Full-Time
Associate Data Solutions Analyst
Medicaid Operations
Posted on 7/23/2026
Highmark Health
5,001-10,000 employees
Health insurance plans and wellness resources
Compensation Overview
$58.1k - $90k/yr
New Mexico, USA + 43 more
More locations: Washington, USA | Kansas, USA | Pennsylvania, USA | North Dakota, USA | Delaware, USA | Iowa, USA | California, USA | Vermont, USA | Wyoming, USA | Florida, USA | Waterbury, CT, USA | Nevada, USA | South Dakota, USA | Georgia, USA | Arizona, USA | Concord, NH, USA | Mississippi, USA | Tennessee, USA | Virginia, USA | Arkansas, USA | Minnesota, USA | Colorado, USA | Nebraska, USA | Rhode Island, USA | Utah, USA | Kentucky, USA | West Virginia, USA | New York, NY, USA | Maryland, USA | Hawaii, USA | Wisconsin, USA | Maine, USA | Massachusetts, USA | North Carolina, USA | Oklahoma, USA | Missouri, USA | Indiana, USA | Louisiana, USA | Alaska, USA | Michigan, USA | Illinois, USA | Alabama, USA | Idaho, USA
Remote
Remote from anywhere in the United States; Pittsburgh area hybrid for on-site Tuesdays–Thursdays if within 50 miles.
Bachelor's, Master's
 Data & Analytics (1) |
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- Bachelor’s degree in Business Administration, Business Management, Information Systems or related field or relevant experience and/or education as determined by the company in lieu of bachelor's degree.
- Information Systems and Technology
- 1-2 years supporting reporting, analytics, or operational decision-making
- Health Insurance or Healthcare Industry
- Basic Analytical Skills
- Basic Problem-Solving
- Basic Communication Skills
- Report Writing
- SQL
- Work with more senior team members, customers, Data Engineers, Data Architects, and Capability Managers to capture capability needs and drive quality data and reporting solutions. Create and maintain deliverables such as data set creation, opertaional reports, and analytical dashboards.
- Collaborate with cross-functional teams on data-driven projects, contributing to various stages of the data delivery lifecycle, leveraging diverse data skills and perspectives to drive project success.
- Support various aspects of data and report delivery requirements testing (e.g. testing plan, scenarios, documentation, defect management) to ensure minimal production defects are realized and completing analysis of the results tying back to customer impacts.
- Assure compliance for required standards and all necessary approvals have been obtained throughout the data delivery lifecycle.
- Effectively communicate with team members, customers, partners and management, including assisting with or conducting requirement walkthroughs and sprint reviews, reporting project status, enabling vendor solutions and providing accurate and concise documentation.
- Other duties as assigned or requested.
- Master’s degree in Business Administration, Business Management, Information Systems or related field
- 1-2 years supporting reporting, analytics, or operational decision-making
- Health Insurance or Healthcare Industry
Highmark Health operates as a health insurer in Pennsylvania, Delaware, and West Virginia, serving individuals, families, businesses, and Medicare beneficiaries. Its plans are funded by premiums and, for eligible services, government reimbursements, covering doctor visits, hospital care, prescriptions, and preventive care, with member resources like symptom checkers and cost details. It differentiates itself through active community involvement and sustainability initiatives alongside a broad member base and Medicare/Medicaid compatibility. Its goal is to improve community health by providing thorough coverage and health resources while operating responsibly and sustainably.
Company Size
5,001-10,000
Company Stage
Grant
Total Funding
$29.6M
Headquarters
Pittsburgh, Pennsylvania
Founded
1996
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Simplify's Take
What believers are saying
- March 2026 revenue reached $32.4 billion, signaling scale and market endurance.
- July 2026 Laguna and UpDoc pilots reduce administrative burden and extend care capacity.
- April 2026 social-care grants and community programs strengthen employer brand in Pennsylvania.
What critics are saying
- Highmark Health posted a $674 million operating loss in 2025, worsening margin pressure.
- Its June 2026 IDR lawsuit shows billing-dispute warfare with Bromedicon and HaloMD.
- AI pilots can backfire if UpDoc or Laguna recommendations trigger patient harm lawsuits.
What makes Highmark Health unique
- Highmark Health combines insurer, provider, and technology assets across 2026 operations.
- Its Gold Card program gave nearly 25,000 doctors instant preauthorization access.
- AHN and Highmark can pilot AI across claims, care management, and clinics.
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Benefits
Professional Development Budget
Growth & Insights and Company News
6 month growth
↑ 8%1 year growth
↑ 8%2 year growth
↑ 8%Concilio celebrates seniors with Annual disco-themed Senior Celebration. PHILADELPHIA, PA - The dance floor was full, classic disco hits filled the room, and laughter echoed throughout the ballroom as Concilio welcomed seniors from across Philadelphia to its Annual Senior Celebration. The event honored the individuals whose lifelong contributions have helped shape the city's diverse communities while providing an afternoon of connection, entertainment, and appreciation. This year's Disco-themed celebration was presented by Aurora Home Care and supported by Highmark Wholecare. Jefferson Health, and Lamb Insurance Services, with New York Life joined the event as a community partner. The afternoon was emceed by Maria del Pilar of La Mega, whose energy and enthusiasm kept guests engaged from beginning to end. One of the day's highlights was a spirited performance by Grupo Alegría from the Norris Square Senior Center, whose music and dancing brought guests to their feet and perfectly captured the celebratory atmosphere. Attendees also explored community resource tables, connecting with organizations that provide valuable health, wellness, and financial services for older adults. The celebration continued with Concilio's beloved Senior King and Queen Coronation, sponsored by Highmark Wholecare. The tradition recognizes two seniors who exemplify leadership, positivity, and community spirit, drawing cheers and applause from friends and fellow attendees. Throughout the afternoon, guests enjoyed raffles sponsored by Highmark Wholecare, Aurora Home Care, and New York Life, while every attendee received a complimentary Dominoes set as a keepsake of the celebration. Volunteers from Lamb Insurance Services were also on hand, helping welcome guests and ensuring the event ran smoothly. "At Concilio, we believe our seniors deserve to be celebrated every day," said Hil Walker, Interim CEO. "Their experiences, resilience, and contributions have strengthened our communities for generations. This event is our opportunity to recognize their impact while bringing people together for a day of joy and connection." Concilio extends its heartfelt gratitude to Aurora Home Care, Highmark Wholecare, Jefferson Health, Lamb Insurance Services, New York Life, Maria del Pilar, Grupo Alegría, and the many volunteers, staff members, and community partners who made this Concilio's Annual Senior Celebration 2026 possible. The Annual Senior Celebration reflects Concilio's mission to strengthen the quality of life in its diverse communities by creating meaningful opportunities for connection, wellness, and engagement for older adults. As guests left with smiles, prizes, and new memories, the event served as a reminder that honoring its seniors means celebrating not only their past achievements but also the vibrant role they continue to play in its community today. ABOUT CONCILIO: Concilio de Organizaciones Hispanas (Concilio) is a non-profit 501(c)(3) founded in 1962. Concilio is a recognized leader in providing an array of social services, ensuring that education, health, adoption, foster care, and cultural opportunities are made available to those in need. Concilio is proud to serve as a cultural convener for some of Philadelphia's largest Latino events. To get Concilio's latest updates, follow @ConcilioPhilly on social media.
Clinical AI: Pittsburgh pilot will take on challenges of diabetes care. Kris B. Mamula Pittsburgh Post-Gazette Jul 21, 2026 In medicine, the uses for artificial intelligence have pretty much been limited to back office stuff - notetaking and appeals to health insurers to cover special medicines and treatments, those sorts of things. That could be ready to change in Western Pennsylvania as the role of AI accelerates further into direct patient care in a pilot planned at Allegheny Health Network. The 16-hospital Highmark affiliated health care system has inked a deal with Palo Alto, Calif.-based UpDoc Inc. to aid in caring for people with chronic diseases by using AI to monitor and adjust medication, as needed, between office visits. If the results of a small clinical trial of the technology are any indication, remote patient intervention may be poised to transform diabetes care. "It's adding a cook to the care team, it's opening the door and allowing the AI agent to join the team," primary care physician and UpDoc CEO Sharif Vakili said. "It's adding something important between doctor's visits; it's doing things in a new way." Here's how it'll be rolled out by primary care physicians at AHN. Doctors will select patients with type 2 diabetes for regular telephone or text contact with UpDoc's conversational AI platform. An AI agent will periodically check on the patient's symptoms, insulin and glucose, and recommend medication adjustments to optimize care. For patients with unruly bloodstream glucose - and they are legion - this often means multiple physician appointments, burdening medical providers and adding to physician burnout at a time when there's not enough primary care doctors, including in parts of Western Pennsylvania, experts say. For patients in the trial, their doctor will come up with a preset range of acceptable glucose levels. Failure to stay within those limits, despite medication tweaks, will prompt a recommendation for the patient to reach out to the treating doctor. All interactions between the AI agent and patient will become part of the patient's electronic medical record for physician review. Clinical applications for AI have been slow to get traction, said Holly Wiberg, assistant professor of Operations Research and Public Policy at Carnegie Mellon University's Heinz College. But that may be changing. "The clinical AI promise has really yet to be realized," she said. "A patient-facing interactive tool is really an exciting kind of frontier. You can reach more patients at a lower cost." Nearly one-quarter of the 33 million U.S. adults with type 2 diabetes in the U.S. have poor glycemic control because they often receive suboptimal doses of insulin, according to a 2023 JAMA Open Network study that was conducted by Vakili, UpDoc chief technology officer and internist Ashwin Nayak and others. "Therapeutic inertia," physician time constraints and competing demands due to a crush of medical practice appointments were among the reasons cited for inadequate insulin dosing. The current standard of care for diabetics with poor glucose control is simply to call the doctor for an appointment, which can delay care. But in the small clinical pilot conducted at Stanford Medicine, people with diabetes using an AI platform achieved effective insulin dosing nearly four times faster than those receiving standard care - median 15 days versus more than 56 days. Medical adherence - a notoriously difficult challenge in caring for people with diabetes - was also better with AI intervention: 83% compliance versus 50% with standard treatment, according to the study, which had 32 participants. Results of the trial were published in the American Medical Association's JAMA Network Open in 2023, the year UpDoc was founded. Getting glucose levels right reduces long-term complications from diabetes, including kidney disease, eye and nerve damage and heart disease, which ultimately holds down treatment costs. There are between 170,000 and 220,000 people with diabetes in the eight-county Pittsburgh metropolitan area, according to extrapolated projections of prevalence by the Centers for Disease Control and Prevention, and direct medical costs of treating the disease range up to $2.6 billion annually. In a prepared statement, AHN said it was anticipating use of UpDoc's digital platform. "Allegheny Health Network is looking forward to introducing this innovative AI platform with a particular emphasis on empowering primary care clinicians," said Amy Crawford-Faucher, chair of AHN Primary Care Institute. "The future integration of UpDoc within our electronic health records will further strengthen care coordination, reduce administrative burden and enable our physicians to devote more of their time to high-value, clinical decision-making - ultimately driving improved long-term health outcomes for our patients and improved population health." Crawford-Faucher was unavailable for further comment. Home monitoring of chronic diseases has been something of a holy grail in medicine, said Derek C. Angus, former chair of the Department of Critical Care Medicine at the University of Pittsburgh and UPMC, who is not affiliated with UpDoc. With infinite patience and no social or cultural barriers to undermine patient care, AI could revolutionize disease management. "The AI revolution in health care is both wonderful and terrifying," he said. "These AI tools are potentially fantastic and they may finally crack the knot of home-based remote care. "On so many levels it is so attractive to think about these tools, but there still can be side effects. They could end up making bad recommendations, but we don't know," he said. "The upside is amazing and the downside is real as well," Angus said. UpDoc has secured $16 million in oversubscribed seed financing from leading health care investors and strategic partners, including the American Diabetes Association, Cathay Innovation, Eli Lilly and Co., Mayo Clinic and others. UpDoc's Vakili said the company planned to roll out other chronic disease management uses for the platform in the coming months. First Published: July 21, 2026, 1:00 a.m. Kris B. Mamula has been a health care business reporter for the Post-Gazette since 2015. A Carnegie Mellon University graduate, he was part of the team that won a Pulitzer Prize for coverage of the synagogue shooting in 2018. Join the Conversation If you would like your comment to be considered for a published letter to the editor, please send it to [email protected]. Letters must be under 250 words and may be edited for length and clarity. Allegheny Health Network LATEST business Create a free PG account. Already have an account?
Highmark chooses Laguna for conversational AI integration. July 5, 2026 Highmark collaborates with Laguna Health to ease administrative burden on care managers. In the world of healthcare, administrative tasks can often take up a significant amount of time for care managers. Highmark, a leading health insurer, is taking steps to alleviate this burden by partnering with Laguna Health, a conversational artificial intelligence company. This collaboration aims to streamline the workflow for care managers and ultimately improve the overall patient experience. Highmark, based in Pittsburgh, Pennsylvania, serves millions of members across several states. By integrating Laguna's AI technology into their platform, care managers will have access to valuable tools that can transcribe conversations, provide insights on patient issues, and offer actionable suggestions for addressing those issues. Additionally, care managers will receive guidance on effective communication strategies, ultimately enhancing their interactions with patients. Yoni Shtein, CEO of Laguna Health, highlights the challenges that care managers face in juggling multiple tasks while trying to focus on patient care. The partnership with Highmark aims to reduce burnout among care managers by streamlining administrative processes and improving overall efficiency. This not only benefits care managers but also enhances the member experience and allows the insurer to demonstrate positive patient outcomes. Benjamin Edelshain, vice president of clinical engagement and digital innovation at Highmark Health, emphasizes the value of this collaboration in improving customer satisfaction and operational effectiveness. By leveraging Laguna's AI technology, Highmark can better meet the needs of their members and provide valuable insights to external stakeholders. The partnership between Highmark and Laguna comes at a time when conversational AI technology is gaining traction in the healthcare industry. While many AI companies focus on the provider side, there is a growing need for similar solutions on the payer side. This collaboration represents a step towards addressing this need and enhancing the efficiency of care management processes. Overall, the collaboration between Highmark and Laguna Health showcases the potential of AI technology to transform healthcare operations and improve patient outcomes. By leveraging innovative solutions, healthcare organizations can streamline processes, reduce administrative burdens, and ultimately enhance the quality of care for patients.
Alleging fraud, Highmark seeks to void $3.9 million in disputed claim payments. Kris B. Mamula Pittsburgh Post-Gazette Jun 2, 2026 You have a medical emergency out of town and need care at a hospital that your health insurance plan says is out of network. Not to worry: A 2022 federal law protects you from getting surprise bills for the care as your insurer and the hospital hash out differences in the amount doctors are owed. But the independent system created by the law for resolving billing disputes between the hospital and your health plan has been hijacked, according to a federal lawsuit filed Monday by Pittsburgh-based health insurer Highmark Inc., the Highmark Health subsidiary that includes its Blue Cross Blue Shield plans. The breakdown is inflating the overall cost of health care by millions of dollars, the suit alleges. Highmark filed the six-count civil lawsuit in the U.S. District Court for the Western District of Pennsylvania against Philadelphia area-based Bromedicon LLC and HaloMD, of Addison, Texas, alleging that 451 claims valued at $3.9 million that were submitted to Highmark in 2024 and 2025 violated federal law. In addition to injunctive relief, Highmark - which accused the companies of fraud, negligent misrepresentation, civil conspiracy and other claims - is seeking to void the bills that have been submitted for payment and assess punitive damages. In the lawsuit, Highmark accused the companies of swamping the nonprofit with "categorically ineligible disputes."(Pam Panchak/Post-Gazette) Bromedicon provides neuromonitoring services to Highmark health plan members who undergo surgery, and HaloMD is a third-party billing and dispute resolution company. In the lawsuit, Highmark accused the companies of swamping the nonprofit with "categorically ineligible disputes," many submitted just days apart, even though federal law requires a 90-waiting period between filing a claim for the same or similar service. In a statement Tuesday, HaloMD spokeswoman Cindy Williams said other federal courts have dismissed similar litigation. "Four federal district courts have dismissed similar copy-paste litigation started by the Blue Cross Blue Shield cabal," she said in a statement. "Highmark's lawfare is intended to intimidate doctors out of seeking fair reimbursement for the care they have already provided." Bromedicon officials were not immediately available Tuesday. Nationwide, HaloMD filed an average of nearly 1,262 claims per day during the first half of 2025 alone, according to Highmark's lawsuit. Highmark alleges that 451 claims valued at $3.9 million - submitted in 2024 and 2025 - violated federal law.(John Heller/Post-Gazette) "The independent dispute resolution process has been overwhelmed by a staggering volume of disputes that far exceed the government's initial estimates," according to the lawsuit, which total more than 4.8 million cases filed nationwide in 2025 alone. "Government data confirms that providers prevail in the substantial majority of independent dispute resolution payment determinations and that provider awards frequently exceed the qualifying payment amount." "Defendants' fraud goes further, threatening the affordability and sustainability of health care coverage for Highmark's members and the self-insured employer groups - including public school district, state and local government entities and labor unions - whose benefits Highmark administers across Pennsylvania and nationwide," according to the lawsuit. Highmark's Blue Cross Blue Shield plans cover more than seven million people in Pennsylvania, Delaware, New York and West Virginia. First Published: June 2, 2026, 7:16 a.m. Kris B. Mamula has been a health care business reporter for the Post-Gazette since 2015. A Carnegie Mellon University graduate, he was part of the team that won a Pulitzer Prize for coverage of the synagogue shooting in 2018. Join the Conversation If you would like your comment to be considered for a published letter to the editor, please send it to [email protected]. Letters must be under 250 words and may be edited for length and clarity. Giuseppe LoPiccolo/Post-Gazette LATEST business Create a free PG account. Already have an account?
Highmark Western and Northeastern New York announces new board appointments. Buffalo, New York (April 24, 2026) - Highmark Western and Northeastern New York today announced changes to its Board of Directors, appointing Richard S. Gold, former President and COO of M&T Bank Corporation, as its new Chairperson. Additionally, Jill K. Bond, Esq., a distinguished attorney, has been named as a new member of the Board. Richard S. Gold brings a wealth of experience and leadership to his new role as Chairperson. He concluded a distinguished three-decade career at M&T in 2023, where he served as President and Chief Operating Officer of M&T Bank Corporation and its principal banking subsidiary, M&T Bank. Throughout his tenure, he cultivated a comprehensive understanding of the banking industry, holding a variety of leadership roles across Retail Banking, Business Banking, Mortgage, Consumer Lending, Risk and Marketing. He holds a Bachelor of Science from Cornell University School of Industrial and Labor Relations and a Master of Business Administration from New York University Stern School of Business, providing a strong foundation for his executive career. Beyond his corporate achievements, Gold demonstrates an unwavering commitment to the Western New York community and the broader banking industry. His dedication is evident through past and recent board service with the United Way of Buffalo & Erie County, Buffalo Seminary, the Buffalo Niagara Partnership, and the Consumer Bankers Association. He further shared his expertise as a valued member of the Dean's Advisory Council at the University at Buffalo School of Management, where he has also enriched students' learning as an adjunct professor for the past twelve years. Jill K. Bond, Esq., a highly respected attorney, joins the Board as a new member, bringing a robust legal background and a fresh perspective. Her expertise will be crucial in guiding Highmark through an evolving health care and regulatory environment. Bond recently founded The Bond Firm, LLC, specializing in Corporate Internal Investigations, Labor and Employment Law, Ethics and Compliance, and Food Regulatory Matters. Prior to this, Bond dedicated 35 years to Rich Products Corporation, retiring in 2023 as Senior Vice President, Chief Ethics and Compliance Officer. Her extensive experience includes leading the company through crises such as food recalls, lawsuits, and the COVID pandemic. She also played a key role in founding and leading Rich's women's affinity group for over a decade. Active in the legal community, Bond served as President of the Bar Association of Erie County and is currently on its Judiciary Committee and the Attorney Grievance Committee for the New York State Appellate Division Fourth Department. She is an alumna of Canisius College and the State University of New York at Buffalo School of Law, where she has also served on their respective boards and advisory councils. Bond has furthered her executive education at the University of Michigan, Kellogg School, and Harvard Business School. She has also contributed to several boards, including the Women's Foodservice Forum and the Center for Elder Law and Justice. These appointments underscore Highmark Western and Northeastern New York's commitment to strong governance and a strong leadership team dedicated to serving the needs of its members and the broader