3 primary teacher jobs found in Jefferson City

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews requests for medication coverage determination for prior authorization review and appeals. Through the Utilization Review system, the incumbent evaluates clinical information provided by the physician against medical policy criteria. The incumbent then uses his/her clinical knowledge compared to the policy and physician request to make a determination. At times, the incumbent may conduct additional research beyond medical policy review to make coverage determinations. ESSENTIAL RESPONSIBILITIES Make coverage determinations by evaluating physician requests for prior authorization or appeals against medical policy through the Utilization Review system. Update the system records appropriately to ensure claims are properly routed and paid. Conduct research beyond medical policy review to make decisions on medication coverage requests. Other duties as assigned. EDUCATION...

Company : Highmark Health Job Description : JOB SUMMARY The Director of Data Product Management is a leadership role responsible for developing, implementing, and continually refining our customer data product strategy from its foundational stages. This individual will define, develop, and execute the strategy for our core customer data products, ensuring they meet the evolving needs of Highmark and our customers. This individual will lead a team of product managers and analysts focused on specific areas of customer data, driving the realization of our Customer Data Product Strategy vision to empower downstream teams with personalized, high-quality, and timely interactions. This role requires a strong leader who can translate strategic opportunities into actionable product roadmaps, champion data quality and governance, and foster a data-driven culture. A robust technical background and the ability to effectively collaborate with engineering teams are paramount to...

Company : Highmark Health Job Description : JOB SUMMARY This job will manage the activities of various project management roles as well as directly apply project leadership to multiple large complex product and technology solutions throughout the IT organization. Actively involved in the cultivation of knowledge, coordination, implementation, problem solving, communication, and training of new technologies and processes as they are developed and moved into the department. Project Leadership activities include directly managing team members involved in various programs/projects in conjunction with the organizational need. The incumbent exhibits and applies the core behaviors which define success for the company and our customers: Purposeful Execution, Teamwork, Transformational Leadership, and a Customer-First mentality. Committed to on-time/on-budget delivery, promoting a culture of collaboration among all project stakeholders, thinking and planning strategically in...