Blue Shield of California jobs - 385 jobs

The Payer Systems Applications team plays a critical role in enhancing customer and technical collaboration while delivering all application development through a Platform and Technology Product Operation Model. The candidate will report to the Sr. IT Manager, Application Services Lead. In this role, you will be responsible for leading, facilitating, and driving continuous improvement of Agile practices for the team or teams that you'll be supporting. The Portfolio is responsible for the development and support of complex technology solutions from claims processing to benefit enrollment. The Agile team that this role will lead has representation from across our matrixed organization, including IT, business & vendor partners, to deliver value & capabilities that meet the needs of our customers. We strive to deliver sustainable solutions that optimize cost, quality, and fit for purpose. This role specifically is planned to support Agile delivery related to our Member Customer Experience area as part of our Membership and Support Platform. Your Knowledge and Experience Requires bachelor's degree or equivalent experience and Scaled Agile (SAFe) Certification and 7 years of Project Management skills or Scrum Master experience Requires Scaled Agile (SAFe) certification: Scrum Master or Product Owner/Product Manager (POPM) Preferred Scrum Master certification (PSM II, PSM III, CSP, CTC); CSM, A-CSM (Scrum Alliance certifications) Preferred experience as a Scrum Master role for minimum of two years for a Scrum team Preferred experience using JIRA and AgilePlace Preferred Healthcare experience Preferred experience on the Pegasystems platform #LI-JA1 In this role, you will: Provide Agile team support by serving as the Scrum Master and Team Coach for Agile teams, ensuring smooth operation and adherence to Agile principles Educate and lead one or more Agile teams in Scrum, Built-in Quality, Kanban, and Scaled Agile (SAFe) principles and practices, fostering a culture of continuous improvement Facilitate Program Increment (PI) Planning readiness by preparing Agile teams for PI Planning sessions, guiding the creation of PI plans, objectives, and business values, ensuring alignment with organizational goals Collaborate with other Scrum Masters, Agile Coaches, and Product Management roles across the enterprise, contributing to the maturation of business units along with IT agile teams on the path towards our business agility Lead iteration execution by facilitating key team events, including backlog refinement, team planning, team synchronization, team review, demo, and retrospective sessions, fostering collaboration, transparency, and continuous improvement within the team

Inventory Operations Returns Senior Supervisor - Job Description What You'll Do: As an Operations Senior Supervisor, you will lead a high-performing team of pharmacy staff driving operational excellence through innovation, accountability, and continuous improvement. You'll be responsible for fostering a culture of engagement, setting clear expectations, and empowering your team to deliver exceptional results while identifying and implementing strategies to reduce inventory waste and streamline processes. Key Responsibilities: Manage and mentor a team of pharmacy staff, promoting a collaborative and inclusive work environment. Lead and support projects aimed at reducing inventory waste and enhancing operational workflows. Collaborate with cross-functional teams to identify root causes of inefficiencies, clarify operational expectations and implement sustainable solutions. Encourage team-driven ideas and pilot innovative approaches to improve service delivery and reduce costs. Occasionally reviews recorded calls to verify technician-patient interactions, address complaints, and ensure adherence to service standards-identifying coaching opportunities when needed. Investigates and resolves quality issues by analyzing system workflows and order handling processes to identify gaps in SOPs, technician errors, or procedural inconsistencies-using findings to guide corrective actions and process improvements. Ensure compliance with regulatory and organizational policies related to pharmacy operations. Set clear performance expectations and hold team members accountable through regular coaching, feedback, and development plans. Foster a culture of ownership, innovation, and continuous improvement. Monitor daily workflow and staff scheduling to ensure optimal coverage and productivity. Review and analyze performance metrics to identify trends, drive accountability, and celebrate successes. Conduct regular team meetings, and performance reviews to align goals and reinforce priorities. Maintain open lines of communication with peers and leadership to share best practices and align strategic goals. Manage employee time tracking, attendance, and scheduling with accuracy and fairness. Maintain documentation of coaching sessions, performance reviews, and improvement plans. Support staffing decisions and resource planning based on business needs and performance data. What you'll need: High School Diploma or GED required 4+ years of experience in inventory operations processing preferred 2+ years of leadership experience required Strong leader with emotional intelligence and ability to engage, enable, and develop staff Proficient in PC-based systems including Microsoft Office, Excel, PowerPoint, SharePoint, Outlook, and Webex Demonstrated ability to train, coach, and mentor staff with patience and clarity Advanced problem-solving skills and ability to collaborate across departments to resolve complex issues with innovative solutions Adaptable to dynamic environments with sound independent decision-making skills Skilled in handling challenging conversations professionally Proven experience supervising diverse teams, fostering accountability, and driving performance Skilled in conflict resolution and performance management to support employee development and retention Demonstrated success in identifying inefficiencies and leading process improvement initiatives Experienced in translating organizational goals into actionable plans and delivering measurable outcomes Strong communicator with ability to lead change, gain stakeholder buy-in, and maintain transparency Uses operational metrics and employee feedback to guide decisions and support continuous improvement Committed to delivering high-quality service aligned with client expectations and organizational standards Experience with medication destruction protocols, especially in healthcare or pharmaceutical environments If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Logistics: Palmetto GBA,- one of BlueCross BlueShield's South Carolina subsidiary companies. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. Location: This a full-time remote position. You will work an 8-hour shift scheduled during our normal business hours of 8:00 a.m.-5:00 p.m. Monday - Friday. It may be necessary, given the business need to work occasional overtime. What You'll Do: Communicates/educates providers on issues such as Medicare coverage, utilization statistics, documentation and medical review by use of written advisories, reports, letters, and telephone contacts. Documents all provider contacts/communications in provider tracking system. Conducts formal conference calls and/or in-person educational visits with providers that are consistently over utilizing services, on progressive corrective action, or have unacceptable denial rates and/or error rates under the medical review program. Conducts coverage and documentation workshops for provider staff (Medicare providers and physicians' staff). Researches, composes, and coordinates the preparation of all regulatory based provider education materials. Performs analysis of effective reports to determine actions to be taken regarding medical reviewed its/audits. Determines what providers are over-utilizing services and what services are being over-utilized. Works with medical review department and provides input regarding actions taken in response to provider billing practices. Targets providers where greatest abuse of Medicare program has occurred. Participates in the medical review process and inter reviewer reliability (IRR) studies. Assists in training of medical review associates regarding coverage and medical review process. To Qualify for This Position, You'll Need the Following: Required Education: If LPN, graduate of accredited School of Licensed Practical Nursing; if LVN, graduate of accredited School of Licensed Vocational Nursing; if RN, graduate of approved School of Nursing. Required Experience: If LPN or LVN, 7 years of clinical experience or equivalent combination of clinical and educator experience. If RN, 5 years of clinical experience or equivalent combination of clinical and educator experience. Required Software and tools: Microsoft Office. Required Skills and Abilities: Knowledge of medical terminology and disease processes. Demonstrated proficiency in word processing and spreadsheet software. Good judgment skills. Effective customer service, organizational, and presentation skills. Demonstrated proficiency in spelling, punctuation, and grammar. Analytical or critical thinking skills. Basic business math proficiency. Knowledge of mathematical or statistical concepts. Ability to persuade, negotiate, or influence. Required Licenses and Certificates: Active LPN or LVN licensure in state hired, OR active compact multistate LPN license as defined by the Nurse Licensure Compact (NLC), OR active RN licensure in state hired OR active compact multistate RN license as defined by the Nurse Licensure Compact (NLC) others. Ability to handle confidential or sensitive information with discretion. We Prefer That You Have the Following: Preferred Work Experience: 3 years of provider relations and Medicare experience. Preferred Skills and Abilities: Knowledge of claims processing software. In-depth knowledge of Medicare program, guidelines, regulations governing coverage. Preferred Software and Other Tools: Working knowledge of Microsoft Access or other database software. Our Comprehensive Benefits Package Includes the Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. Subsidized health plans, dental and vision coverage 401k retirement savings plan with company match Life Insurance Paid Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more What We Can Do for You: We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company. What To Expect Next: After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email ************************ or call ************, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information.

**Resp & Qualifications** **PURPOSE:** The Broker Relations Manager's primary responsibility is to bring the value of CareFirst to the marketplace by engaging and working with CareFirst's distribution channel (brokers). This role combines strategic leadership with hands-on management to ensure brokers receive timely, accurate, and comprehensive assistance. The ideal candidate will foster a customer-centric culture while driving operational excellence and team development. **ESSENTIAL FUNCTIONS:** **Broker Relationship Management** + Serve as the primary escalation point for complex broker inquiries and issues, ensuring timely and satisfactory resolution. + Build and maintain strong relationships with key broker partners, full service producers and consultants, understanding their needs and business objectives. + Monitor broker satisfaction metrics and implement strategies to improve service delivery and partner experience. + Collaborate with sales and account management teams to support broker growth and retention initiatives. **Team Leadership & Development** + Lead, mentor, and develop a team of broker support representatives, fostering a collaborative and high-performance culture. + Conduct regular performance reviews, provide coaching, and identify training opportunities to enhance team capabilities. + Manage team scheduling, workload distribution, and resource allocation to ensure optimal coverage and efficiency. + Recruit, onboard, and train new team members in company policies, systems, and broker service best practices. Operational Excellence + Develop and implement broker service standards, workflows, and standard operating procedures to ensure consistent, high-quality support. + Monitor key performance indicators including response time, resolution time, ticket volume, quality and customer satisfaction scores. + Identify process improvement opportunities and implement solutions to enhance efficiency and service quality. + Manage and optimize the use of Broker360 and ticketing systems to track interactions, issues, and resolutions. + Ensure compliance with regulatory requirements, company policies, and industry standards. + Drive development and adoption of service dashboard(s) to track performance and progress, including broker-level dashboards. + Drive development and ongoing enhancement of broker portals to drive continued automation of broker work with CareFirst. + Support enhancements to Salesforce CRM to drive better data collection and reporting opportunities. **Communication & Collaboration** + Partner with Product, Underwriting, Operations, and IT departments to resolve systemic issues and improve broker experience. + Prepare and present regular reports on team performance, broker feedback, and service trends to senior leadership. + Communicate policy updates, system changes, and important information to the team and broker community. + Facilitate regular staff meetings to share updates, celebrate successes, and address challenges. + Attend and participate in business and community activities to promote CareFirst and identify new opportunities as needed. **SUPERVISORY RESPONSIBILITY:** This position manages people. **QUALIFICATIONS:** **Education Level** : Bachelor's Degree in marketing, business or related field 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 in sales, relationship management and/or marketing. + 1 year supervisory experience or demonstrated progressive leadership experience. **Licenses/Certifications:** + A current Health/Life License in Maryland, Virginia, and District of Columbia is required **Preferred Qualifications:** + Previous experience working directly with insurance brokers or agencies. + Lean Six Sigma or process improvement certification. + Experience implementing or managing CRM or customer service technology platforms. **Knowledge, Skills and Abilities (KSAs)** + Leadership & Team Development: Ability to inspire, motivate, and develop team members while maintaining accountability. + Problem-Solving: Strong analytical skills with ability to identify root causes and implement effective solutions. + Communication: Excellent written and verbal communication skills with ability to explain complex concepts clearly. + Relationship Building: Skilled at building trust and rapport with internal stakeholders and external partners. + Organization & Time Management: Ability to prioritize competing demands and manage multiple projects simultaneously. + Adaptability: Comfortable with ambiguity and able to adjust strategies in response to changing business needs. + Customer Focus: Unwavering commitment to understanding and exceeding broker and customer expectations. + Data-Driven Decision Making: Ability to interpret metrics and analytics to drive continuous improvement. Salary Range: $108,400 - $201,218 **Salary Range Disclaimer** The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Client Relationship Managers **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: ************************* **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-KL1 REQNUMBER: 21520

Blue Cross is hiring Clinical Support Representatives to work alongside our clinical review team as part our Utilization Management department. Job responsibilities include verifying member benefits, provider networks, and prior approval requirements for authorization of services all in a call center type environment. Work hours are Monday-Friday 8:00-4:30. Experience working in the medical field as an office assistant, medical coder, or Licensed Nursing Assistant is preferred and familiarity with medical terminology is helpful. Location: If hired, there will be a six week in-person training program at our Berlin, Vermont office. Representatives will continue working on-site five days per week until proficiency has been demonstrated in performing the role independently. After this time, employees within a 50-mile radius will be expected to come to the office on Wednesdays with flexibility to work remotely the rest of the week. Starting pay at $20.00 per hour. Six-week paid training. Target start date is Wednesday, February 18. Robust benefits package including: Health insurance (including vision) Dental coverage (free to employees) Wellness Program with a $500 year-end incentive 401(k) with employer match Life Insurance Disability Insurance Combined time off (CTO) - 20 days per year + 10 paid holidays Tuition reimbursement Student Loan Repayment Dependent Caregiver Benefits And more! Diversity, Equity, and Inclusion: Blue Cross VT is committed to creating an inclusive environment where employees respect, appreciate, and value individual differences, both among ourselves and in our communities. We welcome applicants from all backgrounds and experiences to join us in our commitment to the health of Vermonters, outstanding member experiences, and responsible cost management for all the people whose lives we touch. Learn more about our DE&I commitment at **************************************************************** **Complete job description attached to ADP posting

To learn more about this role, watch our installation merchandisers in action. As an Field Installation Merchandiser Floater, you'll have the opportunity to collaborate with local store teams and fellow team members with new store installations, resets/remodel, and season installations. You will also support and work independently to showcase your organization and time management skills, your ability to establish retailer relationships, while being the face of Hallmark. There will be occasions when you will collaborate with local store teams to optimize product placement and maintain inventory, when needed. On occasion you may have the opportunity to work with other products from other companies in the stores that Hallmark services. In this role, you will be provided with a schedule in advance for the accounts you will service. The job includes removing product, dismantling and building/assembling fixtures, placing products on display. This could include a a small reset on a 4ft display or it could involve an entire department. Typically, an on-site Installation Supervisor will assign tasks to each Hallmarker on the team. SALARY AND SCHEDULE DETAILS * Your starting hourly pay rate will be between $17.87 - $19.87 depending on your skills and experience. * Eligible Employees receive annual pay increases. * This is a Part-Time position with a variable schedule during the work week. * Average weekly hours for this position are between 5-25 hours per week. * Availability the week before and after major holidays, which may include weekends is required. YOUR ROLE AND RESPONSIBILITIES WILL INCLUDE You'll perform service work in the Hallmark department of various retail stores such as grocery stores, drug stores, department stores, and mass retailers. The field merchandiser position consists of three major components: * Installation day engagement: As part of the Installation team, you will be responsible for the assigned reset/installation activity for the account which could include removing product and trash, dismantling fixtures, building fixtures, and displaying products. This could include evenings or weekend hours. You will Utilize a mobile device provided by Hallmark, to communicate with your supervisor, provide feedback, answer surveys, monitor the inventory of Hallmark products within and outside the Hallmark department. The use of technology is critical in this role, for the day-to-day work as well as communication with your supervisor, reporting time, providing feedback, and answering surveys for required merchandising activities. Professional and courteous interaction with store employees, management, and customers is also vital for success in this role. * Holiday support: Hallmark's operations revolve around seasonal demand. Leading up to and following holidays such as Valentine's Day, Easter, Mother's Day, Father's Day, Halloween, Thanksgiving, and Christmas, you can expect additional days and extended hours during the work week. On occasions like Valentine's Day, Mother's Day, and Father's Day, you may be required to work on the actual holiday itself, which may include the weekend. * One Team Vision: As part of Hallmark's field organization, you are part of a network of merchandisers professionals that often times will support other team members as needed in their territories. * ADDITIONAL REQUIREMENTS This role covers the geographical area of: XXX,XX to XXX,XX to XXX,XX to XXX,XX. XXX,XX is roughly center. You must live within this area and be available to travel to work within the area. This is a physically demanding job that requires a high level of energy and a sense of urgency. You will be working on the selling floor as well as in back stockrooms. You must be able to consistently push, pull, lift, and carry cartons, merchandise, and display fixtures up to 30 pounds throughout the workday and up to 50 pounds on occasion. You will also be required to kneel, squat, walk, and stand throughout your workday, and you may be required to climb stairs and step ladders. BASIC QUALIFICATIONS * You're at least 18 years of age. * You're able to read, write and understand English. * You have the ability to grasp, pull, lift, and carry products up to 30 pounds frequently and 50 pounds occasionally. * Able to operate a digital hand-held device to open and read documents and interpret information. * You have access to a Wi-Fi network and the internet. * You have access to consistent transportation to travel to and between assigned stores as scheduled. Part-time employees with a work schedule less than 30 hours have access to a variety of voluntary benefits through Voluntary Benefits including dental, vision, critical illness, accident insurance, hospital indemnity and minimum essential coverage (preventive care). Prior to applying, watch our installation merchandisers in action. Now's your chance to Make Your Mark-just follow the instructions below to apply. You must show how you meet the basic qualifications in a resume or document you upload, or by completing the work experience and education application fields. Accepted file types are DOCX and PDF. Part-time employees with a work schedule less than 30 hours have access to a variety of voluntary benefits through Voluntary Benefits including dental, vision, critical illness, accident insurance, hospital indemnity and minimum essential coverage (preventive care). In compliance with the Immigration Reform and Control Act of 1986, Hallmark Cards, Inc. and its subsidiary companies will hire only individuals lawfully authorized to work in the United States. Hallmark does not generally provide sponsorship for employment. Employment by Hallmark is contingent upon the signing of the Employment Agreement, signing of an agreement to arbitrate in connection with the Hallmark Dispute Resolution Program, completing Form I-9 Employment Eligibility Verification, and successfully pass pre-employment (post offer) background check. Hallmark is an equal opportunity employer. All qualified applicants will be considered for employment without regard to race, color, religion, sex, age, pregnancy, national origin, physical or mental disability, genetics, sexual orientation, gender identity, veteran status, or any other legally-protected status. Principals only please. HALLMARK - Because Connecting With Each Other Has Never Been More Important For over 100 years, Hallmark has helped people connect and strengthen the relationships that matter most. Today, we're building the next century of connection- blending the warmth of in-store experiences with the ease of digital innovation. We're looking for empathetic learners, strategic thinkers, and enthusiastic visionaries from all backgrounds to help shape what's next. If you're ready to bring fresh ideas and energy, we'd love to have you on the team! At Hallmark, you'll feel welcomed from day one- whether you're remote, hybrid, or in-office. We'll tap into your strengths, offer leadership opportunities, and support your growth every step of the way. Our culture is rooted in care and inclusion. We celebrate diverse perspectives and actively seek out new voices- like yours- to help us grow and evolve. Let's imagine the future of Hallmark together!

**Resp & Qualifications** _CANDIDATES MUST LIVE IN THE MD, DC, NORTHERN VIRGINIA AREA IN ORDER TO TRAVEL INTO THE OFFICES AND FOR CLIENT MEETINGS AND STAFF MEETINGS_ **PURPOSE:** This position is responsible for **new business development** within the **middle market customer** space. This role leads sales initiatives and strategies as well as relationship building with both our external partners and prospects as well internal constituents. The sales consultant position requires a level of knowledge and understanding for selling to fully and self-insured customers with complex benefit arrangements. **ESSENTIAL FUNCTIONS:** + Achieve sales goals and profitable growth for the organization. + Position and sell multiple lines of coverage, medical, stop loss, dental and vision. + Excellent written and presentation skills. + Strategize on proposals to ensure we are meeting the clients objectives and delivering our value proposition. + Be proactive, organized, responsive, detail oriented and track all sales data within the required platforms. + Develop long term relationships with both internal and external constituents. + Ability to strategize and organize a team of subject matter experts for finalist meetings. + Continuously meet with our consultant partners and keep them informed on new products, updates, and relevant information to their business. **SUPERVISORY RESPONSIBILITY:** Position does not have direct reports but does require working closely with internal constituents to develop strategies for selling and presenting to consultants and prospects. **QUALIFICATIONS:** **Education Level:** Bachelors degree in business, Insurance Industry, or related field OR in lieu of a bachelors degree, an additional 4 years of relevant work experience is required in addition to the required work experience. **Licenses/Certifications:** + Current health and life license for the jurisdictions of Maryland, DC, and Virginia Required. **Experience:** 5 years sales/healthcare in a similar sales position. **Preferred Qualifications:** + 5+ years experience in a similar sales position with a competitor or similar industry. **Knowledge, Skills, and Abilities (KSAs)** + Ability to recognize, analyze, and solve for prospects challenges. + Excellent communication skills both written and verbal. + Must be able to meet established deadlines for proposals and work closely with internal constituents. **Travel Requirements** **Estimate Amount:** 80% This position is expected to travel to see consultants and prospective clients within the DC metro area. **Salary Range:** $72,000 - $117,000 **Salary Range Disclaimer** The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** CMLG New Business MD **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: ************************* **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-KL1 REQNUMBER: 21368

Help us automate and maintain our future. Get ready for a job that encourages you to think strategically yet stay connected with your teams. Do you have problem-solving or strategy experience? If so, prepare to innovate, create, and inspire. The Pharmacy Automation Engineer (Automation Engineering Lead Analyst) is primarily responsible for providing first-level electrical and process Controls support for a highly-automated pharmaceutical filling and packaging system. Perform emergency, corrective, and preventive maintenance activities to restore equipment. In addition, key responsibilities will involve implementing equipment and system upgrades, engineering change controls, and continuous improvements. The position will support equipment installations, upgrades, or equipment expansions. Automation engineer also trains, mentors, and supports the development of other team members Responsibilities Performs advanced level maintenance and service on automated equipment by using and understanding electrical, mechanical, and pneumatic drawings and schematics, and using special test equipment and tools. Maintains reliability of the pharmacy automation equipment by executing preventive, corrective, and emergency work orders. Troubleshoot, service, install and repair automated production equipment, to include equipment modifications, upgrades, and spare parts inventory Utilizes knowledge and skill to monitor and improve the Mean Time Between Failures (MTBF) of the electro-mechanical equipment, and supporting application software systems. Observe system for degraded performance using routine inspections, maintenance rounds, and diagnostic equipment. Use a computerized maintenance management system (MAXIMO) to record labor hours, repair parts, and monitor pharmacy equipment performance. Recommend alterations to developers and designers to improve the quality or performance of processes and/or machines. Interpret the output of the reporting systems and take appropriate action that will result in the removal of the root cause problem from the system on a permanent basis. Document all emergency, corrective, and preventive maintenance work via work orders associated with Computerized Maintenance Management System (CMMS - MAXIMO). Operates on-site in an on-call capacity. Qualifications High School diploma; Associates degree preferred. Associate's degree in Industrial Maintenance or related technical field or 2+ years of maintenance experience in an industrial setting preferred. 0+ years of relevant experience with a Bachelor's Degree and mechanical electrical experience related to automated, industrial equipment preferred. Experience working in high volume production or pharmaceutical environment. Experience in troubleshooting complex PLC/computer-operated electro-mechanical equipment; PLC's, I/O, and field devices; repairing, setting up, adjusting, and tuning mechanical systems and pneumatic systems. Experience using of all tools and procedures needed to repair precision electro-mechanical machinery successfully the first time. Experience using preventive and predictive maintenance techniques. Experience using Maintenance Management Systems (CMMS) to report and follow-up on maintenance procedures and work orders. Flexibility to occasionally work outside of normal shift hours, including occasional weekends, as needed to satisfy operational requirements in support of customer demand. Minimal travel to other ESI facilities or vendor sites is possible. Shift schedule: Sunday - Thursday (6am-2:30pm). If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Your Role The Health Qualify and Affordability team is a part of our larger Strategy & Health Solutions organization, which oversees provider partnerships & network management, health transformation acceleration, innovation, healthcare services, strategy, planning, and operations functions at Blue Shield. As an intern, you will support HQA Strategy Planning and Performance initiatives with a focus on analytics and process improvement for two key areas: Quality Review (Auditing Team) Workforce Management This internship offers hands-on experience in data analysis, performance measurement, and operational improvement within a dynamic healthcare environment. Your Knowledge and Experience Actively pursuing a bachelor's or master's degree in public health, business, health care or related field Minimum 1 year of related professional experience, project, or coursework Must reside in the state of California Strong communication skills required, particularly writing for publication Proactive, solution focused mindset with demonstrated creative, problem-solving skills Knowledge of the key synergies necessary among practices, payers, community, populations, and policy leaders to better align health care transformation efforts Passionate about changing healthcare and challenging the status quo to advance health equity Pay $25.00 per hour for Undergraduate $30.00 per hour for Graduate About Blue Shield of California As of January 2025, Blue Shield of California became a subsidiary of Ascendiun. Ascendiun is a nonprofit corporate entity that is the parent to a family of organizations including Blue Shield of California and its subsidiary, Blue Shield of California Promise Health Plan; Altais, a clinical services company; and Stellarus, a company designed to scale healthcare solutions. Together, these organizations are referred to as the Ascendiun Family of Companies. At Blue Shield of California, our mission is to create a healthcare system worthy of our family and friends and sustainably affordable. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. To achieve our mission, we foster an environment where all employees can thrive and contribute fully to address the needs of the various communities we serve. We are committed to creating and maintaining a supportive workplace that upholds our values and advances our goals. Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360 as a Top Regional Company, and one of the 50 most community-minded companies in the United States by Points of Light. Here at Blue Shield, we strive to make a positive change across our industry and communities - join us! About Our Internships Our paid internship program is thoughtfully curated to provide students experience and exposure to the health professional industry. Interns will be given the opportunity to get hands-on experience with real work projects, build meaningful relationship and connections within the organization, and experience our mission and enterprise goals through our program curriculum centered on our leadership model (Personal, People, Thought, and Results Leadership). To see more about our internship program, check out this video. Our Summer 2026 Internship is June 8th or June 15th through August 14th, 2026. Application Process and Timeline: Now: Actively accepting applications January: If you meet the requirements, you will receive an invitation to complete Pre-Recorded Video Interview January-February: 2nd round interviews & offers extended As an intern at Blue Shield of California, you will: Participate in impactful projects during a 10-week internship program Undertake a 10-week curriculum designed to familiarize interns with BSC, leadership development, exposure to the healthcare industry, and more Be invited to participate in BSC employee events and networking opportunities such as Employee Resource Groups, employee volunteer activities, and more Your Work In this role, you will: Assist in developing and maintaining analytics to support strategic planning and performance measurements Provide data-driven insights for the Quality Review team, including audit trends and compliance metrics Support Workforce Management by analyzing staffing models, productivity, and resource allocation Help create dashboards and reports for leadership to communicate performance outcomes Translate complex data into clear, actionable insights for business stakeholders Contribute to process improvement initiatives that enhance efficiency and accuracy in both areas Use appropriate tools and analytical methods to query, evaluate, and interpret data

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together, we will achieve our mission to enhance the health and well-being of the people and communities we serve. The Auditor, Payment Integrity role conducts pharmacy claim audits for Independence Blue Cross to ensure accurate provider payments, detect fraud, waste, or abuse, and improve audit processes. It requires a Certified Pharmacy Technician with at least four years of experience, including pharmacy and audit work, strong analytical skills, and proficiency in Microsoft Office and pharmacy claims systems. Conduct audits of claims submitted to Independence Blue Cross (IBX) to ensure accuracy of provider payments and charges. Analyze provider billing patterns to detect potential fraud, waste, or abuse. Perform audits through daily reviews, live audits, and desk audits to identify inappropriate billing practices. Review and verify provider billing records, collaborating with CFID audit analysts, auditors, investigators, internal, and external sectors Execute standard provider audit assignments using sound audit methodologies to uncover patterns of abuse or fraud. Screen and audit claim samples-both summary and detailed-to select cases for further review. Initiate and validate claim adjustments, maintain comprehensive audit documentation, and prepare statistical reports. Identify and escalate potential provider fraud or abuse to management. Contribute to the development and implementation of new audit processes and functions. Qualifications • Certified Pharmacy Technician (CPhT) required. • Minimum of four (4) years of relevant experience, including: • At least two (2) years in retail or hospital pharmacy. • At least two (2) years in pharmacy audit. • Extensive understanding of healthcare provider audit practices and medical terminology. • Familiarity with fraud, waste, and abuse detection methodologies. • Strong written and verbal communication skills for reporting and presenting audit findings • Proficiency in Microsoft Office applications, including Excel, Word, Outlook, SharePoint, and Access. • Advanced Excel skills (pivot tables, VLOOKUP, data analysis). • Experience with pharmacy claims systems such as RxTrack and RxClaim is preferred but not required. Fully Remote: This role is designated by Independence as fully remote. The incumbent will not be required to report to one of Independence's physical office locations to perform the work. However, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania. IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability. Must have an Android or iOS device that is compatible with the free Microsoft Authenticator app.

Disney Mental Health Concierge Organizational Engagement and Strategy * Consult with managers regarding important workplace issues: including, but not limited to, grief and loss in the workplace, job appropriate behaviors, employee/cast member terminal illness impacts and leadership support. * Facilitate critical incident response by consulting with requesting manager and direct service providers to arrange appropriate clinical services, including onsite services. * Work closely with EAP providers. Educate EAP providers regarding EAP protocols and expectations, and monitors compliance to standards. * Co-create and execute on engagement campaigns/promotion in collaboration with broader Evernorth/Cigna. Cast Member Engagement & Navigation * Primary point of contact and deployment for critical incident occurrences. * Collaborate with Matrix Partners to obtain necessary information to provide the most appropriate resources. * Provide onsite, virtual, and in-person navigation to emotional well-being resources, including EAP referrals, appointment setting assistance, provider searches, work/life programs, health coaching, case management, behavioral case management, etc. * Provide psychological first aid, assessment, and intervention for crisis situations as needed. * Ensure the appropriate next steps are put in place for referrals into medical, pharmacy or behavioral coaching programs, in addition to any alignment with a behavioral provider * Provide follow-up to all Cast Member connections that take place. * Identify and address SDOH needs such as food, housing medication, and transportation. * Assist in connecting Cast Members with identified community resources to meet their needs. * Work closely with Cast Members and Employees to ensure they have the support system they need to recover from their specific need, illness, or injury. * May facilitate and lead manager and employee mental health trainings. * Provide on-call and on-site services as needed. Expected to be available via email, text, or phone. General Expectations * Culturally trained on Disney Organizational, Cast Member and Employee roles and responsibilities, benefits, programs, and inventory of resources. * Will work on-site in Walt Disney World Park and be deployed to various locations as needed. * Will be available to all team members, for consultation. * Perform additional tasks/projects as needed, requested or assigned. * Attend all required trainings. * Comply with all Evernorth Behavioral Health policies and Standard Operating Procedures. * Take initiative for continued professional development. * Work closely with the Disney Account Team, Health Coaches, Case Managers, Onsite EAP providers, EACs, Behavioral UM and CM teams to align on cases and hand off appropriately as needed. * Will work directly with Disney Human Resources and Employee Relations teams as needed. * Consult with Cigna/Evernorth clinical supervisor when needed. * Open to suggesting and implementing improvements and enhancements to Mental Health Concierge role and responsibilities. Qualifications * Current unrestricted independent licensure in a behavioral health field or a medical field with experience in a psychiatric setting (LCSW, LMFT, LPC, LPCC, Licensed Psychologist or RN) * Master's Degree in Behavioral Health field * Knowledge and experience in accessing community resources to help cast members with basic needs. * Certified in Mental Health First Aid * CEAP (certified employee assistance professional) required to obtain within 2 years of employment. * 3+ years post-license mental health experience preferred * 3+ years experience responding effectively to diverse situations while working across all organizational levels. * Excellent communication and interpersonal skills with a focus on customer service * Effective conflict management and negotiation skills * Ability to adapt to change and problem solve * Strong time management and organization skills with an ability to set priorities in a fast-paced environment * Ability to utilize and navigate multiple technology systems * Bilingual in Spanish or Haitian Creole preferred * Knowledge of managed care preferred If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Your Role The Technology Services and Operations team supporting all end point systems and technology. The Technical Support Specialist will report to the Supervisor of End Point Field Services. In this role you will be assisting our customers with computer issues either on-site or remotely while providing the highest level of customer experience possible. Other tasks include imaging and deploying systems to customers for both break-fix and refresh for lease returns. Documenting Service Now with the highest quality notes and keep asset tracking system up to date. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building, and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Your Knowledge and Experience Typically Requires minimum of 3 to 5 years of experience. Vocational or technical education in addition to prior work experience desired. Experience working with Microsoft Client Operating systems Win10 in an operational support/administrative function. Experience working with Microsoft Office applications in an operational support/administrative function in a mid to large organization Experience supporting Cisco AnyConnect and security products on mac OS and Windows like Tanium, Crowd Strike, Symantec Endpoint, Microsoft Defender, Nessus, FireEye, or other industry standard security products. Experience/Exposure to device security policies. Experience in creating accurate and concise support documentation/training manual for support and service desk teams. Experienced or willing to learn custom reporting in JAMF, Microsoft Endpoint Manager and SCCM. Experience troubleshooting & supporting iOS & Android mobile MDM/MAM managed devices in regulated environments. Desired. Proficient and knowledgeable in Active Directory and related services such as DNS and DHCP including Group Policy, Kerberos, and LDAP #LI-EB1 Your Work In this role, you will: Responsible for providing direct installation, diagnostic and problem resolution for all personal computer (PC) hardware, related PC peripheral devices, software, and network services for all BSC employees. Provide guidance and support to team members with the testing, validation and deployment of operating system and application upgrades, patches, etc. Perform workstation provisioning tasks, including installation, configuration, and deployment of Microsoft Windows operating systems. Guide others as to the processes and procedures for workstation provisioning and deployment. Install and configure Microsoft Windows applications using manual, stand-alone and automated methods, and tools (e.g., SCCM, Microsoft Intune/Endpoint Manager, and JAMF). Ensure that assets laptops, desktops and VDIs are updated in Service Marketplace with correct state. Utilize tools and applications required for administration of Microsoft Windows workstations, including tools utilized for remote workstation access (e.g., RDP), Microsoft SCCM for application installations, Symantec anti-virus and Enterprise Vault clients, Active Directory for domain binding, group memberships and workstation policy configurations Demonstrate an in-depth understanding of the skills equivalent to the successful completion of CompTIA A+ certification, including Microsoft operating system fundamentals and file systems, as well as TCP/IP fundamentals, including configuration and administration of workstation and printer network connectivity (wired and wireless). Implement, maintain, and troubleshoot workstation file and folder permissions. Provide input and recommendations for the effective administration and management of workstation file and folder permissions, including Local Administrator Rights Demonstrate a strong understanding of Microsoft Active Directory components that pertain to Windows workstations (Organizational Units, policies, group memberships, etc.). Provide guidance and recommendations for efficient and effective organization of Active Directory configurations pertaining to end-user workstations Provide basic to complex support for mobile devices, including mobile device operating system functionality (iOS, Android, Windows Phone) and fundamental mobile device applications.

Your Role The Law Department Intern will work with the attorneys in the Law (Corporate Law, Litigation, Health Law, Privacy, and Compliance) and Government Affairs teams to support clients across the Company. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Your Knowledge and Experience Must be a current 1st or 2nd year Law School Student Must reside in the state of California Requires strong research, analytical, writing skills and strong interpersonal and communication skills Requires at least 1 year of related professional experience, project, or coursework Requires strong communication skills, particularly writing for publication Experience analyzing and presenting sets of data and reports preferred Interest in health care preferred Proactive, solution focused mindset with demonstrated creative, problem-solving skills Pay: $25.00 per hour for Undergraduate $30.00 per hour for Graduate About Our Internships Our paid internship program is thoughtfully curated to provide students experience and exposure to the health professional industry. Interns will be given the opportunity to get hands-on experience with real work projects, build meaningful relationship and connections within the organization, and experience our mission and enterprise goals through our program curriculum centered on our leadership model (Personal, People, Thought, and Results Leadership). To see more about our internship program, check out this video. Our Summer 2026 Internship is June 8th or June 15th through August 14th, 2026. Application Process and Timeline: Now: Actively accepting applications November: If you meet the requirements, you will receive an invitation to complete Pre-Recorded Video Interview November - January: 2nd round interviews & offers extended As an intern at Blue Shield of California, you will: Participate in impactful projects during a 10-week internship program Undertake a 10-week curriculum designed to familiarize interns with BSC, leadership development, exposure to the healthcare industry, and more Be invited to participate in BSC employee events and networking opportunities such as Employee Resource Groups, employee volunteer activities, and more Your Work In this role, you will: Review and draft pleadings, contracts, board minutes, and legal memos Attend client meetings Conduct legal and policy research Perform other special assignments

Your Role The AI and Analytics team oversees the artificial intelligence platform and analytical functions. In this role, you will be providing critical analytics support to our healthcare insurance clients (BlueShield of California and other health plans). This role is responsible for driving data-informed strategies and delivering actionable insights to optimize marketing campaigns and improve business outcomes. The ideal candidate is a strategic thinker with a strong analytical mindset and a passion for using data to solve complex Marketing business problems. They would be leading projects end-to-end, independently presenting insights to senior leadership, and mentoring junior analysts. Your Knowledge and Experience Bachelor's degree in Statistics, Mathematics, Economics, Computer Science, Marketing, Business Analytics, or related quantitative field Master's degree in Data Science, Statistics or Business Analytics (preferred) Requires 10+ years of experience in a marketing analytics role Proven experience in providing analytics support to clients or internal stakeholders in a consultative capacity. Experience with meeting with senior stakeholders within or external to the company Demonstrated ability to communicate complex ideas clearly, with strong presentation skills and a proven track record of delivering impactful insight to diverse stakeholders. Strong proficiency in SQL for data extraction, manipulation, and analysis. Expertise in Python for statistical analysis, predictive modeling, and data automation. Advanced skills in Tableau for creating interactive dashboards and data visualizations. Demonstrable experience in building and deploying marketing mix models, acquisition and retention models and brand effectiveness models for marketing teams. Solid understanding of web analytics and customer journey analytics. Proven experience with experimentation methodologies (A/B, MAB, MVT) Requires five years of experience in Health Care (managed care, academic, or gov't payer) Experience with Generative AI (GenAI) and Large Language Models (LLMs) in a marketing or analytics context (preferred) Hands-on experience with the Databricks platform for large-scale data processing and analytics (preferred) Experience with CRM platforms (e.g., Salesforce) (preferred) Cloud Platforms: AWS, Azure, or Google Cloud experience (preferred) Certifications in analytics tools like Adobe Analytics and Databricks (preferred) #LI-EB1 Your Work In this role, you will: Design, execute, and analyze marketing campaigns across various channels to measure their effectiveness and provide recommendations for optimization. Develop and maintain dashboards and reports to track key performance indicators (KPIs) and communicate campaign performance to stakeholders. Utilize advanced analytical techniques to segment customer data, identify target audiences, and personalize marketing messages. Develop and refine customer personas to enhance campaign relevance and drive engagement. Build and deploy predictive models to forecast marketing outcomes, identify at-risk customers, and uncover new growth opportunities. Generate actionable insights from Marketing datasets to inform strategic decision-making and drive business growth. Develop marketing mix, brand effectiveness, and acquisition/retention models • Design and implement A/B and multivariate tests to optimize website performance, user experience, and conversion rates. Analyze test results and provide data-driven recommendations for continuous improvement. Create and maintain interactive dashboards and data visualizations using Tableau to provide real-time insights into marketing performance. Communicate complex data stories in a clear and compelling manner to both technical and non-technical audiences. Provide detailed specifications for the marketing Datamart to IT developers and ensure it is built in alignment with the analytics team's requirements. This DataMart will support key functions such as insights generation, dashboarding, model development, and facilitate self-serve Adhoc requests via agentic solutions. Independently lead and execute complex marketing analytics projects from start to finish, delivering insights and strategic recommendations to senior leadership with a sharp focus on uncovering opportunities that drive business growth. Serve as a trusted advisor to Stellarus clients, providing expert analytics support and strategic guidance. Collaborate with client teams to understand their business objectives and translate them into analytical requirements. Apply strong critical thinking and presentation skills to effectively communicate insights to stakeholders. You will also manage stakeholder relationships with professionalism, demonstrating the ability to navigate conflicts and foster collaboration. Mentor and guide junior analysts on the team.

Summary: This position is responsible for investigating, evaluating and negotiating settlement of assigned large loss Commercial Auto Body Injury Claims in accordance with best practices and to promote retention or purchase of insurance from Grange Enterprise. If you're excited about this role but don't meet every qualification, we still encourage you to apply! At Grange, we value growth and are committed to supporting continuous learning and skill development as you advance in your career with us. What You'll Be Doing: Pursuant to line of business strategies and good faith claim settlement practices, investigates, evaluates, negotiates, and resolves (within authorized limits) assigned claims. Demonstrates technical proficiency, routinely handling the most complex claims with minimal manager oversight. Establishes and maintains positive relationships with both internal and external customers, providing excellent customer service. Assists in building business relationships with agents, insureds and Commercial Lines partners through regular, effective and insightful communications. May include face-to-face as needed. Will be the “point person” (when required) for certain identified large customer accounts where specialized communication and handling are required. Regularly develops and mentors other associates. Assists leadership in advancing the technical acumen of the department through the development of formal and informal training and resources. Establishes and maintains proper reserving through proactive investigation and ongoing review. Assists other departments (when required) with investigations. May be assigned general liability claims during high volume workload periods. Demonstrates effectiveness and efficiencies in managing diary system and handling workload with limited supervision or direction. What You'll Bring To The Company: High school diploma or equivalent education plus five (5) years claims experience with at least three (3) years of Commercial Casualty experience. Experience in General Liability preferred. Bachelor's degree preferred. Must possess strong communication and organization skills, critical thinking competencies and be proficient with personal computer. Requires excellent decision-making ability, a broad depth of experience and technical competence and capacity to manage work to meet time sensitive deadlines. Demonstrated ability to interact with internal and external customers in a professional manner. State specific adjusters' license may be required. About Us: Grange Insurance Company, with $3.2 billion in assets and more than $1.5 billion in annual revenue, is an insurance provider founded in 1935 and based in Columbus, Ohio. Through its network of independent agents, Grange offers auto, home and business insurance protection. Grange Insurance Company and its affiliates serve policyholders in Georgia, Illinois, Indiana, Iowa, Kentucky, Michigan, Minnesota, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and Wisconsin and holds an A.M. Best rating of "A" (Excellent). Grange understands that life requires flexibility. We promote geographical diversity, allowing hybrid and remote options and flexibility in work hours (role dependent). In addition to competitive traditional benefits, Grange has also created unique benefits based on employee feedback, including a cultural appreciation holiday, family formation benefits, compassionate care leave, and expanded categories of bereavement leave. Who We Are: We are committed to an inclusive work environment that welcomes and values diversity, equity and inclusion. We hire great talent from various backgrounds, and our associates are our biggest strength. We seek individuals that represent the diversity of our communities, including those of all abilities. A diverse workforce's collective ideas, opinions and creativity are necessary to deliver the innovative solutions and service our agency partners and customers need. Our core values: Be One Team, Deliver Excellence, Communicate Openly, Do the Right Thing, and Solve Creatively for Tomorrow. Our Associate Resource Groups help us create a more diverse and inclusive mindset and workplace. They also offer professional and personal growth opportunities. These voluntary groups are open to all associates and have formed to celebrate similarities of ethnicity/race, nationality, generation, gender identity, and sexual orientation and include Multicultural Professional Network, Pride Partnership & Allies, Women's Group, and Young Professionals. Our Inclusive Culture Council, created in 2016, is focused on professional development, networking, business value and community outreach, all of which encourage and facilitate an environment that fosters learning, innovation, and growth. Together, we use our individual experiences to learn from one another and grow as professionals and as people.  We are committed to maintaining a discrimination-free workplace in all aspects, terms and conditions of employment and welcome the unique contributions that you bring from education, opinions, culture, beliefs, race, color, religion, age, sex, national origin, handicap, disability, sexual orientation, gender identity or expression, ancestry, pregnancy, veteran status, and citizenship.

Bilingual Spanish Onsite Health Coach - Evernorth Workplace Care - Miami FL Evernorth Workplace Care offers health care delivery services along with population health and health coaching solutions, conducted in person. Our mission is to deliver proactive, personalized, and holistic patient care and coaching by acting on health data and insights to improve the overall health and wellness of our clients' employees, and those they care about most, by providing access to high quality, affordable services where they work and live. Our Evernorth Workplace Care solution isn't a one-size-fits-all model. Using data-driven insights, we'll customize a solution that addresses your organization's most pressing needs-creating a more affordable, predictable, and simple health care experience. Evernorth Workplace Care - Personalized Care Where You Are Our experienced Health Coach will: • Provide onsite face-to-face customer coaching and support • Identify customer health education needs through targeted health assessment activities. • Collaborate with customers to establish health improvement plans, set personalized evidence-based goals, and support customers in achieving those goals. • Empower customers to become an active participant in their own health outcomes. • Assist Customer in overcoming barriers to better health • Lead and support a variety of Health and wellness promotional activities, such as group coaching, wellness challenges and Health related seminars. • May perform biometric screenings, including finger sticks, blood pressure, body composition, etc. • Utilize biometric values and motivational interviewing techniques to collaborate with customer to drive to improve clinical outcomes. • Provide support for health-related site events, which include open enrollment, wellness committee facilitation, flu shot events, health fairs, etc. Qualifications: • Strong Clinical skills with at least 3 or more years of experience health coaching, health education and health promotion • Bachelor's degree in a health-related field. Master's degree preferred. • Registered Dietitian licensed in respective state is preferred • CPR/BLS certification through the American Red Cross or American Heart Association is required. • High energy level, with dynamic presentation skills is required. • Positive role model in demonstrating healthy behaviors • Passion for health improvement • Ability to work independently • Customer-centric focus • Ability to proactively collaborate professionally with the client and other matrix partners. • Understand and own a variety of clinical targets and outcome measurements. Develop action plans that drive clinical value for the customers and clients. • Proven administrative abilities, with strong computer and software application skills. • Bilingual Spanish and ability to pass oral and written assessments Bonus points for: • CHES (Certified Health Education Specialist) • Motivational interview training/experience. • Smoking cessation and diabetes experience. This role is based in person in Miami FL. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. About Evernorth Health Services Evernorth Health Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction, prevention and treatment of illness and disease more accessible to millions of people. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Join our team as a Cyber Security Analyst and help safeguard critical systems while driving innovation in security practices. We are looking for a proactive professional who thrives in a collaborative environment and is passionate about protecting data and infrastructure. Responsibilities Lead efforts to monitor and maintain security across servers, networks, and endpoints. Administer and enhance network security defenses to prevent breaches. Analyze vulnerabilities and implement solutions to strengthen system integrity. Respond to and investigate cyber incidents, ensuring timely resolution and documentation. Develop and maintain security policies, standards, and guidelines aligned with best practices. Collaborate with IT teams to ensure security controls, and compliance and risk management strategies are effective. Educate staff on cybersecurity awareness and best practices. Qualifications Required: Minimum 5 years of experience in cybersecurity, network engineering, or system analysis. Strong knowledge of incident response, intrusion detection, and risk management. Proficiency in analyzing complex systems and security audit results. Excellent communication and problem-solving skills. Preferred: Bachelor's degree in Computer Science or related field. Certifications such as CISSP, CEH, or CISA. Experience with Windows Server, Linux, Cisco, and security tools like Wireshark. Since 1981, Allegiance by Cigna Healthcare has specialized in the administration of medical benefits, offering core services such as claims processing, customer service, utilization management, and case management. Backed by a unique high-touch approach to both member and client service, Allegiance supports and administers some of the nation's most innovative approaches to Health Plan benefits. If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an hourly rate of 32 - 49 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.

Your Role Reporting to the VP, Network Operations, the Director, Provider Services - Relations, Blue Shield of California and Promise Health Plan (BSCPHP), is responsible for creating and maintaining high integrity relationships with risk-baring medical providers, hospitals and health systems in their assigned region to enable BSCPHP to become the health plan of choice. The outcome of being the ideal partner for our providers will be to materially improve cost, quality, maintain compliance, service and together grow membership in service to our communities across BSCPHP business. The Director will lead in a highly matrixed environment across multiple internal business teams to provide strategic alignment, business planning, and effective execution of the business plans for all providers in their region for BSCPHP business as well as partner with all lines of business as they impact our Provider Network. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning. Your Knowledge and Experience Requires a college degree or equivalent experience. Master's degree is preferred Requires 10 years prior relevant experience in Provider Relations or healthcare network contracting Requires 6 years of management experience and must be comfortable operating in a matrixed/collaborative environment Minimum 5 years of direct Medicare and Medi-Cal experience with a Managed Care Organization (MCO) preferred Previous experience in management of process analysis and improvement Experience in the development of policies and procedures pertaining to Network Management Strong experience and orientation to the quadruple aim coupled with knowledge of markets, sales, operations, product development, network management, clinical operations, finance, regulatory issues and compliance Able to collaborate and work strategically in a team setting with various professional, technical, and administrative staff, integrating resources in a timely and organized manner Comprehensive knowledge of managed care risk contracts and the operational requirements involved in managing a provider network Outstanding verbal and written communication abilities, with demonstrated effectiveness when engaging executive leadership Demonstrated ability to build enduring, trustworthy relationships and effectively interact across all organizational levels, both internally and externally Ability to lead and manage significant culture change. Demonstrated experience with change and organization management; possess a performance driven management style Strong leadership skills, including excellent interpersonal, communications, problem solving and negotiating skills Ability to think strategically while at the same time drive operational performance Proven project management experience applying industry methodologies and practices Technologically savvy and able to utilize information systems and Office software effectively Proven ability to mentor and coach leaders in their respective teams Your Work In this role, you will: Lead the Provider Relations team which serves as the primary liaison between BlueShield and Blue Shield Promise Health Plan and the contracted provider networks upholding transparency, integrity, and reliability in interactions with both internal and external stakeholders Oversee the management of provider concerns, including but not limited to contract interpretations, claims discrepancies, eligibility and capitation payment issues, credentialing challenges, service area changes, rate load corrections, retroactive member assignments, provider terminations, member moves and third-party disputes Develop and implement an operations engagement strategy that incorporates statewide Joint Operations Meetings, inclusive of Medi-Cal requirements, and includes interaction with provider leadership. The aim is to support provider satisfaction with Blue Shield, encourage provider wellness, and maintain operational performance in areas such as access to care, member experience, affordability, and sustainability Manage structured processes for claims disputes and appeals, driving research, root cause analysis, and corrective action plans to prevent recurring issues Deliver expert insight and guidance for strategic and operational initiatives impacting Provider Relations, driving effective execution of implementation tasks within the team's scope Provide effective and detailed thought leadership to inform the Blue Shield Provider Engagement Model working with the Performance Enablement Team Work collaboratively with Provider Partnerships and the Regional Medical Directors, along with other internal provider-facing partners, to execute an overall strategic engagement strategy Identify and implement process improvement as it pertains to provider operations, contract and regulatory compliance, efficient relationship management and other areas Establish operational Key Performance Indicators to assess the effectiveness and performance of the Provider Relations team. Define baseline metrics, set measurable targets, and drive achievement through ongoing process improvement Assess regulatory, government, or organizational mandates to ensure Blue Shield and Blue Shield Promise Health plans comply with all requirements. Work collaboratively with various departments to maintain internal compliance with regulations by leading workgroups and taskforces Build and lead a high-performing team that meets all operating goals, including cost of health care, clinical quality improvement, regulatory compliance, administrative costs and employee engagement Foster a culture of innovation and creativity to enable Blue Shield of California to meet changing market conditions and strategy Promote and model a collaborative and partnership-oriented culture by cultivating strong relationships with internal stakeholders to achieve collective success

Are you ready to launch your Healthcare Fraud Investigator career and make a real difference? If you're a recent college graduate eager to take the first step in your professional journey, this early‑career opportunity is designed for you. This is a fantastic opportunity for someone with a Bachelors degree in Criminal Justice and is early in their career seeking to grow in a dynamic organization. As a Junior Fraud Investigator for Cigna's Special Investigations Unit, you'll support our US Commercial Healthcare Business in conducting and supporting audits and investigations of potentially fraudulent claim activity by providers. You will bring investigative and analytics skills that include planning, developing and implementing investigative processes and procedures, along with making recommendations for potential corrective actions that include prosecution, recovery and/or litigation based on investigative findings. What you'll do: Analyze information gathered by investigation/audit and report findings and prepare written summary/recommendations Prepare evidence package for referral to third parties including contract holders, state insurance fraud bureaus and law enforcement agencies Support on-site inspections and patient/provider interviews as necessary Respond to subpoenas and requests for information from law enforcement agencies and State Departments of Insurance. May represent company as a witness in judicial proceedings when appropriate Prepare reports to expedite tracking and reporting of investigations What you need to do the job: A bachelor's degree in a Criminal Justice, or related field (Economic Crime) 1+ years professional work experience, preferably with health insurance investigations/audit Outstanding technical & analytical skills, with particular proficiency with Access, Excel and Word Excellent verbal and written communication skills, along with ability to effectively manage conflict Keen ability to deal with ambiguity and leverage reasoning skills Possession of a strong desire and demonstrated ability to lead If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.For this position, we anticipate offering an annual salary of 56,700 - 94,500 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. At The Cigna Group, you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here. About The Cigna Group Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we're dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. If you require reasonable accommodation in completing the online application process, please email: ********************* for support. Do not email ********************* for an update on your application or to provide your resume as you will not receive a response. The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.