168 data security jobs found in Lansing

Company : Highmark Health Job Description : JOB SUMMARY The job is an integral member of an agile software engineer team responsible for building scalable software applications across all digital channels to serve our customers. The position will be responsible for taking an enterprise-wide, architectural view of the solutions and the technical execution of products using the technical stack that best meets the needs of the platform. The position will collaborate with the internal/external clients and be involved in every aspect at part of the software application build process from ideation, business analysis, technical design and software development using the latest technologies and design patterns. A principal engineer may be accountable for a team of software engineers to drive and develop products meeting the needs of our clients and product roadmaps. ESSENTIAL RESPONSIBILITIES Lead the resolution of a variety of technical and business problems...

Company : Highmark Inc. Job Description : JOB SUMMARY This job plans, develops, and maintains operational processes and reporting related to group/provider facility and professional reimbursement configurations and other operational processes. Acts as the primary liaison between provider contracting, provider reimbursement, and claims experience. Collaborates with the pricing team to troubleshoot reimbursement issues and works with the Reimbursement Policy and Compliance team team to develop and maintain effective reimbursement quality programs and reporting. ESSENTIAL RESPONSIBILITIES Perform management responsibilities to include, but are not limited to: involved in hiring and termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have...

Company : Highmark Health Job Description : JOB SUMMARY The job is an integral member of an agile software engineer team responsible for building scalable software applications across all digital channels to serve our customers. The position will be responsible for taking an enterprise-wide, architectural view of the solutions and the technical execution of products using the technical stack that best meets the needs of the platform. The position will collaborate with the internal/external clients and be involved in every aspect at part of the software application build process from ideation, business analysis, technical design and software development using the latest technologies and design patterns. A principal engineer may be accountable for a team of software engineers to drive and develop products meeting the needs of our clients and product roadmaps. ESSENTIAL RESPONSIBILITIES Lead the resolution of a variety of technical and business problems...

Company : Highmark Health Job Description : JOB SUMMARY The Senior Strategy Partner plays a critical role in driving the evolution and optimization of Highmark's Living Health Acceleration operating model. This individual will be instrumental in continuously enhancing the product operating model within PHE and with critical partners, ensuring it aligns with strategic goals and market demands. The Senior Strategy Partner will bring an external perspective on operating model and workforce optimization for the Product organization, collating and subsequently leveraging data to inform decision-making to enhance operating model performance and maturity. This role also encompasses leading strategic communications, managing leadership meetings, and spearheading special projects on behalf of the Product organization and leadership team, to advance the organization's goals and priorities. This role can be hybrid or remote - if you are within 50 miles of an office you are...

Company : Highmark Health Job Description : JOB SUMMARY This role is responsible for supporting the execution of member activation and engagement initiatives across products and solutions, with a particular focus on the clinical side of the business. As part of the Customer Relationship Management (CRM) team, this individual will contribute to developing a center of excellence for creating and managing profitable customer relationships and experiences. Key responsibilities include developing end-to-end strategies that will help with managing relationships with clinical partners, identifying C2V savings, overseeing wellness programs, addressing diagnosis and care gaps, and promoting member health through education and preventative steps. Preferred experience as a clinician or in a clinical setting. This role can be hybrid or remote. If you live with 50 miles of an office you are required to be onsite 3 days a week (T,W,Th). Outside of 50 miles will be remote....

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 Inc. Job Description : JOB SUMMARY HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve. This job supervises and coordinates the day to day activities of the various claims processing or claims adjustment units responding to internal inquiries or inquiries received by members, providers, or account representatives across all markets. This job administers the day-to-day activities related to collecting, analyzing and reporting on source data and key performance metrics for the purpose of supporting operational efficiency, overall tracking of business performance and management intelligence for effective decision-making. Along...

Company : Highmark Inc. Job Description : JOB SUMMARY This job provides front line staff guidance, ensures effective and efficient delivery of Pharmacy call center services. Serves as first line reviewer in monitoring and ensuring adherence to the health plan's state and federal multiple drug benefit design offerings. The incumbent responds to physician and pharmacy network provider inquiries concerning oral, injectable and infusion medication requests, and drug claim edits/prior authorizations. By reviewing member claims history, clearly defines the medical necessity of non-formulary and prior authorization medication exception requests. Interacts with pharmacy network providers to evaluate, educate and/or assist in addressing denied point of sale prescription claim transitions and coordination of benefits practices/procedures. ESSENTIAL RESPONSIBILITIES Communicate effectively with physician and pharmacy network providers to ensure that the needs of the...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Capital One. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Senior Digital Marketing Manager (Email) - Capital One Software (Remote) Capital One Software is the enterprise B2B software business of Capital One, dedicated to helping organizations manage their data in the cloud with speed, agility, and efficiency. Born out of our own digital transformation, we commercialize the internal tools that powered our journey to becoming the first major U.S. bank to go "all-in" on the public cloud. Our flagship products, Slingshot (data cloud...

Company : enGen Job Description : JOB SUMMARY This pivotal role will lead the strategic transformation and optimization of workforce operations across enGen, encompassing both internal resources and external vendors. The Senior Director will be a key driver in establishing robust frameworks for tracking hours, managing financial allocations, and ensuring highly efficient resource deployment. This individual will possess a deep understanding of transformational initiatives, serving as a change expert who can intelligently engage with vendors, internal stakeholders, and senior leadership to align business operations with strategic objectives and deliver significant value. This leadership role is responsible for influencing, shaping, and executing high-impact strategies and initiatives delivering significant enterprise-level value. The Senior Director level demands a high degree of strategic leadership, independent decision-making, and accountability for fostering...

Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews inquiries to determine if they meet the definition of a grievance/appeal; documents, investigates, refers and coordinates grievances and appeals; initiates a case file for each grievance and appeal; ensures compliance with organizational and regulatory requirements for member or provider issues; independently coordinates the resolution with internal/external parties as required; and documents and summarizes to all parties involved in the case the investigation results. ESSENTIAL RESPONSIBILITIES Review inquiries to determine if they meet definition of appeal/grievance. Request and review all related relevant documentation and assemble case file. Coordinate resolution results and relay investigative results with all involved parties. Participate in workgroup meetings to address trends in appeals and grievances and to work on process improvement initiatives with cross...

Company : Highmark Inc. Job Description : JOB SUMMARY This job resolves standard and occasional non-standard customer inquiries, comments, and concerns by applying a seamless and positive customer experience gained through many recurring cycles of on the job work engagement. ESSENTIAL RESPONSIBILITIES Engages with customers in a confident and compelling manner, performing the full range of customer service duties and responsibilities, as assigned. Strives to resolve customer concerns in a single interaction via telephone, written, or face to face communication. Responds to a diverse set of customers with an equal level of confidence regardless of the issue at hand. Works independently of support from a senior customer service representative, frequently utilizing the knowledge center, answering customer inquiries. Routinely responds to customers with an in-depth product knowledge achieved through a continuously improving set of...

Company : Highmark Health Job Description : JOB SUMMARY This job is a senior level actuarial analyst position. Participates in Highmark's Actuarial Executive Development Program and is expected to make continued progress towards actuarial credential. Utilizes experience and industry knowledge to define & diagnose a problem, outline data requirements for a study or analysis, and devise potential solutions. Guides and mentors less experienced staff and provides decision support to team members while initiating and leading the development of actuarial studies, analyses, and presentation materials needed to appropriately inform decision makers and making appropriate recommendations to management. Will work to develop efficient processes and will apply actuarial techniques and statistical analysis to several functions which may include insurance premium and pricing development, claim trend analysis, experience studies, medical economics, profitability analysis,...

Company : Highmark Health Job Description : JOB SUMMARY We are seeking a highly motivated and experienced Senior Product Manager with a clinical background to drive the strategic vision and execution for our "Well360" platform, specifically focusing on commercial buyups. This pivotal role defines the product's fundamental value proposition, outlines its vision and execution plans, and gains alignment and support from key strategic partners and stakeholders. The incumbent will oversee the end-to-end execution of this vision, ensuring successful product delivery and market impact. This role also involves providing coaching and guidance to junior team members, fostering their professional growth. The Senior Product Manager will actively attend and participate in milestone reviews with the Delivery team, ensuring seamless collaboration and product development. A strong understanding of both clinical operations and commercial buyouts is essential for success in this...

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...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Pricing Analyst - REMOTE Job Description The Pricing Analyst maintains, provides analyses, consults and conducts financial modeling in support of Prime's financial pricing programs and/or underwriting functions. This position uses analytics to develop reporting, models and methodologies in support of Prime's financial pricing strategies and assists with high-complexity pricing analyses. Responsibilities Analyze and produce pharmacy claims data reporting of varying complexity to assess competitiveness & accuracy of Prime's financial pricing programs against adjudicated claims to identify trends and draw insights to provide pricing recommendations Apply mathematical, statistical, and economic techniques to...

Job Description Join Oracle's Health Data Intelligence (HDI) team as a Software Engineer 4 and contribute to the reliability, scalability, and performance of our world-class analytics platform. In this role, you will develop, maintain, and optimize the infrastructure and data pipelines that power healthcare analytics globally. You will work within a collaborative team to implement robust solutions for business intelligence and reporting, ensuring our platform handles massive datasets with precision and speed. U.S. citizenship is required for this position, as the successful candidate will be required to obtain (and maintain) a U.S. government security clearance after hire. Required Skills Infrastructure & Reliability: Experience implementing and maintaining high-availability systems with a focus on performance monitoring and fault tolerance. Data Technologies: Proficiency in Data Warehousing platforms (e.g., Vertica, Snowflake) and ETL...

It's fun to work in a company where people truly BELIEVE in what they're doing! Job Description Summary: The Senior Account Executive is an enterprise software sales professional who sells a platform of professional services solutions to Global 1000 clients. This individual understands executive selling into large companies, outstanding communication skills and brings current relationships. Proactively prospecting and leading meetings with customers weekly. Our Enterprise Suite division is looking for dynamic Services Sales Executive to engage with Micro Focus clients in the Americas to provide expert, advisory and technical integration services that maximize customer ROI - with Services revenue approximately $500k--2M or transition/ transformation for a more complex $2M- 10M deal. Essential Duties and Responsibilities : Sells Consulting Services Solutions for Enterprise Refactoring Business Develops long term sales pipeline to increase the company's...

Become a part of our caring community The Senior Financial Underwriter computes rates for both renewing and prospective moderate to complex group Dental and Vision accounts. You will complete work assignments involving moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Financial Underwriter reports to the Manager, Financial Underwriting. You will prepare a variety of financial reports for large accounts and provides rationale and support to other areas within the organization and to clients regarding rate computations and financial activity. You will provide expense estimates and accurate analysis of financial exhibits. You will influence department's strategy. You will make decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. You will exercise considerable latitude in determining objectives and...

Job Description This role requires U.S. Citizenship and eligibility for a Federal Security Clearance Our Team Building off our Cloud momentum, Oracle has formed a new organization - Oracle Health Data, Analytics Platform. This team will focus on product development and product strategy for Oracle Health, while building out a complete platform supporting modernized, automated healthcare. This is a net new line of business, constructed with an entrepreneurial spirit that promotes an energetic and creative environment. We are unencumbered and will need your contribution to make it a world class engineering center with the focus on excellence. Oracle Health Data, Analytics Platform has a rare opportunity to play a critical role in how Oracle Health products impact and disrupt the healthcare industry by transforming how healthcare and technology intersect. You will have the opportunity to: Reach billions of people with our products & services Create...

Job Description Role Overview As a Facilities Manager supporting our Electrical Facilities, you will lead the safe, reliable, and compliant operation of mission-critical electrical systems supporting OCI data centers. This role owns electrical maintenance execution, vendor performance, technician leadership, operational readiness, and incident response to ensure continuous uptime and protection of compute load. You will oversee the operation and maintenance of systems such as switchgear, UPS, batteries, generators, transfer switches, PDUs, busway, grounding, and related monitoring platforms. This role is centered on plant operations and field execution rather than primary design authority. Key Responsibilities Lead day-to-day operation, maintenance, and service execution for critical electrical infrastructure. Single POC as the technical lead for all mechanical systems, including incident escalation Own electrical plant readiness, including...

At Acxiom, we're committed to being a great place to work - one that welcomes new ideas, encourages diverse perspectives, develops our people, and fosters a collaborative team environment. As a Senior Delivery Analyst, you will receive exposure to all functions and learn the end-to-end mechanics of Acxiom's business. Daily, you will build & execute the necessary processes to deliver data products and information to customers. You will analyze customer requirements and ensure that the requirements reflect the actual needs of the customer and advise on potential process improvements and optimum use of data. Preferred Location - AR Design, setup, monitor, and validate data product workflows leveraging standard processes and procedures for client accounts. Ensure workflows and quality audits meet client requirements, service level agreements and security policies. Identify, document, and make necessary workflow changes to meet client requirements. As a Senior Delivery...

At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Director, Account Management - Remote Job Description The Director of Account Management is responsible for providing strategic and operational leadership to a team of account executives and is accountable for the satisfaction and retention of assigned employer/Administrative Services Only (ASO) clients. This position collaborates across functions to ensure strategic alignment and execution of Prime, the health plan, and the assigned employer groups priorities. Responsibilities Provide strategic and operational leadership to the account executive function; serve as point of escalation and accountable leader for issue resolution across employer groups Establish processes and tracking methodologies to monitor...

Job Description As a Facilities Technician - Mechanical, you will provide engineering ownership for the reliability, efficiency, and lifecycle performance of mission-critical mechanical and HVAC systems supporting hyperscale data centers. This role sets technical direction, resolves high-impact issues, and drives standards and upgrades that protect uptime and improve long-term performance. Key Responsibilities Define, review, and improve mechanical/HVAC architectures and designs for high-availability environments (e.g., chilled water, DX, airside, redundancy strategies). Provide Tier-3 technical escalation for complex issues, including RCA, corrective action development, and verification of sustained fixes. Develop and maintain fleet standards for cooling redundancy, controls integration, equipment selection (e.g., chillers), and energy performance. Partner on capacity planning, retrofits, and emerging initiatives (e.g., liquid cooling, efficiency...