Highmark Health

Role Description This position serves as a strategic business partner supporting the Senior Dental Director of Government Business in driving enterprise priorities, organizational effectiveness, and transformational initiatives. The role is responsible for coordinating strategic planning, business performance management, governance, communications, employee engagement, and change management activities that support successful execution of organizational objectives. - Partner with leadership to develop, coordinate, and execute strategic initiatives. - Facilitate planning processes, translate strategies into actionable plans with measurable outcomes, and manage risks and opportunities to achieve business results. - Monitor organizational performance through dashboards and KPIs. - Support budget planning and resource allocation. - Analyze data to identify trends, efficiencies, and areas for improvement, establishing robust processes and reporting structures. - Lead change management initiatives to enhance employee engagement, communication, and adoption of new processes. - Coordinate enterprise communications, leadership messaging, and engagement activities to foster collaboration and accountability. - Serve as a trusted advisor to senior leadership, managing strategic communications, executive presentations, and facilitating key meetings. - Ensure effective information flow and represent leadership in cross-functional forums. - Lead complex strategic projects and initiatives, research emerging trends, and drive continuous improvement to enhance efficiency, employee experience, and organizational performance. - Other duties as assigned or requested. Qualifications - Bachelor's degree in Business Administration, Public Health, Communications, Strategic Development, Project Management, or related field. - 6 years of related and progressive experience in lieu of Bachelor's degree. - Master's degree in Business Administration, Public Health, Communications, Strategic Development, Project Management, or related field (preferred). Requirements - 5 years in Strategic Process Development. - 3 years in Healthcare/Health Insurance. - 3 years of presenting and communicating with large audiences. Benefits - Pay Range Minimum: $79,300.00 - Pay Range Maximum: $127,100.00 - 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. 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. Employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. 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, including adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

• Manage a book of business • Assist with selling new to blue clients • Serve as product expert for existing clients • Deliver product implementation presentations • Develop account specific marketing plans for key accounts

Role Description This job works in close partnership with sales, marketing and product management to drive purchase and/or adoption of innovative Organization products and services (i.e. spending account, transparency, value based benefits, clinical platform, health advocate, etc). The incumbent plans and delivers client presentations in conjunction with sales, works with marketing and product to understand product positioning vs. competitors, messaging, features – and works consultatively with clients to meet their wants and needs. Additionally, for large key accounts may take responsibility for development and implementation of client-specific marketing plans. This is a remote based role in Western, PA. - Manage a book of business, in partnership with sales executives and client managers as the expert on various products (particularly complex, innovative and new products). - Assist with selling new to blue clients and selling additional services to existing clients utilizing consultative selling skills. - Serve as product expert for existing clients to solve client problems by analyzing and resolving client specific issues regarding product and process design, both internally and externally. - Assist, educate and train clients with product implementation. - Deliver product implementation presentations, responding to issues and questions in a consultative manner. - Develop account specific marketing plans for key accounts, leading the effort that leverages marketing strategy and planning, CCR, sales client management, and other Organization resources. - Deliver client specific marketing plan tactics, overseeing the final product and serving as the key client relationship for the plan. - Gain product knowledge and understanding of the Organization’s desired positioning and messaging with a close on-going partnership with Marketing Strategy and Planning and Product teams. - Proactively and reactively provide feedback and direction for marketing materials, messaging and other sales support required for successful sales and implementation. - Participate in internal workgroups as needed as subject matter experts and/or problem solvers. - Understand and utilize the Organization marketing processes and procedures (brand standards, marketing operations management system for project documentation/routing and approvals, development of creative briefs for key deliverables, etc). - Other duties as assigned or requested. Qualifications - Required: Bachelor's Degree or relevant experience and/or education as determined by the company in lieu of bachelor's degree. - Preferred: Master's Degree in Business Administration. Requirements - Required: 3 years of relevant, progressive experience in the area of specialization. - Preferred: 4 years of consultative sales or marketing experience in health insurance or employee benefits field. Licenses or Certifications - Required: State specific Producer License’s for Life, Accident & Health are required or must be obtained within 45 days of hire. - Preferred: None. Skills - Excellent written and verbal communications skills with comfort and ease working with clients. - A working understanding of business to business and business to consumer marketing. - Strong analytical skills, adept at understanding and representing complex data and information to a client. - Ability to work within a team, collaborating on outcomes and actively taking responsibility for key tasks. - Customer service orientation and desire to do whatever it takes to satisfy a client. Travel Requirement - 0% - 25%. Physical, Mental Demands and Working Conditions - Position Type: Office-based. - Teaches / trains others regularly: Occasionally. - Travel 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): Never. - Physical work site required: Yes. - Lifting: up to 10 pounds: Constantly. - Lifting: 10 to 25 pounds: Occasionally. - Lifting: 25 to 50 pounds: Rarely. Pay Range - Minimum: $72,700.00. - Maximum: $116,600.00. 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.

Role Description This job works in close partnership with sales, marketing and product management to drive purchase and/or adoption of innovative Organization products and services (i.e. spending account, transparency, value based benefits, clinical platform, health advocate, etc). Plans and delivers client presentations in conjunction with sales, works with marketing and product to understand product positioning vs. competitors, messaging, features – and works consultatively with clients to meet their wants and needs. Additionally, for large key accounts may take responsibility for development and implementation of client-specific marketing plans. This is a remote based role in Western, PA. Essential Responsibilities - Manage a book of business, in partnership with sales executives and client managers as the expert on various products (particularly complex, innovative and new products). - Assist, educate and train clients with communications, member engagement, education, new initiatives, consumerism and product implementation. - Serve as product expert for existing clients to solve client problems by analyzing and resolving client specific issues regarding product and process design, both internally and externally. - Assist with selling new to blue clients and selling additional services to existing clients utilizing consultative selling skills. - Deliver product implementation presentations, responding to issues and questions in a consultative manner. - Develop account specific marketing plans for key accounts, leading the effort that leverages marketing strategy and planning, CCR, sales client management, and other Organization resources. - Deliver client specific marketing plan tactics, overseeing the final product and serving as the key client relationship for the plan. - Conduct member-facing meetings and events in person, virtual and recorded. - Other duties as assigned or requested. Qualifications - Bachelor's Degree in Marketing, Communications or Related Field. - 6 years of related and progressive experience in lieu of Bachelor's degree. Experience - 1 year of relevant, progressive experience in the area of specialization. Licenses or Certifications - State specific Producer's License for Life, Accident & Health are required or must be obtained within 45 days of hire. Skills - Excellent written and verbal communications skills with comfort and ease working with clients. - A working understanding of business to business and business to consumer marketing. - Strong analytical skills, adept at understanding and representing complex data and information to a client. - Ability to work within a team, collaborating on outcomes and actively taking responsibility for key tasks. - Customer service orientation and desire to do whatever it takes to satisfy a client. Travel Requirement - 25% - 50% - up to 40% travel. Physical, Mental Demands and Working Conditions - Position Type: Office-based. - Teaches / trains others regularly: Occasionally. - Travel 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): 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 - Pay Range Minimum: $62,700.00. - Pay Range Maximum: $97,200.00. Equal Opportunity Employer 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. Accessibility 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 HRServices@highmarkhealth.org.

• Creates data-driven insights which identify actionable opportunities and/or create analytics and reporting solutions • 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 • Establishes strong, collaborative and effective relationships and communication with internal and external clinical, administrative, operational, financial and technical stakeholders • Serves as a strategic business partner to internal and external stakeholders as demonstrated by providing thought leadership and subject matter expertise

Role Description This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. - Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%) - Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) - Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) - Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these updates in daily work. (5%) - Performs other duties as assigned or required. (5%) Qualifications - Minimum: High School/GED - Successful completion of coding courses in anatomy, physiology and medical terminology - 1 year of Hospital and/or Physician Coding - 1 year coding at mid-level facilities or clinics - 1 year coding major surgeries, observations and/or E/Ms - Medical Terminology - Strong data entry skills - An understanding of computer applications - Ability to work with members of the health care team - Any of the following: - Registered Health Information Technician (RHIT) - Registered Health Information Associate (RHIA) - Certified Coding Specialist Physician (CCS-P) - Certified Professional Coder (CPC) - Certified Outpatient Coder (COC) - CPC-A Certified Professional Coder - Apprentice - Preferred: Associate's Degree in Health Information Management or related field Requirements - This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. - Employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. - 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. - It is every employee’s responsibility to comply with the company’s Code of Business Conduct, including adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Benefits - Pay Range Minimum: $21.97 - Pay Range Maximum: $34.39 - 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.

• Provide timely and accurate responses to external customers. • Resolve general account issues. • Input data into processing systems to ensure work deliverables are free of errors and all relevant and complete information is included in final output. • Perform sales support duties, including but not limited to: direct inquiries to appropriate Sales staff, analyze new and/or renewal submission request for completeness, enter data in sales system from source documents, follow up with Brokers/Producers/TPAs for missing information. • Support and interact with multiple departments to ensure proper distribution and implementation of paperwork, binder checks, and maintains the daily activities/updates in applicable system. • Obtain and process paperwork by thoroughly checking for missing information on the group application, enrollment applications, and any additional documents needed before account can be installed or paperwork can be sent to underwriting. • Perform general office duties that may include: document management, ordering supplies, processing invoices, opening and distributing mail, making travel arrangements, assisting with facilities management. • Other duties as assigned or requested.

Role Description Improves the overall quality and completeness of medical documentation; facilitates enhancements to clinical documentation through extensive interaction with physicians, nursing staff, case managers, other patient caregivers, and medical records coding staff to ensure that the appropriate reimbursement is received for the level of service rendered to all inpatients; ensures the accuracy and completeness of clinical information used for measuring and reporting physician and hospital outcomes; educates all members of the patient care team on an ongoing basis. Essential Responsibilities - Facilitate appropriate clinical documentation through concurrent, prospective, and retrospective medical record review (30%) - Facilitate modifications to clinical documentation through extensive interaction with physicians, nurses and ancillary staff based on knowledge of coding and HCC guidelines, documentation strategies, and clinical documentation requirements (25%) - Work collaboratively with coding professionals to assure documentation of diagnoses and comorbidities are a complete reflection of the patient's clinical status and care (10%) - Formulate credible clinical documentation clarifications to improve clinical documentation (10%) - Educates all internal customers on compliant documentation responsibilities, coding, and reimbursement issues, as well as performance improvement methodologies (15%) - Performs other duties as assigned or required (10%) Qualifications - Minimum: - High school/ GED - Bachelor's Degree in Nursing OR Relevant experience and/or education as determined by the company in lieu of bachelor's degree - 5 years in a nursing role - Current State of PA RN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) - Preferred: - Experience in Clinical Documentation Integrity (CDI) - Experience in Coding - Knowledge of ICD 10 and HCC coding guidelines - Knowledge of Electronic Medical Record (Epic) - Knowledge of Encoder (3M 360 Encompass) - Excellent communication skills - Critical thinking skills - Certified Coding Specialist (CCS) - Certified Outpatient Clinical Documentation Improvement Specialist (CCDS-O) - Certified Clinical Documentation Improvement Specialist (CCDS) - Certified Clinical Documentation Improvement Professional (CDIP) Company Description

• Completes and documents psychosocial assessments and care coordination • Provides crisis intervention to enhance patient/family coping mechanisms • Engages in the discharge process to identify post-acute resources • Provides education regarding psychosocial factors related to illness

Role Description Serves as a communication facilitator for patients, referring physicians, and caregivers. Identifies new and recurring patients, provides welcoming and comfort calls, and assists the Nurse Navigator with patient flow. Works with the Nurse Navigator to facilitate a plan which provides clinical and support care to the patient, including scheduling of appointments and utilization of supportive care services within the Network. Takes lead and assumes responsibility and accountability for the management of resources through the interdisciplinary collaboration to achieve optimal patient outcomes. - Responsible for community outreach and high-risk populations to connect the patient to appropriate clinical care. - Coordinates data, community services, and AHN resources into a seamless model of access and care benefiting patients, physicians, and family members. - Provides patients with a welcoming/courtesy call and post-visit comfort call; available for any questions or concerns the patient/family may have. - Provides patients with a welcoming/hospitality packet including information related to supportive services and programs available. - Leads process improvement strategies within the patient's experience to improve flow and operations. - Assists patients in scheduling appointments as needed, including all aspects of the multi-disciplinary team (physicians, consults, supportive care services, etc.). - Facilitates the patient journey to procedures and visits as needed. - Coordinates with Nurse Navigator and other members of the health care team to facilitate all aspects of patient care. - Works with CM/RN/SW to facilitate the patient's transfer of care. - Integrates and facilitates care for patients across the care continuum. - Trends data and outcomes required for the navigation program. - Provides surveys for patients and completes log of data and desired outcomes. - Tracks patient concerns and complaints and provides service recovery to the patients, notifying clinical staff of those issues. - May work with and assist cancer registry staff to obtain data to evaluate patient outcome information related to the care delivery model. - Identifies the patient's insurance concerns and issues and facilitates resolution. - Works as a liaison between the hospital and post-acute providers. - Provides support to the patient's family members and caregivers. - Identifies problems and opportunities and takes appropriate action. - Leads a team of navigators, liaisons, and volunteers to improve the patient experience. - Performs other duties as assigned or required. Qualifications - Minimum: Associate degree or equivalent experience. - 3 years of clinical experience in physician office practice or hospital. - Competency in Excel, Word, and PowerPoint. - Preferred: Knowledge of the healthcare delivery system, resources, community for the oncology population. Requirements - This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. - Employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. - Compliance with the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures. - Compliance with the company’s Code of Business Conduct, including adherence to applicable federal and state laws, rules, and regulations. Benefits - Pay Range Minimum: $19.25 - Pay Range Maximum: $29.07 - 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.