Jobs at Highmark Health

Performs detailed financial, operational, and clinical analysis for hospital and physician organizations. Analyzes revenue, costs, profitability, budgets, forecasts, variances, patient mix, procedure mix, and payer mix to explain performance and identify improvement opportunities. Conducts ad hoc analyses, develops executive-level presentations, and provides strategic recommendations. Partners with stakeholders across the organization and mentors junior analysts.

Administer and optimize DB2 databases across production and test environments. Responsibilities include database design, performance tuning, upgrades, backups, disaster recovery, monitoring, troubleshooting, compliance, automation, documentation, application support, and on-call incident resolution. The role collaborates with development teams, mentors staff, supports testing and releases, and improves database availability, security, and operational standards.

Owns the strategy, roadmap, lifecycle, and performance of clinical programs and care management products. Partners with clinical, operational, analytics, technology, digital, and vendor teams to develop solutions that improve member outcomes, experience, quality, affordability, and engagement. Responsibilities include business case development, backlog prioritization, governance, stakeholder alignment, product measurement, optimization, and portfolio management. The role requires healthcare domain knowledge, data-driven decision-making, and cross-functional leadership.

Leads complex, cross-functional programs by developing roadmaps, coordinating project teams, managing dependencies, and overseeing scope, schedule, budget, quality, and strategic alignment. Partners with executive sponsors and business owners, monitors program performance, directs corrective actions, presents status updates, manages stakeholder relationships, and improves project management practices. The role also requires risk mitigation, negotiation, conflict resolution, and compliance with organizational, audit, privacy, and information security requirements.

Investigates and resolves employee relations matters, including performance, conduct, policy, discipline, harassment, discrimination, and retaliation concerns. Advises employees and managers, conducts internal investigations, responds to third-party charges, identifies workplace trends, and recommends policy or practice improvements. Collaborates with HR, legal, and business leadership while supporting projects and maintaining compliance in a multi-site, multi-state environment.

Software Engineer responsible for designing, developing, testing, and maintaining scalable applications across legacy mainframe and modern open-system environments. The role requires COBOL and Java/Python expertise, full-stack development, REST services, databases, DevOps, AI automation, Agile participation, code reviews, architecture design, and mentoring associate engineers. Experience migrating mainframe workloads to open architectures and working with healthcare technology is preferred.

Performs financial and business analysis, including forecasting, trend analysis, variance analysis, reporting, and research. Develops spreadsheets and databases, prepares presentations and ad hoc reports, interprets financial data, and recommends improvements to management. Leads financial analysis projects, coordinates cross-functional activities, documents findings, and ensures project completion within established timelines.

Leads financial and business analysis projects, including forecasting, trend analysis, financial reporting, variance analysis, and ad hoc research. Develops and maintains spreadsheets and databases, prepares reports and presentations for management, provides recommendations based on findings, and coordinates cross-functional projects through completion. Communicates project status, interprets financial and statistical data, and supports improvements to accounting, reserves, assets, and expenditures.

Performs financial and operational analysis, budgeting, forecasting, variance analysis, contract and payor performance evaluation, financial reporting, and root-cause analysis. Maintains processes supporting monthly close, audits, cost accounting, regulatory reporting, and third-party requirements. Provides financial guidance, recommends revenue and cost improvements, interprets healthcare and reimbursement regulations, and serves as a technical resource for team members and operational stakeholders.

Supports enterprise HRIS and payroll applications by gathering requirements, configuring and testing system changes, deploying enhancements, resolving production issues, and coordinating upgrades. Partners with HR stakeholders, process owners, IT teams, and third-party providers to improve business processes and user experience. Maintains reporting and calculated fields, manages project activities, documents solutions, and ensures compliance with change control and audit requirements.

Leads government relations strategy for a regional market, managing relationships with legislators, regulators, officials, trade associations, and lobbyists. Analyzes legislation and regulations, advises leadership on policy impacts, coordinates advocacy efforts, develops policy communications and testimony, and represents the organization in external government affairs activities. Manages staff, supports strategic initiatives, and ensures leadership understands relevant legal, regulatory, and operational developments.

Leads government relations for a regional market, developing legislative and regulatory strategies, advising leadership, monitoring policy developments, managing lobbying efforts, and building relationships with government officials and trade associations. The role analyzes policy impacts, coordinates advocacy, prepares testimony and position materials, and directs a government affairs team. It is remote in Delaware with required onsite attendance in Wilmington as needed.

Performs actuarial studies and statistical analyses involving pricing, claims trends, experience, medical economics, profitability, predictive modeling, provider efficiency, contracting, and reserving. Defines analytical problems, develops data requirements and solutions, prepares recommendations and presentations for management, validates results, improves processes, manages multiple projects, and mentors less experienced staff while progressing toward actuarial credentials.

Performs actuarial analyses supporting insurance pricing, premium development, claims trends, experience studies, medical economics, profitability, predictive modeling, provider analysis, and claim reserving. Develops data queries, conducts studies, prepares presentations, validates work quality, recommends process improvements, manages multiple projects, and communicates findings to technical and non-technical stakeholders. Participates in an actuarial development program and progresses toward professional credentialing.

Leads insurance product-related projects from strategy and product vision through implementation. Provides market and competitor analysis, supports product roadmaps and launch plans, coordinates regulatory, legal, operational, communications, marketing, and system integration activities, and oversees product design and administration. Ensures compliance with insurance regulations and company policies while advising product managers and mentoring stakeholders.

Manages physician preference items and clinical supply contracts across General Surgery. Builds physician panels, coordinates vendors and clinical staff, drives product standardization and contract compliance, identifies savings opportunities, supports affiliate business development, and facilitates implementation and conversion plans. The role also trains other coordinators and requires extensive relationship management, clinical contracting support, and travel across partner organizations.

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

Leads data-quality strategy and end-to-end testing oversight across SQL, databases, ETL, migrations, integrations, and data flows. Manages quality metrics, risks, defects, root-cause analysis, release readiness, and Agile delivery. Guides test data management and automation while leading and mentoring QA teams. Partners with clients, technical teams, and executives to communicate quality risks and business impacts, with emphasis on healthcare data such as claims, membership, provider, and care management information.

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

Owns the vision, strategy, roadmap, backlog, governance, and execution of enterprise customer data exchange products. Partners with business, technology, data governance, privacy, security, and external stakeholders to enable secure, scalable, standardized data sharing. Identifies opportunities to improve products, drives cross-product value, communicates priorities to executives and teams, and ensures trusted data assets maximize business value.