-Based Clinical Criteria Writing:** Research, analyze, and synthesize clinical literature, professional society guidelines, and internal data to develop clear, concise, and evidence-based medical necessity criteria for assigned policies. + **Data-Driven Policy Development & Influence:** Utilize robust, data-driven insights from complex healthcare datasets (e.g., claims, clinical, utilization, pharmaceutical) to inform policy development, identify areas for improvement, and assist in quantify the potential impact of policy changes on clinical outcomes, cost, and member experience. + **Operational Integration & Coding:** Engage non-clinical teams to ensure operational guidelines are aligned with clinical policy intent. Develop and maintain a thorough understanding of medical coding (ICD-10, CPT, HCPCS) and ensure accurate coding principles are incorporated into policy criteria. + **Policy Publication & Quality Assurance:** Manage the full publication process for assigned policies. Conduct peer reviews of other policies as part of the quality assurance process to ensure accuracy, clarity, and consistency. + **Consultative & Expert Role:** Serve as a clinical lead/expert on various workgroups and sub-committees, providing clinical and data-driven insights. Act as a subject matter and technical expert for internal and external customers, articulating analytic findings, business implications, and recommendations. + **Stakeholder Liaison:** Serve as a key liaison between the Medical Policy department, other internal departments (e.g., Operations, Provider Relations, Clinical Programs), and external vendors to ensure seamless policy implementation and understanding. + **Mentorship & Training:** Train and orient new staff to the department and policy development/review procedures. Mentor new team members on best practices in policy writing, research, and data application. + **Complex Data Analysis:** Conduct statistical analysis on large and complex healthcare datasets, identifying significant patterns, correlations, and causal relationships relevant to medical policy decisions and impact assessment. + **Communication & Presentation:** Effectively translate complex clinical and analytical findings into clear, concise, and compelling presentations and reports for diverse audiences, including clinical professionals, executive leadership, and operational partners. **ESSENTIAL RESPONSIBILITIES** + Leads the design, development, execution, dissemination and interpretation of clinical and population health analyses, metrics and reports using clinical, member, financial and administrative data to identify, develop and/or monitor actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and effectively managing projects to successful completion. + Establishes strong, collaborative and effective relationships and communication with internal and external clinical, administrative, operational, financial and technical stakeholders to ensure analytics are actionable and aligned with organizational strategic priorities, needs, plans and resources. + Serves as a strategic business partner to internal and external stakeholders as demonstrated by providing thought leadership and subject matter expertise, and by anticipating and actively proposing, designing and executing analyses. + Provides consultative, technical, subject matter and business expertise mentorship to colleagues across the enterprise. + Other duties as assigned or requested. **EDUCATION** **Required** + Master's Degree in Public Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology or Pharmacy or related field **Substitutions** + Bachelor's Degree in Public Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology, Pharmacy **OR** related field with 2 years of relevant work experience in lieu of a Master's Degree OR 8 years of relevant work experience **Preferred** + Doctorate in Medicine, Public Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology, Pharmacy or related field **EXPERIENCE** **Required** + 7 years of leading the design, execution and dissemination of clinical and population health reporting, analyses and studies of progressive scope and complexity + 7 years with coding languages, analytical software, systems, tools and processes using claims, clinical, enrollment and provider data + 5 years of project leadership in a complex, matrixed environment (payer and/or provider preferred) + 5 years of providing analytical consultation to clinical, administrative, operational and financial stakeholders **Preferred** + Experience with medical policy and utilization management functions + Medical coding experience **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + Medical coding certificate (AAPC) **SKILLS** + Demonstrated record of data-driven discovery, intense intellectual curiosity, and a passion for working with data to answer important questions about clinical care and population health that drive the Quadruple Aim + Strong working knowledge of coding languages, relational databases, quantitative and qualitative analytic methodologies, advanced analytics and statistics + Excellent communication and facilitation skills with project team members, stakeholders, executives, and external customer, exceptional written and oral presentation skills, proven ability to communicate interpersonallly and technically with technical and non-technical, and internal and externbal audiences, and the ability to lead through influence + Healthcare industry expertise and experience, knowledge about the shifting healthcare environment including trends concerning health insurance, healthcare delivery, provider relationships and regulatory issues + Sophisticated knowledge of how organizations work and how to get things done through formal and informal channels + Exhibition of perseverance through energy, drive and demonstrated success when resistance or setbacks are encountered + In-depth understanding of and experience with both clinical and business processes, and the ability to identify opportunities for improvement and develop solutions + Demonstrated ability to informally lead matrixed teams of technical, clinical, administrative, financial and operational staff to achieve shared organizational objectives and strategic goals **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Frequently Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required No Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ _ments._ **Pay Range Minimum:** $78,900.00 **Pay Range Maximum:** $147,500.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273990

This role delivers high-impact analytics and insights focused on Social Determinants of Health (SDOH) to support enterprise strategy and population health initiatives. The position contributes to the development and evolution of enterprise SDOH dashboards and self-service analytic tools, with a focus on analytical rigor, scalability, and alignment to high-value use cases. The incumbent serves as a consultative analytic partner to the Enterprise SDOH team, collaborating to refine analytic questions and translate complex needs into clear, actionable analytic approaches. As reporting capabilities mature, this role will support advanced analysis of varied and multilevel data in exploratory, evaluative, and research-adjacent analytic work, and development of insights that inform program design and strategic decision-making. **ESSENTIAL RESPONSIBILITIES** + Supports and leads the design, development, execution, dissemination and interpretation of clinical and population health analyses, metrics and reports using clinical, member, financial and administrative data to identify, develop and/or monitor actionable opportunities for improving health and healthcare outcomes and clinical quality and costs of care, efficiently and effectively managing projects to successful completion. + Establishes strong, collaborative and effective relationships and communication with internal and external clinical, administrative, operational, financial and technical stakeholders to ensure analytics are actionable and aligned with organizational strategic priorities, needs, plans and resources. + Serves as a strategic business partner to internal and external stakeholders as demonstrated by providing thought leadership and subject matter expertise. + Provides consultative, technical, subject matter and business expertise mentorship to colleagues across the enterprise. + Other duties as assigned or requested. **EDUCATION** **Required** + Bachelor's Degree in Public Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology or Pharmacy or closely related field **Substitutions** + None **Preferred** + Master's Degree in Medicine, Public Health, Nursing, Economics, Health Sciences, Informatics, Biostatistics, Statistics, Epidemiology, Pharmacy or related field **EXPERIENCE** **Required** + 5 years of leading the design, execution and dissemination of clinical and population health reporting, analyses and studies of progressive scope and complexity + 5 years with coding languages, analytical software, systems, tools and processes using claims, clinical, enrollment and provider data + 3 years of project leadership in a complex, matrixed environment (payer and/or provider preferred) + 3 years of providing analytical consultation to clinical, administrative, operational and financial stakeholders **Preferred** + Applied experience analyzing Social Determinants of Health (SDOH) data + Experience developing analytic applications or dashboards (e.g.,RShiny, Tableau) to support self-service analytics + Experience partnering with stakeholders to refine and prioritize analytic questions in ambiguous problem spaces **LICENSES or CERTIFICATIONS** **Required** + None **Preferred** + None **SKILLS** + Demonstrated record of data-driven discovery, intense intellectual curiosity, and a passion for working with data to answer important questions about clinical care and population health that drive the Quadruple Aim + Strong working knowledge of coding languages, relational databases, quantitative and qualitative analytic methodologies, advanced analytics and statistics + Excellent communication and facilitation skills with project team members, stakeholders, executives, and external customer, exceptional written and oral presentation skills, proven ability to communicate interpersonally and technically with technical and non-technical, and internal and external audiences, and the ability to lead through influence + Healthcare industry expertise and experience, knowledge about the shifting healthcare environment including trends concerning health insurance, healthcare delivery, provider relationships and regulatory issues + Sophisticated knowledge of how organizations work and how to get things done through formal and informal channels + Exhibition of perseverance through energy, drive and demonstrated success when resistance or setbacks are encountered + In-depth understanding of and experience with both clinical and business processes, and the ability to identify opportunities for improvement and develop solutions + Demonstrated ability to informally lead matrixed teams of technical, clinical, administrative, financial and operational staff to achieve shared organizational objectives and strategic goals **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office-based Teaches / trains others regularly Frequently Travel regularly from the office to various work sites or from site-to-site Occasionally Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required Yes Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $67,500.00 **Pay Range Maximum:** $126,000.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J273839

Summary of Job Maximize agent productivity by providing issue resolution to the individual agent; coordinate with training and HR team for onboarding and offboarding activities. Responsible for the intra-day timeline reporting to the Call Center Management; work closely with the team to analyze and improve the performance. Provide advanced level of RTA support. Partner with department management throughout the enterprise to ensure the appropriate number of Call Center resources at the right time and the right place to maximize the best-in-class customer service experience. Responsibilities * Support Manager, Workforce Engagement to identify schedule gap, out of adherence activities, provide approval of PTO, and support over Intra-day resources allocation decisions. * Adjust intraday forecasts derived from attendance report, business drivers to determine required staffing levels by projecting call volumes, call duration and required staffing levels using current trends and historical data. * Support real time queue monitoring for the Emblem, CCI, and ACPNY line of business, etc. Perform agent / agent group skill adjustment when necessary. * Produce attendance, intra-day reporting including the End of Day and Agent Out of Adherence reporting. Incorporate vendor's data to create additional insights. * Runs and analyzes reports with the result of making recommendations for adjusting staffing levels to meet departmental productivity and profitability goals. * Support Performance Management - Site level Dashboard, Agent Scorecard creation, and new initiatives. * Monitor / coordinate regular morning team huddles, Supervisor 1 on 1 meetings. * Provide / assist Supervisor teams on the site level communications to the agent / Supervisor teams. * Manage and track the issue resolution, escalate system level outage and provide quick resolutions to the operations. * Collaborate with training team and / or HR to provide a better onboarding experience. Track offboarding activities. Qualifications * Bachelor's Degree in Business Management or related * 3 - 5+ years' Call Center experience in workforce management function (Required) * 1+ year experience working with Verint, Genesys WFO or another workforce management systems (Required) * 1+ year experience with ACD / IVR Reporting (Required) * Additional experience/specialized training may be considered in lieu of educational requirements (Required * Help desk experience (Preferred) * Call Center Supervisory / Management experience (Preferred) * Ability to create reports in Excel using formulas - vlookup, count, sum, etc., graphs, and other tools (Required) * Proficient with MSOffice - Word, Excel, Access, PowerPoint, Outlook, SharePoint with advanced Excel skills (Required) * Ability to effectively organize and manage multiple task/projects with conflicting priority levels and deadlines (Required) * Ability to perform research and utilize technical/statistical/policy & procedure knowledge to identify and solve problems (Required) * Ability to work successfully in a team environment, while maintaining strong individual performance (Required) * Excellent customer service skills, with a commitment to seeing tasks through to completion (Required) Additional Information * Requisition ID: 1000002612 * Hiring Range: $56,160-$99,360

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Remote Available. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Position Purpose: Perform various analysis and interpretation to link business needs and objectives for assigned function. Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems. Identify and analyze user requirements, procedures, and problems to improve existing processes. Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations. Identify ways to enhance performance management and operational reports related to new business implementation processes. Coordinate with various business units and departments in the development and delivery of training programs. Develop, share, and incorporate organizational best practices into business applications. Diagnose problems and identify opportunities for process redesign and improvement. Formulate and update departmental policies and procedures. Serve as the subject matter expert on the assigned function product to ensure operational performance. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Bachelor's degree in related field or equivalent experience. 4-6 years of business process or data analysis experience, preferably in healthcare. Project management experience preferred. By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified. Pay Range: $70,100.00 - $126,200.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Position Purpose: Perform various analysis and interpretation to link business needs and objectives for assigned function. Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems Identify and analyze user requirements, procedures, and problems to improve existing processes Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations Identify ways to enhance performance management and operational reports related to new business implementation processes Coordinate with various business units and departments in the development and delivery of training programs Develop, share, and incorporate organizational best practices into business applications Diagnose problems and identify opportunities for process redesign and improvement Formulate and update departmental policies and procedures Serve as the subject matter expert on the assigned function product to ensure operational performance Ability to travel Performs other duties as assigned Complies with all policies and standards Education/Experience: Bachelor's degree in related field or equivalent experience. 4-6 years of business process or data analysis experience, preferably in healthcare. Project management experience preferred. The Position Management team plays a critical role in supporting organizational structure, workforce planning, and operational efficiency. Advanced Excel skills highly preferred. Experience with staffing models, capacity planning or workforce planning a plus. By applying to this requisition, you acknowledge and understand that you may be considered for other job opportunities for which Centene believes you may be qualified. Pay Range: $70,100.00 - $126,200.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

You could be the one who changes everything for our 28 million members by using technology to improve health outcomes around the world. As a diversified, national organization, Centene's technology professionals have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Collaborates with business and technology stakeholders to analyze and translate moderately complex business requirements into clear functional and non-functional specifications for technical implementation. Gathers and validates business / technology requirements to establish scope and parameters of requirements and define project impact, outcome criteria, and metrics Analyzes and verifies requirements for completeness, consistency, comprehensibility, feasibility, and conformity to standards Translates conceptual user requirements into functional requirements in a clear manner that is comprehensible to developers / project team Creates systems and business process models, specifications, diagrams, and charts to provide direction to developers and/or the project team Interprets user requirements into feasible options and communicate these back to the business stakeholders Manages and tracks the status of requirements throughout the project lifecycle; enforce and redefine as necessary Communicates changes, enhancements, and modifications of business requirements to project managers, sponsors, and other stakeholders so that issues and solutions are understood Plans user acceptance testing (UAT) Monitors and review levels of IT services specified in the service-level agreements (SLAs) with the business Research, reviews, and analyzes the effectiveness and efficiency of existing requirement gathering processes and develop strategies for enhancing or further leveraging these processes; quantify potential efficiency opportunities and track accordingly Maintains system protocols by writing and updating procedures Provides references for users by writing and maintaining user documentation; provide help desk support; train users Prepares technical reports by collecting, analyzing, and summarizing information and trends Performs other duties as assigned Complies with all policies and standards Education/Experience: A Bachelor's degree in a quantitative or business field (e.g., statistics, mathematics, engineering, computer science) and requires 2 - 4 years of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Technical Skills: One or more of the following skills are desired. Power BI ServiceNow SQL Pay Range: $30.58 - $55.09 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

UPMC is hiring a Senior Systems Analyst to join their team. This opportunity offers a work life balance, culture of learning and knowledge sharing, and supportive leadership. If you have strong project management, communication skills, and technical knowledge APPLY NOW! Work Location: Fully Remote Work Hours: Core hours 9:00 - 3:00p.m., with flexible start times for the full 8 hours. Purpose: Under the general direction of the management team and senior staff, the Systems Analyst - Senior requires a proficient level of experienced analytical services, defining requirements, developing and/or maintaining computer applications/systems, and providing services to meet client IT and business needs. Responsibilities: + Leading IT projects by maintaining and monitoring schedules and milestones. + Analyze budgets and forecasts to ensure cost control and financial transparency. + Provide clear updates on overall project progress, major risks, and key decisions. + Communicate deadlines to keep milestones on track, prevent costly delays, and maintain budget alignment. + Monitor financials through monthly burndowns and reforecast regularly to ensure timely delivery. + Documentation: Complete detail-oriented documentation for new and moderately complex processes. Responsible for the quality and validity of produced documents. Extract and document customer/business requirements and needs for use by enterprise architecture and engineering teams (network, system, and software). + Second and Third Level Support (Including Maintenance Activities): Independently triage and resolve Level 2 and Level 3 support issues. Act as a mentor to less experienced staff in resolution of Level 2 and Level 3 issues. Ability to handle problem management as appropriate. + Project Management: Take ownership of a project and have the ability to distribute tasks to team members and meet milestone completion. Update all project management and time tracking tools accordingly. + SDLC (System Development Life Cycle): Have a proficient understanding of multiple system/application development life cycles. + Data Confidentiality/Security: Maintain confidentiality of sensitive information at all times. + Data Quality: Maintain data quality at all times. + Vendor Relationships: Interact with vendors (technical issues, project initiatives) independently, as necessary. Ability to act as the point person for issue escalation. + Report Writing/Analysis: Write and analyze complex reports. Make modifications to complex reports. + Mentor less experienced team members. Communicate with the business/act as business analyst. + End User Training: Ability to create training content. Facilitate more detailed user training sessions. Ability to train peers. + Process Improvement: Ability to manage process improvement efforts. Create and update processes, as necessary. Ability to independently recognize opportunity for process improvements. + Application Upgrades and Implementation: Identify new functionality and/or hardware requirements related to application upgrades and implementations. Creates test plans. Responsible for review and validation of functionality. Report back any problems. Create and/or manage cutover plans including downtime, etc. Responsible for evaluating impact and coordinating efforts across multiple platforms as necessary. + Communication: Responsible for demonstrating appropriate, clear, concise, and effective written and oral communications in all interactions to build relationships and accomplish day-to-day work and projects. + Interactions with Others: Successfully completes projects, tasks, and initiatives by embracing a team-first approach. Works in collaboration with team and offers feedback, where appropriate, to complete individual and group efforts. Shows the ability to adjust and be flexible to change by adapting approach when necessary. Mentors less experienced staff. + Self-Development: Responsible for continuous self-study, trainings, partnering with more senior members of team, and/or seeking out opportunities to broaden scope to stay up to date with industry and organizational trends. Seeks feedback from senior team members for development and effectively incorporates feedback into work and behaviors. + System Integration: May be responsible for coordination of tasks and resources related to system integration, validation of testing and implementation. + *Performs in accordance with system-wide competencies/behaviors. + *Performs other duties as assigned. * Typically, has 5+ years' experience with modern technology and application support through education or practical experience. * Highly driven and self-motivated to exceed expectations. * Ability to work independently and in a team-based environment. * Demonstrates thorough understanding of information technology fundamental tools and concepts (SDLC) of one of the information technology professional disciplines and applies that understanding to make independent practical contributions to IT work within a UPMC department or function. * Completes on-going training on-the-job, through courses, self-study, certifications, and/or advanced degrees to maintain and enhance technical and business capabilities. * Responds to unfamiliar, undefined, unexpected, or unstable situations with the professionally prescribed standard response Recognizes subtle problems with system design or performance and acts appropriately to improve the condition, seeking validation of actions in advance as appropriate. (Preferred) * Effective in relationships with business partners, professional peers, and other team members Coaches less experienced IT professionals Must meet IT Career Level Criteria for Individual/Team Contributors. (Preferred) Top 3 Skills Needed: * Strong Project Management (especially agile methodologies) * Technical Understanding * Communication Preferred: * 7+ years of experience with modern technology and application support through education or practical experience * Preferred Experience with Agile/SAFe Agile development lifecycles * Current or Past UPMC employee or contractor Licensure, Certifications, and Clearances: Act 34, Preferred Licensure:ACBT - Avaya CBTCXADMIN - AVST Cert CX AdminITIL - IT Infrastructure Library UPMC is an Equal Opportunity Employer/Disability/Veteran

Company :Highmark Inc. : This job collaborates with internal stakeholder to understand moderate to complex business requirements and processes related client, product, and benefits configuration solutions. Performs standard and custom benefit coding and new client and group installation, translating group and client information into system configuration, including but not limited to client, group, rates, and commissions data. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve This role is looking for someone who has ZELIS/RedCard experience along with reading and interpreting code within the health insurance space. This is a remote based role. ESSENTIAL RESPONSIBILITIES Perform basic analysis using knowledge of moderate-to-complex business rules by interpreting and analyzing data from various sources and formats and utilize the data for configuration activities. Translate moderate-to-complex business needs and business rules to define and execute operations activities for high quality solutions to meet customer and plan partner needs. Document and execute medium-to-complex product and benefit configuration rules. Assist in and is accountable for identification, documentation, and escalation of risks, data errors and issues throughout the configuration process. Assist in development of testing plan, scenarios, and documentation to ensure high quality of product. Perform both end-to-end and user acceptance testing to ensure high quality of product. Other duties as assigned or requested. EDUCATION Required High School Diploma/GED Substitutions None Preferred Associate's Degree in Healthcare Administration, Business, Information Science or other related field EXPERIENCE Required 3 - 5 years of experience in health care industry or other related field 3 - 5 years of experience in business analysis, system analysis, or other related function working with logical data structures Preferred 3 - 5 years of experience in health insurance operations, benefits operations, or other related field related is preferred 3 - 5 years of experience with client, product, and/or benefits configuration techniques LICENSES AND CERTIFICATIONS Required None Preferred None SKILLS Excellent detail-oriented skills Good customer service skills with moderate experience working with customers, sales, and/or clients High proficient oral and written communication skills Ability to understand and resolve moderate to complex data relationships, data conflicts, and data discrepancies Ability to apply logical thinking and critical thinking skills to resolve moderate to complex problems and designs Proficient in understanding, analyzing, and applying moderate to complex business rules and configuration concepts LANGUAGE REQUIREMENT (Other than English)? None TRAVEL REQUIREMENT 0% - 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-Based Teaches/Trains others regularly Rarely Travels regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (Sales employees) Does Not Apply Physical Work Site Required No Lifting: up to 10 pounds Does Not Apply Lifting: 10 to 25 pounds Does Not Apply Lifting: 25 to 50 pounds Does Not Apply Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum: $24.53 Pay Range Maximum: $38.00 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Company :Highmark Inc. : This job collaborates with internal stakeholder to understand moderate to complex business requirements and processes related client, product, and benefits configuration solutions. Performs standard and custom benefit coding and new client and group installation, translating group and client information into system configuration, including but not limited to client, group, rates, and commissions data. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve This role is looking for someone who has ZELIS/RedCard experience along with reading and interpreting code within the health insurance space. This is a remote based role. ESSENTIAL RESPONSIBILITIES Perform basic analysis using knowledge of moderate-to-complex business rules by interpreting and analyzing data from various sources and formats and utilize the data for configuration activities. Translate moderate-to-complex business needs and business rules to define and execute operations activities for high quality solutions to meet customer and plan partner needs. Document and execute medium-to-complex product and benefit configuration rules. Assist in and is accountable for identification, documentation, and escalation of risks, data errors and issues throughout the configuration process. Assist in development of testing plan, scenarios, and documentation to ensure high quality of product. Perform both end-to-end and user acceptance testing to ensure high quality of product. Other duties as assigned or requested. EDUCATION Required High School Diploma/GED Substitutions None Preferred Associate's Degree in Healthcare Administration, Business, Information Science or other related field EXPERIENCE Required 3 - 5 years of experience in health care industry or other related field 3 - 5 years of experience in business analysis, system analysis, or other related function working with logical data structures Preferred 3 - 5 years of experience in health insurance operations, benefits operations, or other related field related is preferred 3 - 5 years of experience with client, product, and/or benefits configuration techniques LICENSES AND CERTIFICATIONS Required None Preferred None SKILLS Excellent detail-oriented skills Good customer service skills with moderate experience working with customers, sales, and/or clients High proficient oral and written communication skills Ability to understand and resolve moderate to complex data relationships, data conflicts, and data discrepancies Ability to apply logical thinking and critical thinking skills to resolve moderate to complex problems and designs Proficient in understanding, analyzing, and applying moderate to complex business rules and configuration concepts LANGUAGE REQUIREMENT (Other than English)? None TRAVEL REQUIREMENT 0% - 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-Based Teaches/Trains others regularly Rarely Travels regularly from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (Sales employees) Does Not Apply Physical Work Site Required No Lifting: up to 10 pounds Does Not Apply Lifting: 10 to 25 pounds Does Not Apply Lifting: 25 to 50 pounds Does Not Apply Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum: $24.53 Pay Range Maximum: $38.00 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Explore opportunities with Kelsey-Seybold Clinic, part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together. Position in this function shows ability and competency to work on most phases of application systems analysis, workflow analysis, build, design, testing and programming activities but requires instruction/guidance/mentoring in other phases. May be responsible to work on a team or project team(s) in the capacity to be a member of the project or lead a phase of the project. Has the ability and can multi-task. May be responsible to work or lead business owners, stakeholders, and IT personal to assess project needs as guided by management. Supports implementation and upgrades to clinical and bio-medical applications as required. Provide weekly status updates on project(s) progress to team lead or management. Position will require travel to KSC clinic locations for implementation, training and support. Other duties as assigned. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities: * 10% Project Management: Participate on projects as assigned in accordance with standard KSC project management and documentation standards with guidance from team lead/management. Has some Project Management skills and has the ability to learn build, testing, and document in accordance with KSC PMO standards. Maintain complete and up to date project documentation for all assigned projects and requested by Project leads. Work with project team leads/members so that defined objectives and benefits are achieved. Serves as a member to assigned user group(s) or IT groups * 10% Teamwork: Establish strong working relationships with project lead(s), team, and of other application teams/management to ensure proposed system changes are thoroughly vetted and potentially adverse downstream consequences are discovered. Learning to develop and communicate risk mitigation strategies. Participate/support in Help Desk service, working service desk tickets, and 24 x 7 on call program, along with other team members * 10% System Development: Under general supervision, diagnose and resolve problems. Define and document business/clinical system requirements and workflows as required by project. Configure system settings and master files to meet business requirements, sign off may be required by project lead. Provide or support system go lives and problem resolution. Begin to achieve a higher level application knowledge, proficiency, and problem solving skills as guided by IT management. Can deliver work that is consistently accurate, precise, thorough, neat, ethical, and reliable. Has some knowledge of quality standards and follows applicable quality guidelines. Understands concepts of process improvement and results to improve the quality of services. Completes all duties as assigned in the required timeframes. Meets deadlines for regular duties and projects * 10% System Support: Under general supervision, ongoing application support, problem resolution and question and answer services. Participate in Application Service Desk duty and 24 x 7 on call program with other team members. Assists application analysts and Help Desk with support of resolving help desk tickets * 10% Proficiency: Begin to maintain and develop competency level application knowledge, proficiency and problem solving skills, as well as follow KSC IT project management tools and processes, change management/control and service procedures * 10% Communication/Customer Relations: Maintains an effective working relationships with project teams, IT management, Clinical and/or business leadership. Ability to maintain working relationships with application vendor technical staff as directed by project assignments. Ability to facilitate rapid problem resolution and service delivery, where vendor services are needed. Possesses the ability to effectively communicate relevant information, in a clear and concise manner, at all levels of the organization. Promotes and practices effective listening skills in all interpersonal contacts. Demonstrates competence in grammar and clarity in all oral and written communication * 10% Optimization: Begin to learn and participate on implementation efforts for system improvements in accordance with KSC project management tools and processes, standard change control and change management procedures. Communicates system changes to all applicable users. Provides a high level of output and productivity. Meets team and project objectives. Does not waste skills, time, and resources. Looks to find ways to improve processes and control costs * 10% Interpersonal Skills: Solid positive attitude, interpersonal and relational skills, ability to make and keep commitments, meet project timelines, and provide outstanding customer service is required. Communication regarding technical matters in language easily understood by non-technical staff is required. Conducts effective meetings and ability to lead IT projects as assigned. Possesses the ability to be flexible in changing situations, meet changing priorities, and solve new and existing problems. Understands the value of adaptability with patients, customers, clinicians and business owners. * 10% Reliability: Can be counted on to arrive and start work on time. Meets expectations for completion of duties as assigned in the required timeframes. Meets deadlines for regular duties and projects without management intervention * 5% Certifications: Certification required based on application. KSC IT Management will determine if certification is required * 5% Other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Bachelor's degree or equivalent work experience * 3+ years of experience in applicable healthcare clinical operations, or Epic Application or other similar healthcare application systems design, configuration or support * Understanding of physician practice operations, and ways improved information management can lead to clinical, operating and financial improvement in a health care organization. Proficiency in use of desktop computer systems (Windows, Microsoft Office, email) and some experience in use of clinical or practice management systems in medical practice * Proven to have a positive and "can do" attitude. Ability to learn quickly, and to obtain Epic System Proficiency level certification (as defined by Epic) and/or other clinical system certifications * Proven ability to translate clinical and operating requirements into clear, specific and actionable system configurations and ability to implement those configurations. Ability to test and audit personally developed system configurations, in order to assure functional accuracy * Proven excellent communication, relationship, teamwork and project management skills * Proven communication, presentation, project management, teamwork, problem solving and technical skills are also required. * Valid Texas Driver's License Preferred Qualifications: * Clinical Degree * 5+ years of experience * Demonstrable knowledge of clinical data sets (CPT, HCPCS, ICD-9, etc) * Proven participated on clinical projects and implementations successfully * All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

**Explore opportunities with Kelsey-Seybold Clinic,** part of the Optum family of businesses. Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind **Caring. Connecting. Growing together.** Position in this function shows ability and competency to work on most phases of application systems analysis, workflow analysis, build, design, testing and programming activities but requires instruction/guidance/mentoring in other phases. May be responsible to work on a team or project team(s) in the capacity to be a member of the project or lead a phase of the project. Has the ability and can multi-task. May be responsible to work or lead business owners, stakeholders, and IT personal to assess project needs as guided by management. Supports implementation and upgrades to clinical and bio-medical applications as required. Provide weekly status updates on project(s) progress to team lead or management. Position will require travel to KSC clinic locations for implementation, training and support. Other duties as assigned. You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. **Primary Responsibilities:** + 10% Project Management: Participate on projects as assigned in accordance with standard KSC project management and documentation standards with guidance from team lead/management. Has some Project Management skills and has the ability to learn build, testing, and document in accordance with KSC PMO standards. Maintain complete and up to date project documentation for all assigned projects and requested by Project leads. Work with project team leads/members so that defined objectives and benefits are achieved. Serves as a member to assigned user group(s) or IT groups + 10% Teamwork: Establish strong working relationships with project lead(s), team, and of other application teams/management to ensure proposed system changes are thoroughly vetted and potentially adverse downstream consequences are discovered. Learning to develop and communicate risk mitigation strategies. Participate/support in Help Desk service, working service desk tickets, and 24 x 7 on call program, along with other team members + 10% System Development: Under general supervision, diagnose and resolve problems. Define and document business/clinical system requirements and workflows as required by project. Configure system settings and master files to meet business requirements, sign off may be required by project lead. Provide or support system go lives and problem resolution. Begin to achieve a higher level application knowledge, proficiency, and problem solving skills as guided by IT management. Can deliver work that is consistently accurate, precise, thorough, neat, ethical, and reliable. Has some knowledge of quality standards and follows applicable quality guidelines. Understands concepts of process improvement and results to improve the quality of services. Completes all duties as assigned in the required timeframes. Meets deadlines for regular duties and projects + 10% System Support: Under general supervision, ongoing application support, problem resolution and question and answer services. Participate in Application Service Desk duty and 24 x 7 on call program with other team members. Assists application analysts and Help Desk with support of resolving help desk tickets + 10% Proficiency: Begin to maintain and develop competency level application knowledge, proficiency and problem solving skills, as well as follow KSC IT project management tools and processes, change management/control and service procedures + 10% Communication/Customer Relations: Maintains an effective working relationships with project teams, IT management, Clinical and/or business leadership. Ability to maintain working relationships with application vendor technical staff as directed by project assignments. Ability to facilitate rapid problem resolution and service delivery, where vendor services are needed. Possesses the ability to effectively communicate relevant information, in a clear and concise manner, at all levels of the organization. Promotes and practices effective listening skills in all interpersonal contacts. Demonstrates competence in grammar and clarity in all oral and written communication + 10% Optimization: Begin to learn and participate on implementation efforts for system improvements in accordance with KSC project management tools and processes, standard change control and change management procedures. Communicates system changes to all applicable users. Provides a high level of output and productivity. Meets team and project objectives. Does not waste skills, time, and resources. Looks to find ways to improve processes and control costs + 10% Interpersonal Skills: Solid positive attitude, interpersonal and relational skills, ability to make and keep commitments, meet project timelines, and provide outstanding customer service is required. Communication regarding technical matters in language easily understood by non-technical staff is required. Conducts effective meetings and ability to lead IT projects as assigned. Possesses the ability to be flexible in changing situations, meet changing priorities, and solve new and existing problems. Understands the value of adaptability with patients, customers, clinicians and business owners. + 10% Reliability: Can be counted on to arrive and start work on time. Meets expectations for completion of duties as assigned in the required timeframes. Meets deadlines for regular duties and projects without management intervention + 5% Certifications: Certification required based on application. KSC IT Management will determine if certification is required + 5% Other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Bachelor's degree or equivalent work experience + 3+ years of experience in applicable healthcare clinical operations, or Epic Application or other similar healthcare application systems design, configuration or support + Understanding of physician practice operations, and ways improved information management can lead to clinical, operating and financial improvement in a health care organization. Proficiency in use of desktop computer systems (Windows, Microsoft Office, email) and some experience in use of clinical or practice management systems in medical practice + Proven to have a positive and "can do" attitude. Ability to learn quickly, and to obtain Epic System Proficiency level certification (as defined by Epic) and/or other clinical system certifications + Proven ability to translate clinical and operating requirements into clear, specific and actionable system configurations and ability to implement those configurations. Ability to test and audit personally developed system configurations, in order to assure functional accuracy + Proven excellent communication, relationship, teamwork and project management skills + Proven communication, presentation, project management, teamwork, problem solving and technical skills are also required. + Valid Texas Driver's License **Preferred Qualifications:** + Clinical Degree + 5+ years of experience + Demonstrable knowledge of clinical data sets (CPT, HCPCS, ICD-9, etc) + Proven participated on clinical projects and implementations successfully *All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 to $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable. **Application Deadline:** This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._

Company :en Gen : This job is responsible for configuring, rolling out, and supporting the Epic HIM team. Responsibilities include business/systems analysis, requirements definition and documentation, system design, and problem resolution. The analyst communicates with system end-users to understand issues and implement solutions. ESSENTIAL RESPONSIBILITIES Plans, designs/builds, tests, implements, and supports the needs of Epic EMR software. Analyzes and determines system requirements and specifications. Performs and documents workflow analysis while evaluating user experience. Supports and maintains environments or applications using domain knowledge. Creates and maintains documentation and training materials regarding the implementation of applications. Using knowledge of Epic, configures changes within the Epic environments to provide standardized, comprehensive workflows. Corrects issues, conducts routine maintenance, updates systems with new functionality to meet the end user's needs, and implements new technologies. Provides guidance and support to end-users to enhance the use of Epic and offers solutions to resolve end-user system issues. Design, develop, and implement operational solutions for Clinical Documentation Improvement (CDI), Release of Information (ROI), Diagnosis Related Groups (DRGs) and communications/faxing solutions. Contributes to and manages small to medium projects independently. Updates stakeholders as appropriate on a timely basis regarding progress on assigned tasks, projects, and issues. Conducts problem-solving and root cause analysis to resolve routine to moderately complex problems. Identifies solutions and completes documentation. EXPERIENCE Required 3 years of systems administration experience within one or more Epic modules. Preferred 3 years of experience in the healthcare industry Health Information Management experience. SKILLS An understanding of Health Information Management Epic HIM exposure and certification is a plus. Ability to handle analysis, design, system configuration and testing tasks at basic to moderate levels of complexity Excellent customer service skills Uses critical thinking skills for assigned tasks Highly effective written and verbal communication and interpersonal skills to establish working relationships that foster optimal teamwork. Strong organizational skills in managing priorities Demonstrates knowledge of project management principles as they relate to assigned tasks Willingness to learn and implement technologies in a healthcare environment EDUCATION Required Associates Substitutions 2 years of relevant work experience in lieu of an Associate's Degree Preferred Bachelor's degree in Computer Science, Information Systems, Healthcare or relevant experience. LICENSES or CERTIFICATIONS Required Epic Application Certification within 6 months. Preferred None Language (Other than English): None Travel Requirement: 0% - 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Remote-based Teaches / trains others Occasionally Travel from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required No Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum: $57,700.00 Pay Range Maximum: $107,800.00 Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice

You could be the one who changes everything for our 28 million members by using technology to improve health outcomes around the world. As a diversified, national organization, Centene's technology professionals have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Design, build, test and maintain enablers of business processes, including technology and process solutions with a focus on medium to high complexity, multiple large application business processes and/or business relationships. Contribute to the entire implementation process Drive definition of improvements based on business need and architectural improvements Responsible for overall solution design, build and test, root cause analysis, and advanced performance tuning complex business processes and functionality Consult with users to identify current operating procedures and to clarify program objectives May be expected to write documentation to describe program development, logic, coding, and corrections. Write manuals for users to describe installation and operating procedures Education/Experience: Bachelor's degree in Computer Science, MIS, related field or equivalent experience. 3+ years of related experience. One or more of the following skills: ETL Deployment SQL Server Power BI Pay Range: $87,700.00 - $157,800.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

This job is responsible for configuring, rolling out, and supporting the assigned Epic application(s). Responsibilities include business/systems analysis, requirements definition and documentation, system design, and problem resolution. The analyst communicates with system end-users to understand issues and implement solutions. **ESSENTIAL RESPONSIBILITIES** + Plans, designs/builds, tests, implements, and supports the needs of Epic Payer Platform software. + Analyzes and determines system requirements and specifications. Performs and documents workflow analysis while evaluating user experience. Supports and maintains environments or applications using domain knowledge. Creates and maintains documentation and training materials regarding the implementation of applications. + Using knowledge of Epic, configures changes within the Epic environments to provide standardized, comprehensive workflows. Corrects issues, conducts routine maintenance, updates systems with new functionality to meet the end user's needs, and implements new technologies. Provides guidance and support to end-users to enhance the use of Epic, and offers solutions to resolve end-user system issues. + Contributes to and manages small to medium projects independently. Updates stakeholders as appropriate on a timely basis regarding progress on assigned tasks, projects, and issues. + Conducts problem-solving and root cause analysis to resolve routine to moderately complex problems. Identifies solutions and completes documentation. **EXPERIENCE** **Required** + 3 years of systems administration experience within one or more Epic modules. **Preferred** + 3 years of experience in the healthcare or health insurance industry **SKILLS** + Ability to handle analysis, design, system configuration and testing tasks at basic to moderate levels of complexity + Excellent customer service skills + Uses critical thinking skills for assigned tasks + Highly effective written and verbal communication and interpersonal skills to establish working relationships that foster optimal teamwork. + Strong organizational skills in managing priorities + Demonstrates knowledge of project management principles as they relate to assigned tasks **EDUCATION** **Required** + Associates **Substitutions** + 2 years of relevant work experience in lieu of an Associate's Degree **Preferred** + Bachelor's degree in Computer Science, Information Systems, Healthcare or relevant experience. **LICENSES or CERTIFICATIONS** **Required** + Epic Application Certification within 6 months. **Preferred** + None **Language (Other than English):** None **Travel Requirement:** 0% - 25% **PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS** **Position Type** Office- or Remote-based Teaches / trains others Occasionally Travel from the office to various work sites or from site-to-site Rarely Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required No Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Occasionally Lifting: 25 to 50 pounds Rarely **_Disclaimer:_** _The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job._ **_Compliance Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies._ _As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy._ _Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements._ **Pay Range Minimum:** $57,700.00 **Pay Range Maximum:** $107,800.00 _Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets._ Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at ***************************** California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID: J271134

You could be the one who changes everything for our 28 million members by using technology to improve health outcomes around the world. As a diversified, national organization, Centene's technology professionals have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Integrates, conforms, profiles and maps complex data, and provides quality assurance oversight (data error detection and correction) on business processes where data is collected, stored, transformed, or used. Examines more complex data to optimize the efficiency and quality of the data being collected, resolves complex data quality problems, and collaborates with the business and ETL database developers to improve systems and database designs. Interprets and analyzes complex data from multiple sources including claims, provider, member, and encounters data. Proactively identifies and assesses the business impact of trends Develops, executes, maintains, and troubleshoots complex scripts and reports developed using SQL, Microsoft Excel, or other analytics tools Identifies and performs root-cause analysis of data irregularities and presents findings and proposed solutions to leadership and/or customers Manages multiple complex and variable tasks and data review processes with no supervision within targeted timelines and succeeds in a demanding, quickly changing environment Delivers business solution architecture and implementation validation Engages in data profiling and source to target mapping. Works on complex data integration from disparate sources. Applies senior level expertise in quantitative analysis, data mining, and the presentation of data to see beyond the numbers and understands how customers interact with analytic products Supports multiple functions and levels of the organization and effectively, both verbally and visually, communicates findings and insights to non-technical business partners Engages with customers and business partners to gather requirements and validate results Presents data-driven insights and recommendations to both internal and external stakeholders, soliciting and incorporating feedback when required Performs other duties as assigned Complies with all policies and standards Education/Experience: A Bachelor's degree in a quantitative or business field (e.g., statistics, mathematics, engineering, computer science) and Requires 4 - 6 years of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Technical Skills: One or more of the following skills are desired. Experience with Big Data; Data Processing Experience with Data Manipulation; Data Mining Experience with one or more of the following Programming Concepts; Programming Tools; Python (Programming Language); SQL (Programming Language) Experience with Agile Software Development Soft Skills: Intermediate - Seeks to acquire knowledge in area of specialty Intermediate - Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions Intermediate - Ability to work independently Intermediate - Demonstrated analytical skills Intermediate - Demonstrated project management skills Intermediate - Demonstrates a high level of accuracy, even under pressure Intermediate - Demonstrates excellent judgment and decision making skills Pay Range: $73,800.00 - $132,700.00 per year Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act