Blue Cross Blue Shield of Michigan Jobs

- 169 Jobs

  • Sharepoint/Power Apps Developer

    We are seeking a skilled SharePoint/Power Apps Developer to join our team.
    $75k-96k yearly est.13d ago

  • EQR Program Manager I

    FULL TIME REMOTE POSITION General Purpose of Position: Requires three years of Managed Care experience and/or External Quality Review Organization (EQRO) Experience. Responsible for coordination of all contract deliverables and collaboration with the contractor and other contract stakeholders. Manages team members and provides guidance and support to health plans and the contractor regarding EQRO Activities quality improvement plan development, implementation, measurement, and evaluation. Supports other functional areas of the organization as directed and performs other duties as assigned. This position is remote and reports to the EQRO Director. Major Duties and Responsibilities: Develop, maintain, and monitor quality assurance in all communication, deliverables, and activities to achieve contract requirements. Expert in CMS EQRO protocols and state nuances. Conduct validation of managed care organization studies. In addition to EQRO Director, serves as main point of contact via written, telephonic, video conference and face-to-face interaction with the designated state contractor in matters related to contract deliverables. Provide technical assistance and training to managed care organizations and the contractor. Coordinates and conducts quality studies including medical record review. Coordinate all activities with the contactor throughout the design, development, and finalization of all technical reports and other deliverables. Designate appropriate staff to meet with the contractor's staff to provide clarification or direction in relation to projects. Facilitate meetings to include providing an agenda, minute taking, and creation and distribution of informational materials. Facilitate and prepare oral presentations of review findings, recommendations, corrective action plans, and technical assistance to contractor staff. Ensure all final technical reports and other deliverables are timely, well written, accurate, and complete. Assist the contractor in responding to any questions from the contractor, CMS or other stakeholders about any final technical reports or deliverables. Prepare and deliver activity reports to the contractor, including any due dates, milestones, and project status. Willingness to travel up to approximately 30 percent. Knowledge, Skills and Attributes: Advanced analytic computing skills. Knowledge of managed care organizations Knowledge of CMS EQR protocols including: Understanding of all protocols Application of all protocols Monitoring CMS and other resources for any updates to protocols Strong customer-service orientation, both internally and externally. Strong team leadership, quality improvement experience and project management skills. Ability to work on multiple projects simultaneously, and ability to effectively deal with changes in project requirements. Attention to detail. Ability to work in a team environment while possessing strong self-directed capabilities. Excellent written & verbal communication skills. Educational presentations skills. Basic computer skills (Word, Excel, PowerPoint, Access, Outlook, and Sharepoint). Takes the initiative to remain current with relevant clinical topics and managed care performance improvement issues Education and Experience: Advanced degree/master's level, or equivalent experience. Minimum of 3 years External Quality Review experience preferred. Minimum 5 years management experience. Experience in managed care, health care quality improvement, and project management. Knowledge and understanding of NCQA Accreditation and HEDIS. Certifications: HEDIS Certification preferred. CPHQ or interest in pursuing preferred. The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements and criteria considered necessary to successfully perform the job. #IND1000
    $65k-105k yearly est.24d ago

  • Senior IT Project Manager (Remote)

    **Resp & Qualifications** **PURPOSE:** Sr. IT Project Manager, leads, plans, executes, monitors, controls and closes projects for the Enterprise Project Management Office (EPMO). This role oversees and directs complex $5M+ enterprise wide corporate initiatives involving 15-50+ stakeholder groups across several organizational work streams utilizing Agile methodology to deliver results **ESSENTIAL FUNCTIONS:** + Actively plans and manages large scale Waterfall or Agile projects holistically around scheduled program increments and milestones, scope, cost, resource health and risks while collaborating with stakeholders in key meetings resulting in successful project delivery. + Plans and owns project finances which includes timing implications and key payment dates while proactively reporting status, scorecard creation and fulfilling project analysis requests by using critical and creative thinking. + Leads and contributes to vendor selection and procurement activities under program manager guidance while identifying, producing and fulfilling resource and go-live operational plans to insure project success. + Prepares key documents, present business cases and produces other reports as needed while collaborating with stakeholders to bring projects through project funding conversations and initiation ceremonies. **SUPERVISORY RESPONSIBILITY:** Leads a team utilizing a matrix management system **QUALIFICATIONS:** **Education Level:** Bachelor's Degree in Health Informatics, Information Technology, Information Systems or related discipline OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. **Experience:** 5 years experience leading projects in a cross-functional, technical systems implementation. **Knowledge, Skills and Abilities (KSAs)** + Strong Financial Management ability including comprehension of project financials, profit and loss and the ability to create and manage and adhere to a broader project budget. + Strong Communication skills both written and verbal. + Ability to successfully lead in a matrixed environment. **Licenses/Certifications:** + Certified Project Management Professional (PMP)-PMI Preferred. + SAFe Scrum Master Certification Preferred. **Department** **Department:** Enterprise Portfolio Planning **Equal Employment Opportunity** CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. **Hire Range Disclaimer** Actual salary will be based on relevant job experience and work history. **Where To Apply** Please visit our website to apply: www.carefirst.com/careers **Federal Disc/Physical Demand** Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. **Sponsorship in US** Must be eligible to work in the U.S. without Sponsorship \#LI-RC1 REQNUMBER: 18360
    $100k-137k yearly est.3d ago

  • Provider Credentialing Specialist I (Remote)

    + Analyzes credentialing applications to perform the primary source verification of the appropriate credentials in order for a practitioner to participate in the CareFirst networks. **Licenses/Certifications** Certified Provider Credentialing Specialist (CPCS) Preferred.
    $36k-55k yearly est.5d ago

  • Diversity, Equity and Inclusion Intern (Remote- MD/DC/VA only)

    **Resp & Qualifications** **_This is a Year-Round Paid Internship. We are looking for students who can commit to work_** **_40 hours per week during the summer and up_** **_to 15-20 hours per week during the academic year in the Fall/Spring and_** This internship is for a motivated, undergraduate or graduate level student interested in a career in Diversity, Equity and Inclusion. Coursework in diversity studies, project management, and/or data analytics preferred. This internship offers the opportunity to work with a variety of internal stakeholders and exposure to senior level leadership as well as experience with diversity initiatives. **PRINCIPLE ACCOUNTABILITIES:** + Assist with data analysis and presentation of diversity related data; use data to report progress and inform decision-making + Contribute to the employee/business resource group strategy, including support of ERG leaders, coordination of diversity events and initiatives, and contributing to the development of key processes and tools. + Work in partnership with ERG and DEI leaders to leverage ERGS in the areas of attraction, recruitment, development, advancement, and retention. + Create and update PowerPoint presentations and other materials as needed + Support registration, tracking, surveys and other program needs + Support the strategic Diversity, Equity and Inclusion roadmap utilizing processes and tools designed to improve the organization in partnership with the DEI team. Principle responsibilities will include participation on projects and day to day tasks such as data analysis and reporting, updating policies and processes, project management, Employee Resource Groups, communications. Roles on these projects will include, but may not be limited to: + Best Practices Research + Data Collection + Attending and contributing to meetings and department discussions + Administrative Tasks **QUALIFICATIONS:** **Education Level:** This position requires an individual working towards at least a bachelor's degree from an accredited College or University. **Experience:** Junior or Senior Undergraduate student targeting majors in Diversity Equity and Inclusion, Human Resources, Business Administration, Psychology or related studies with a cumulative GPA of 3.25 or above. **Knowledge Skills Abilities (KSA's):** + Strong analytical and information organization skills. + Strong written communication skills. + Great attention to detail. + Proficient with Microsoft Office, including Teams, PowerPoint, Excel and Word. + Strong verbal and written communication and follow up skills, including ability to effectively communicate with all levels of management. + High level of energy, personal accountability, and integrity. + Excellent project management, organizational, time management and planning skills. **Department** **Human Resources: Diversity, Equity and Inclusion** **Equal Employment Opportunity** CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. **Where To Apply** Please visit our website to apply: www.carefirst.com/careers **Federal Disc/Physical Demand** Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. **Sponsorship in US** Must be eligible to work in the U.S. without Sponsorship REQNUMBER: 18155
    $91k-134k yearly est.58d ago

  • Director, Exam Security

    As a Director, Exam Security, you will have the opportunity to: The Director, Exam Security will be responsible for ensuring the efficacy of processes that protect the integrity the CFA Institute's exam programs and designations. This role leads the operations of the Exam Security team, including the identification, prevention, and mitigation of risk associated with all CFA Institute exams. CFA Institute is the world's largest association of investment management professionals. At CFA Institute, we care about our employees' mental, physical, social, and financial well-being.
    $117k-197k yearly3d ago

  • Senior Systems Engineer, (Remote)

    **Resp & Qualifications** **PURPOSE:** Ensures the stability, integrity and efficient operation of the organization information systems that support organizational functions. This is achieved by monitoring, supporting and optimizing all networked software and associated operating systems. Assesses architecture and current system limitations, defines and designs system specifications, disaster recovery procedures and evaluates input/output processes and working parameters for hardware/software compatibility. **ESSENTIAL FUNCTIONS:** + Installs, tunes, upgrades, troubleshoots, and maintains all computer systems relevant to the supported applications including all necessary tasks to perform operating system administration, user account management, disaster recovery strategy and networking configuration. + Develop and implement techniques to prevent system problems, troubleshoots incidents to recover services and supports root cause analysis + Automates the installation and configuration of applications in development and productions environments. + Evaluates new systems by performing in-depth tests, including end-user reviews. Researches software and related products to support recommendations and purchasing. Determines systems integration issues by evaluating components; developing and completing performance tests; analyzing test data; studying project requirements; analyzing user and potential user input; evaluating similar and related products and systems. Develop system automation and system integration of business processes. + Improves engineering job knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the-art practices; participating in professional societies. **SUPERVISORY RESPONSIBILITY:** Position does not have direct reports but is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources. **QUALIFICAITONS:** **Education Level:** Bachelor's Degree, Information Technology or Computer Science OR In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. **Experience:** 5 years software, hardware and/or systems engineering related experience **Licenses/Certifications** ITIL Foundations v3 within 180 Days Pref **Knowledge, Skills and Abilities (KSAs)** + Knowledge of programming languages and web based technologies. + Proficient in Microsoft Office applications. + Ability to collaborate to solve technical problems across teams. + Excellent communication skills both written and verbal. + Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time. Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging. **Department** **Department:** (FEP Bridge - Operational Support) **Equal Employment Opportunity** CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. **Hire Range Disclaimer** Actual salary will be based on relevant job experience and work history. **Where To Apply** Please visit our website to apply: www.carefirst.com/careers **Federal Disc/Physical Demand** Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. **Sponsorship in US** Must be eligible to work in the U.S. without Sponsorship \#LI-TJ1 REQNUMBER: 18240
    $109k-134k yearly est.20d ago

  • Coding Admin Analyst

    \ As a member of Team Blue, you.ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community. Blue Cross and Blue Shield of Nebraska (BCBSNE) is more than just an insurance company; we exist to be there for people in the best and hardest moments of their lives.
    $42k-59k yearly est.12d ago

  • Account Executive Small Group

    \ As a member of Team Blue, you.ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community. Blue Cross and Blue Shield of Nebraska (BCBSNE) is more than just an insurance company; we exist to be there for people in the best and hardest moments of their lives.
    $48k-71k yearly est.9d ago

  • Senior Director, Brand and Engagement Marketing

    Bring your true colors to blue. As the Senior Director of Brand and Engagement Marketing, you'll lead the development of brand and creative strategies that elevate the BCBSMA brand, enhance our reputation in the marketplace and drive brand love. Location Boston, Hingham
    $198k-242k yearly3d ago

  • Data Engineer

    Other element of the role is to work in conjunction with Senior Data Engineer to contribute towards the delivery of Data Platform. Responsibilities: + The Data Engineer will be responsible for the development, implementation, testing, documentation, and maintenance of analytics deliver and insights data solution applications. At Blue Cross Blue Shield of Massachusetts, we have an exciting opportunity for a Data Engineer to join our Core Data Engineering team of analytics delivery and insights.
    $95k-121k yearly est.3d ago

  • Executive Assistant

    Bring your true colors to blue. The Executive Assistant extensively interfaces between departments and outside parties, normally working with information that is of a critical and sensitive nature. The Executive Assistant to the Chief Commercial Officer (CCO) and Executive Vice President (EVP) will provide executive level administrative support and coordination.
    $41.3-50.4 hourly4d ago

  • FEP Service Representative

    As a FEP Service Representative at Blue Cross Blue Shield of Massachusetts you are in charge of solving member and/or providers' problems and helping them get back to enjoying their lives as quickly and effortlessly as possible. As the primary contact for our members and providers, the Service Representative is one of the most important positions at Blue Cross Blue Shield of Massachusetts. The Federal Employee Program is Blue Cross Blue Shield of Massachusetts's largest single account. At Blue Cross Blue Shield of Massachusetts, we value our employees as much as our members and providers. Blue Cross Blue Shield of Massachusetts is the largest health care provider in the Commonwealth.
    $41k-51k yearly est.6d ago

  • Senior Manager, Digital Product Management

    Bring your true colors to blue.
    $100k-124k yearly est.9d ago

  • Health Engagement Strategist

    Bring your true colors to blue. Assists with responses to RFP and RFI requests to competitively position BCBSMA health engagement programs and services.Proactively keeps up to date on current trends relevant to the wellness and health insurance industries.Maintain internal account management systems for assigned book of business.
    $78.8k-96.3k yearly9d ago

  • Solution Architect - Healthcare Integration and API's

    Bring your true colors to blue. Master's degree is a plus.Minimum of 8 years of technology experience Minimum of 3 years of experience leading architecture discussions, decision making, and collaborating with other architecture teams in the enterprise.Cloud & Agile certifications e.g., AWS Developer or Solutions Architect.Strong communication skills with the abilities to communicate with technical & non-technical individuals at all levels of the organization
    $112k-144k yearly est.9d ago

  • Senior Data Governance Technical Engineer

    $117.4k-143.4k yearly9d ago

  • Senior Manager, IT and Information Security Audit

    Bring your true colors to blue.
    $121.3k-148.3k yearly9d ago

  • Senior Test Engineering Lead

    Bring your true colors to blue. As a Senior Test Engineering Lead, you will work in a highly collaborative environment interfacing with Salesforce developers, Scrum Masters and Product Owners to help test and deliver critical Salesforce solutions.
    $98k-118k yearly est.9d ago

  • QA Test Analyst

    Bring your true colors to blue. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance You can also join our Talent Community to stay in the know on all things Blue.
    $72k-95k yearly est.9d ago

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Updated May 26, 2023

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Blue Cross Blue Shield of Michigan may also be known as or be related to BLUE CARE NETWORK OF MICHIGAN, Blue Cross Blue Shield Of Michigan, Blue Cross Blue Shield of Michigan, Blue Cross Blue Shield of Michigan Inc, Blue Cross Blue Shield of Michigan Mutual Insurance Company and Blue Cross and Blue Shield of Michigan Foundation.