Learn More. The Peer-to-Peer request must be received by Maryland Amerigroup maryland prior authorization Care within two 2 business days of the initial notification of the denial. The intent of the Peer-to-Peer is to discuss the denial decision with the ordering clinician or attending physician. For specific details prioe authorization requirements, please refer to our Quick Reference Guide. Certain carefirst mental providers require prior authorization regardless of place of service.
Accountabilities include, but are not limited to, supporting deliverable content, providing analysis, and building and sharing institutional knowledge. 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.
Sign Up. Sorry, this listing is no longer accepting applications. The incumbent partners with teams and leadership across Business and IT, focusing on project delivery work, and how that work delivers value for Business.
The incumbent reports to Health Plan business leadership. Mobilize strategy for strategic initiative STI planning, execution, and deployment. This is both for long range STI's and short term projects, as well as foundational investments. For an assigned functional area e. Define structured professional development including mentorship, formal training, templates, and best practices in the area of project management and consulting. In managing complex projects and initiatives on behalf of the Health Plan for a department or functional area, build, share, and maintain expertise in both IT components as well as the business environment and external marketplace.
Collaborate with business leadership team on the strategic alignment of how HMHS affects operational and business customer needs.
Work with HMHS practice and delivery leads to write the business requirements to be translated into technical requirements. Identify process improvement opportunities from technical issues that arise. Work with business leadership to address root causes, driving and overseeing recommended changes and process improvements.
Collaborate with business leadership on the development of business cases, with aligned ROI, for future STI funded work that is over hours. Ability to "roll up sleeves" and actively deliver and troubleshoot HMHS engagement opportunities, develop executive level communication strategies on high complex and escalated issues.
Communicate with HMHS senior consultants and solutioning and delivery leads to ensure that technical issues are properly defined as enhancements, defects, routine maintenance, etc. Provide regular status reporting on all tickets to business leadership, identifying tickets which require executive leadership influence to affect outcomes. Strategically plan communications to Health Plan business stakeholders on new initiatives and capabilities to ensure proper engagement and adoption.
Communicate and escalate enhancements requiring VP level approval. Monitor and maintain enhancement hours and budget. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact number below.
Project Consultant-Business Platform. The incumbent delivers value to customers through client-facing advisory and delivery service in support of the HM Health Solutions and Health Plan product offerings and capabilities. Accountabilities include, but are not limited to, owning deliverable artifacts, leading workstreams, engaging key customer stakeholders, building and sharing institutional knowledge, and developing junior professionals.
We are hiring for 2 Sr. Business Systems Consultants. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
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. Senior Level.
They do a great job of making everyone feel like they are a part of the team and, as a result, everyone is willing to help the company progress! Excellent pay and benefits, very stable, mostly dedicated coworkers Good, friendly people. Lots of integrity and the focus is on doing the best job for the Company's clients. This position works closely with a team of Power Users, helping this team and its clients get the most value from this Asset Management firms technology and systems.
The Analyst will work closely with Portfolio Management, Trading and Enterprise Capital Strategy Teams to implement and support industry leading models and applications delivered through Capital and Risk Analytics platform. Contribute to the design and development of analytical solutions and thought leadership initiatives and publications, addressing industry challenges, and showcasing analytical capabilities and solutions Collaborate with team to develop new features for an analytics and risk platform Support various ongoing production processes such as valuation, data integrity, rating agency and peer reporting Analyze systems and processes to find efficiencies and improve accuracy and timeliness of reporting and reduce costs.
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.
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. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. We endeavor to make this site accessible to any and all users.
Read more. Covid Vaccination Information Effective November 1, , Highmark Health and its affiliates are requiring all new hires beginning employment to submit proof of full vaccination with one of the three authorized COVID vaccines. Company : Highmark Inc. Supports Annual Planning process and all portfolio management processes and standards with little oversight. Owns the portfolio tracking and reporting of key metrics around financial performance, benefits and value levers, portfolio health, and strategic alignment.
Manages portfolio communications. Other duties as assigned or requested.
Highmark Health. President and CEO, Highmark Health and Chairman of the Board, Highmark Inc. Executive Vice President, Chief Strategy and Transformation Officer. Executive Vice . Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation. Highmark Inc. and its health insurance subsidiaries and affiliates collectively are one of America's largest health insurance organizations. Highmark Inc. and its affiliates operate .