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Senior Network Operations Analyst in Pittsburgh, PA

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compensation:

$80K - $100K*

specialty:

System & Network Administration

experience:

5 - 7 years

Job Description

JOB SUMMARY

This job is a key member of the HCS Network Strategy and Reimbursement team, taking on a significant role for complex operational aspects of network design/development and value-based reimbursement programs. This includes evaluating networks and contract structures relative to current and proposed future state through the lens of the overall HCS post-acute network strategy, and making recommendations based on an understanding of that strategy. The incumbent will also support HCS as a subject matter expert on contract terms, including payment provisions, and develop recommendations for how to standardize these provisions and terms to best practice, value-based arrangements across multiple business lines, including Commercial and Government P

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Valid through: 2020-4-9

About Highmark

Highmark is a private healthcare company based in Pittsburgh, Pennsylvania, United States. It is the largest health insurer in Pennsylvania, and through a purchase in 1996, the largest health insurer in West Virginia and also later Delaware. As Highmark Blue Cross Blue Shield, it primarily serves the 29 counties of western Pennsylvania. As Highmark Blue Shield, it serves 21 counties in Central Pennsylvania and the Lehigh Valley. There is also a presence in the border areas of eastern Ohio, and all of West Virginia through its subsidiary, Highmark Blue Cross Blue Shield West Virginia. Highmark acquired the largest health insurer in northeastern Pennsylvania, Blue Cross of North East Pennsylvania, BCNEPA, in July 2015. It is currently[timeframe?] the largest individual not-for-profit health insurer in the United States, which operates several for-profit subsidiaries. Highmark was created in 1977 and in the 1990s by the consolidation of two Pennsylvania licensees of the Blue Cross and Blue Shield Association — Pennsylvania Blue Shield (now Highmark Blue Shield) based in suburban Harrisburg, and Blue Cross of Western Pennsylvania based in downtown Pittsburgh (now Highmark Blue Cross/Blue Shield). The consolidated group serves 49 of the states 67 counties. In West Virginia, the company operates as Highmark Blue Cross Blue Shield West Virginia, and in Delaware, it operates as Highmark Blue Cross Blue Shield Delaware. The new company based its head offices in downtown Pittsburgh and features greatly expanded services. On March 28, 2007, Highmark announced it intended to consolidate with Independence Blue Cross of Philadelphia. The combination of the 2 insurers would have created a new company with over 18,000 employees, dual-headquarters in both Pittsburgh and Philadelphia and an economic impact of over $4 billion throughout the Commonwealth of Pennsylvania. On January 22, 2009, Highmark and Independence Blue Cross withdrew their applications to consolidate due to the unacceptability of conditions that the Pennsylvania Insurance Department was going to place upon the merger: to give up either of their well-known "Blue Cross" or "Blue Shield" trademarks.
Total Jobs:
156
Total Experts:
18
Average Pay:
$116,905
Total value of jobs:
$35,890,000
% Masters:
48%

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