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HCSC jobs - 1,197 jobs

  • Coding Investigator Auditor

    HCSC 4.5company rating

    HCSC job in Danville, IL

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position is responsible for performing clinical, billing, coding and lowest cost setting reviews for services pre and post payment utilizing medical, contractual, legislative, policy, and other information to validate claims submitted and billed. Conducting research; preparing documentation of findings and consulting with medical directors as needed. Coordination with all departments involved in each case required such as special investigations, customer service, pass, network management, marketing, case management, medical review, legal, pricing and database. Required Job Qualifications: * Bachelor Degree; one year of business experience, law enforcement experience, or regulatory agency experience may substitute for each year of college. * Certified Coding Certification, or acquire within 24 months of hire * 3 years experience in claims processing operations and reporting systems, including 2 years experience in auditing or developing computer system reports. * Knowledge of accreditation, i.e. URAC, NCQA standards and health insurance legislation. * Awareness of claims processes and claims processing systems. * PC proficiency to include Microsoft Word and Excel and health insurance databases. * Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings. * Organizational skills and prioritization skills Preferred Job Qualifications: * Registered Nurse (RN) with unrestricted license in state. * Certified Coder preferred * 3 plus years of claim adjudication/payment integrity * 3 years clinical experience This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state. #LI-Remote #LI-DP1 * CA Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $54,800.00 - $121,100.00 Exact compensation may vary based on skills, experience, and location.
    $54.8k-121.1k yearly Auto-Apply 14d ago
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  • Healthcare Project Delivery Specialist - National Partnerships

    HCSC 4.5company rating

    HCSC job in Chicago, IL

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position projects as functional liaison between the Intake team, and operations teams. Reviewing project scope, supporting business needs across delivery cycle and production and/or system change requests to deliver on enterprise initiatives. Researching and analyzing business impacts against project scope and supporting effective project delivery. Responsible for medium complexity business delivery initiatives that could cross multiple business functions. Facilitating communication of changes and any updates needed as a result of enhancements delivered to impacted business units. Required Job Qualifications: * Bachelor's degree and 3 year of experience in project management, method analysis, or operations/systems analysis OR 7 years of experience in project management, method analysis, or operations/systems analysis. * Knowledge of business process design. * Knowledge of SDLC and Agile delivery methodologies, * Clear and concise verbal and written communication skills. * Customer service and interpersonal skills and tactful in dealing with people. * PC proficiency with Microsoft applications including Access, Excel, Word and Power Point. Preferred Job Qualifications: * Health insurance industry experience. This is a Flex (Hybrid) role: 3 days in office; 2 days remote. Sponsorship is not available. #LI-MW2 #LI-Hybrid Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $60,300.00 - $133,400.00 Exact compensation may vary based on skills, experience, and location.
    $60.3k-133.4k yearly Auto-Apply 20d ago
  • Physician / Administration / Oklahoma / Permanent / Medical Director - Medicaid (remote)

    Humana 4.8company rating

    Remote or Oklahoma City, OK job

    Become a part of our caring community and help us put health first The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.
    $213k-308k yearly est. 1d ago
  • Member Customer Service, Benefit Value Advisor

    Health Care Service Corporation 4.1company rating

    Danville, IL job

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** Being A Compassionate And Dedicated Advocate For The Member To Demonstrate A Concierge Attitude When Assisting Members With Maximizing Their Benefits. Navigating The Healthcare System And Reaching Their Optimal Health. Responsible For Working On The Phone All Day In A Call Center To Assist Members And Physicians By Responding To Telephone And Written Inquiries In A Prompt, Accurate And Objective Manner. Conducting Research. Spending Approximately 90 Of The Scheduled Time On The Phone According To Business Need. JOB REQUIREMENTS: * High school diploma OR GED. * 6 months customer service experience OR 6 months experience in an office environment. * Clear and concise verbal and written communication skills, including motivational interviewing to interact with the members and physicians. * Expertise and ability to successfully execute concierge level service for all members. * Experience evaluating customer situations, making decisions, and responding quickly to questions. * Data entry and/or typing experience. * Interpersonal, verbal, and written communication skills and independent decision-making skills. * Analytical and organizational skills. * Ability to spend approximately 90% of the scheduled time on the phone according to business needs and sit for long periods of time with scheduled breaks. * Web and PC proficiency. PREFERRED JOB REQUIREMENTS: * 6 months customer service experience in a health care or health insurance environment. * 6 months data entry experience in an office environment. * Knowledge with health benefit plans and the insurance industry. * Experience working with additional offerings (Ex: CDHP, Medicare, Wellness, Care and Condition Management). * Knowledge of medical terminology and anatomy. **This role will work onsite at the office address listed and the primary schedule will be Monday - Friday within 8am-6pm, based on business need. Pay will start at $22.50/hour.** **\#LI-TB1** **\#INKT** **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $17.75 - $27.83 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $17.8-27.8 hourly 15d ago
  • Modern AI Scientist

    Healthcare Services 4.1company rating

    Remote job

    Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers' toughest challenges. While we continue updating the Solventum Careers Page and applicant materials, some documents may still reflect legacy branding. Please note that all listed roles are Solventum positions, and our Privacy Policy: *************************************************************************************** applies to any personal information you submit. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Description: AI Scientist - Modern AI Applications 3M Health Care is now Solventum At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers' toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you. The Impact You'll Make in this Role As a Principal AI Scientist with deep expertise in Agentic AI, Generative AI, and Natural Language Understanding (NLU), you will lead high-impact technical innovation in HIS applications. In this role, you will be a hands-on research and development leader - driving technical breakthroughs, designing novel AI architectures, and directly influencing the integration of advanced AI into mission-critical healthcare products. You will collaborate closely with other scientists, engineers, and domain experts to create solutions that are explainable, reliable, and transformative for healthcare operations. Key Responsibilities Research & Innovation Design, prototype, and evaluate novel AI models for autonomous, agent-based systems in healthcare workflows. Advance state-of-the-art NLU for clinical, operational, and administrative healthcare text. Explore and implement new capabilities in reasoning, decision-making, and multi-modal understanding. Healthcare-Focused AI Development Adapt and fine-tune large language models to handle healthcare-specific language, regulatory requirements, and ethical considerations. Create AI pipelines that can process structured and unstructured healthcare data (FHIR, HL7, clinical notes, claims data). Contribute to domain-specific model architectures that improve clinical decision-making, revenue cycle management, and patient engagement. Technical Leadership Serve as the primary technical authority on Agentic and Generative AI within project teams. Mentor junior AI scientists and engineers through code reviews, research guidance, and technical workshops. Drive internal knowledge-sharing on emerging AI trends, frameworks, and best practices. Operational & Compliance Excellence Implement rigorous model evaluation frameworks for accuracy, robustness, and fairness. Ensure compliance with healthcare privacy and data security regulations (HIPAA, HITRUST). Partner with engineering to move research prototypes into production environments. Required Qualifications Master's in Computer Science, AI, Machine Learning, or related field AND 5+ years of experience in AI/ML, with a strong portfolio of deployed models. Or PhD in Computer Science, AI, Machine Learning, or related field AND 3+ years of experience in AI/ML, with a strong portfolio of deployed models. Experience in Python, R, and modern ML libraries. Experience with GenAI, LLMs, and transformer architectures. Experience with AI development tools and frameworks (PyTorch, TensorFlow, Hugging Face, LangChain, RAG systems). Preferred Skills Multi-modal AI research experience (text, image, structured data). Knowledge graph integration and symbolic reasoning expertise. Proven ability to take AI research from concept to production. Hands-on experience with autonomous AI agents and reasoning systems. Strong track record applying AI to healthcare or life sciences use cases. Familiarity with cloud platforms (AWS) and MLOps practices. Work location: US Remote Travel: May include up to 10% domestic Relocation Assistance: Is not authorized Must be legally authorized to work in the country of employment without sponsorship for employment visa status (e.g., H1B status). Supporting Your Well-being Solventum offers many programs to help you live your best life - both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope. Onboarding Requirement: To improve the onboarding experience, you will have an opportunity to meet with your manager and other new employees as part of the Solventum new employee orientation. As a result, new employees hired for this position will be required to travel to a designated company location for on-site onboarding during their initial days of employment. Travel arrangements and related expenses will be coordinated and paid for by the company in accordance with its travel policy. Applies to new hires with a start date of October 1st 2025 or later.Responsibilities of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties. Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers. Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain *****************. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains. Please note, Solventum does not expect candidates in this position to perform work in the unincorporated areas of Los Angeles County.Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status. Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly. Solventum Global Terms of Use and Privacy Statement Carefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at Solventum are conditioned on your acceptance and compliance with these terms. Please access the linked document by clicking here, select the country where you are applying for employment, and review. Before submitting your application you will be asked to confirm your agreement with the terms.
    $79k-120k yearly est. Auto-Apply 36d ago
  • Sr Business Solutions Consultant

    Health Care Service Corporation 4.1company rating

    Chicago, IL job

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This position is responsible for leading business analysis, ensuring alignment and integration across functional areas in support of divisional strategies, and ensuring consistency and efficiency of major, complex, and strategic cross-divisional and enterprise-wide projects and initiatives from inception to completion. Provides oversight & coordination of project teams, resources, and budget to implement projects or initiatives according to dynamic and critical timelines. Interacts with all levels of management including senior management. Supports the prioritization of transformational program activities and tracks progress to goals. Support writing and executing test cases based on business requirement hands on experience with SQL excel and test management **NOTE: This hybrid role can be located in CHICAGO IL, NASHVILLE, TN or RICHARDSON TX ~ relocation will not be offered; sponsorship is not available.** **Required Job Qualifications:** *** Bachelor's degree and 5 years of experience OR 9 years of experience in business testing, business analysis, process improvement,** project management, business operations or relevant health care industry experience * 3 years of experience leading with large and complex multi-million-dollar projects. * Experience communicating with senior management from multiple divisions. *** Experience developing and delivering presentations.** * Problem resolution experience and skills. * Knowledge of strategic planning techniques and industry trends * Experience interpreting business and financial information * Negotiations skills. *** Verbal and written communications skills including establishing working relationships across departments, preparing presentations to senior management, and establishing team environment.** * Organizational skills. * Experience managing multiple complex projects successfully. * Detail oriented. * PC proficiency to include MS Office products * Knowledge and/or experience with: + **· Medicare Part A/B/D** + · Provider workflows & Provider application - Symplr + · EDI formats - 837 I&P, 276/277, 270/271, 278, 834 + · Member Enrollment - Elements application + · Member Collaterals + · Provider Credentialing - sCRED application + · Claims Intake process + · Claims Adjudication logic - FACETS application + · EOB + · Provider Payments - 835 remittance files & EOP + · CMS reporting + · SalesForce + · Evolve/Broker *** Test case management tools such as Zephyr** * Agile tool such as Jira/Rally * SQL * Health insurance or healthcare industry experience with emphasis on Product/Sales knowledge **Preferred Required Job Qualifications:** * Proven strategic thinking and execution * Ability to drive decisions, create optionality and determine impacts of options \#LI-BS1 \#LI-Hybrid \#INCR **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $82,700.00 - $149,300.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $82.7k-149.3k yearly 60d+ ago
  • Physician Review Coordinator - LHB

    HCSC 4.5company rating

    Remote HCSC job

    At Luminare Health , our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job SummaryThe Physician Review Coordinator is primarily responsible for initiation and oversight of the Healthcare Management Division's physician-level review process with Independent Review Organizations. Additionally, when business needs warrant, the individual conducts medical necessity reviews utilizing evidence-based medical criteria.Required Job Qualifications: Active RN License required Minimum three years of experience in a clinical setting Active MCG UM/CM Certification or obtain MCG UM/CM Certification within 6 months of hire Possess strong time management and organizational skills Ability to work independently and complete tasks in a timely manner, reprioritizing workload to meet customer and business needs Willingness to adjust and adapt to meet the business needs in an atmosphere that sometimes requires rapid change Comfort with telephonic and written communications with all levels of leadership within the organization, providers, IROs and business contacts in an efficient, professional manner Excellent customer service and interpersonal skills Comfort with using electronic applications including electronic documentation system and the ability to accurately document electronically while engaging callers or reviewing medical documents Excellent verbal and written communication skills Ability to use commonsense understanding to carry out instructions furnished in written, oral or diagram form Demonstration of excellent critical thinking skills to deal with problems in varying situations and reach reasonable solutions Proficient in MS Word, Excel and Outlook with the willingness to expand knowledge of the MS Suite of tools Preferred Job Qualifications: Utilization Management, Case Management, or Claims experience with a TPA or insurer highly preferred Bachelor of Science in Nursing Must reside in one of the following States: Illinois Montana New Mexico Oklahoma Texas Indiana Missouri Wisconsin Iowa Kansas North Carolina Pennsylvania Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! EEO Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Pay Transparency Statement: At Luminare, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for associates. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. Min to Max Range: $56,700.00 - $106,400.00 Exact compensation may vary based on skills, experience, and location.
    $56.7k-106.4k yearly Auto-Apply 41d ago
  • Assistant General Counsel - Contracting

    Health Care Service Corporation 4.1company rating

    Chicago, IL job

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This is an opportunity for a motivated lawyer to provide counsel relating to complex contracting, including vendor, provider network, producer/customer, and strategic sourcing contracting. In a highly complex and evolving legal and technology environment, the ideal candidate will provide sound, actionable legal advice on regulatory, business, and operational matters. A successful candidate will serve as a partner to our business leaders in developing adaptive strategies to support HCSC's established business and to further its growth while continually advancing HCSC's mission. HCSC is the largest customer-owned health insurer in the United States, operating Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. In addition to its core health insurance offerings, HCSC is proud to serve millions of people through a diverse portfolio of businesses that provide adjacent products and services. These companies help advance HCSC's goal of expanding access to quality, cost-effective health care to help people live healthier. The position can be based in Chicago, Illinois; Richardson, Texas; Tulsa, Oklahoma; Albuquerque, New Mexico; Helena, Montana, or Nashville, Tennessee. Please note this role is a hybrid role. This requires in-office hours 3 days a week at the respective office location. Sponsorship is not available for this position. **JOB REQUIREMENTS** **:** + Juris Doctor Degree and a license to practice law in the state where the legal department is located. + 5 years' experience as a practicing attorney after receiving a law degree. + Clear and concise verbal and written communication skills. **PREFERRED JOB REQUIREMENTS** **:** + Knowledge or understanding of the health care, health insurance, or claim administration field. + 3+ years' experience advising providers, insurers, or other health care entities. \#LI-AZ1 \#LI-Hybrid **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $118,800.00 - $220,800.00 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $118.8k-220.8k yearly 60d+ ago
  • Strategic Account Executive; U500 (Hybrid/Atlanta, GA)

    The Cigna Group 4.6company rating

    Remote or Atlanta, GA job

    As a Strategic Account Executive, you are the face of Cigna to the client. Your focus is on spending time with clients in person to cultivate the relationship, addressing client issues, selling annual renewal rate increases in addition to new products and services to expand the relationship. You will be the trusted advisor and go-to partner for your clients, helping them navigate their business challenges and opportunities by offering strategic insights and ensuring an exceptional client and customer experience. **Key Responsibilities:** + Client Partnership: Act as a key influencer and trusted advisor, cultivating strong, personal relationships with decision-makers and other key stakeholders. + Industry Expertise: Deeply understand your clients' businesses, their industries, and their unique challenges. Continuously learn and adapt, offering tailored recommendations that address both their immediate needs and long-term goals. + Relationship Building: Engage at all levels with both decision-makers and those who influence the decision-making process, ensuring Cigna's voice is heard and valued. + Market Insights: Keep clients informed about the latest industry trends, helping them stay ahead of the curve and leveraging Cigna's solutions to meet their evolving needs. + Financial & Underwriting Expertise: Strengthen your understanding of financials and underwriting to guide clients in managing their costs. Demonstrate the value of Cigna's solutions, including specialty products, and offer creative, proactive solutions to meet their needs. + Portfolio Management: Drive growth, earnings and retention across your client portfolio, meeting targets for both new business and renewals. Work to expand Cigna's relationships through cross-selling additional products and services. + Collaboration: Work closely with underwriting teams to ensure alignment, build trust, and ensure clients receive tailored, strategic solutions. + Client Experience: Oversee client service requests, ensuring seamless execution and swift resolution by directing them to the right team for problem-solving. + Channel Management: Manage key partner relationships to ensure client budgets align with reality, holding internal partners accountable and leveraging resources as needed to maintain success. **What You Bring:** + Strong relationship-building skills and a passion for developing deep client connections + Expertise in financials, underwriting, and providing strategic solutions + A collaborative mindset with the ability to work effectively across teams + Proactive, creative thinking to develop tailored solutions for each client + A desire to grow with a company that's committed to delivering innovative solutions in an ever-changing industry At Cigna, we value people who bring both strategic insight and a hands-on approach to client management. If you're driven by client success and want to work for an organization that values both innovation and personal relationships, we want to hear from you! **Qualifications** + Bachelor's degree or equivalent experience. + Experience: 3+ years of experience in health benefits or client management **Skills:** + Strong communication, sales negotiation, and relationship-building skills. + Proven ability to manage and grow client relationships, particularly with clients + Experience in sales, marketing, underwriting, or operations is preferred. + Financial acumen with the ability to identify and drive growth opportunities within the book of business. + Additional: Demonstrated success in managing large, complex client accounts with a focus on relationship-building and revenue growth. 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 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._
    $86k-116k yearly est. 55d ago
  • Sr Staff Actuary

    HCSC 4.5company rating

    HCSC job in Chicago, IL

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This position is responsible for managing the implementation, maintenance and critical review and analysis of models, studies and systems which use actuarial principles for the purposes of pricing, underwriting, statistics, reserving, forecasting and other actuarial functions; developing complicated models and teaching others how to develop models; developing written and oral presentations that drive the delivery of information for decision making; and managing day-to day projects that may include non-Actuarial departments. Must also possess and demonstrate a deep understanding of one actuarial area or business segment Required Job Qualifications: * Bachelor's degree in Actuarial Science, Mathematics, Statistics or Economics. Other Bachelor (or higher) Degrees may be considered. * Associate of the Society of Actuaries (ASA) and Membership in the American Academy of Actuaries (MAAA). Compliance with the membership requirements for each professional designation. * At least 5 years of actuarial experience in the health insurance or related field. * Verbal and written communications skills to prepare effective documentation, facilitate training and development, and participate in presentations. * PC proficiency to include Word and Excel. Preferred Job Qualifications: * Access, SQL, Visual Basic or other programming skills. * Data visualization tools experience * Medicare experience is a plus #LI-LK1 #LI-Hybrid #INJLF Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $90,900.00 - $164,200.00 Exact compensation may vary based on skills, experience, and location.
    $90.9k-164.2k yearly Auto-Apply 42d ago
  • Category Management Advisor

    Cigna 4.6company rating

    Remote or Chicago, IL job

    As a member of the Enterprise Wellness team within the Category Management and Strategic Sourcing (CMSS) organization, the Category Management Advisor is accountable for sourcing on, near, and offshore supplier delivery of customer-facing and functional business processes that lower costs and increase operational benefits to The Cigna Group. The individual will lead negotiations with suppliers to secure competitive prices, improve delivery, and achieve favorable terms to The Cigna Group. Understanding of business process, legal contracts, and financial acumen is desired. This resource must have experience in dealing with dynamic requirements that are tied to strategic level business objectives. The individual will regularly interface with managers, directors, and senior directors to complete assigned work. As part of strategy and contract finalization, this role also will interact with senior leaders at the vice president and above levels within The Cigna Group. Major Objectives * Support, execute and implement sourcing initiatives; take accountability for the results of these efforts * Execute clearly written contracts that optimize value and mitigate risk to Cigna * Establish the role as a valued advisor to business teams Major Activities * Lead the end to end sourcing process, from market analysis to RFP, through business terms and contract execution * Analyze business requirements to formulate high level supply chain strategies and processes that are aligned with various Cigna business units * Research potential suppliers and recommend alternatives * Review and draft contracts with suppliers to optimize benefits and minimize risks to The Cigna Group. * Identify and implement process improvements * Lead and direct the proactive management and understanding of industry best practices and technology trends; provide insight to executive management Key Competencies * Bachelor degree preferred * 5+ years relevant work experience * Fundamental understanding of the healthcare sector and health services industry * Project and stakeholder management * Strong analytical, teamwork, and interpersonal skills * Effective verbal and written communication skills * Knowledge of procurement and outsourcing principles, theories, and processes * Demonstrated experience in drafting and reviewing contracts that include Master Services Agreements and Statements of Work * Experience with eSourcing applications 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 92,100 - 153,500 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. We want you to be healthy, balanced, and feel secure. That's why 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) with company match, 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, visit Life at Cigna Group. 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.
    $49k-89k yearly est. Auto-Apply 51d ago
  • Clinical Compliance Manager

    Healthcare Services 4.1company rating

    Remote job

    Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers' toughest challenges. While we continue updating the Solventum Careers Page and applicant materials, some documents may still reflect legacy branding. Please note that all listed roles are Solventum positions, and our Privacy Policy: *************************************************************************************** applies to any personal information you submit. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Description: Clinical Compliance Manager(Solventum) 3M Health Care is now Solventum At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers' toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you. The Impact You'll Make in this Role As a Clinical Compliance Manager you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. Here, you will make an impact by: Providing leadership and oversight for the team responsible for authoring and maintaining clinical evaluation documentation, including Clinical Evaluation Plans (CEPs), Clinical Evaluation Reports (CERs), and associated processes. Allocating resources and monitoring timelines to ensure deliverables meet regulatory and business needs, and managing this process across the entire Dental Solutions product portfolio. Authoring and coordinating clinical evaluations for new products and legacy devices. Collaborating with cross-functional teams to generate a clinical evaluation that collects, analyses and assesses the clinical data pertaining to a medical device to verify the safety and performance in compliance with applicable regulations. Owning and continuously improving the clinical evaluation process, including developing SOPs, templates, and best practices for clinical evaluation documentation. Acting as the primary point of contact for audits and regulatory inspections related to clinical evaluation. Your Skills and Expertise To set you up for success in this role from day one, Solventum requires (at a minimum) the following qualifications: Bachelor's degree or higher from an accredited institution, preferably in a scientific or technical discipline (Biology, Chemistry, Biomedical Eng, etc.) AND seven (7) years of experience in the medical device industry Strong knowledge of EU MDR, MEDDEV 2.7/1 and clinical evaluations, including 5 years of experience medical writing according to EU MDR or comparable experience. 2+ years of experience managing teams and complex documentation processes. Additional qualifications that could help you succeed even further in this role include: Dental experience in a private, public, government or military environment. Ability to work effectively in cross-functional and cross-cultural teams. Strong understanding of global regulatory requirements for medical devices. Excellent organizational, leadership, and communication skills. Proven strength in clinical and medical writing. Ability to manage multiple complex projects simultaneously. Strategic thinking, critical thinking, reasoning, and interpretive skills Proficiency in Microsoft Office applications (Excel, Teams, Word, PowerPoint) with strong analytical skills. Ability to leverage AI technologies to strategically optimize team workflows, drive automation of key processes, and elevate operational efficiency across the team. Work location: Remote - United States Travel: May include up to 10% domestic Relocation Assistance: Not authorized Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status). Supporting Your Well-being Solventum offers many programs to help you live your best life - both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope. Applicable to US Applicants Only:The expected compensation range for this position is $160,284 - $195,903, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate's relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: *************************************************************************************** of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties. Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers. Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain *****************. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains. Please note, Solventum does not expect candidates in this position to perform work in the unincorporated areas of Los Angeles County.Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status. Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly. Solventum Global Terms of Use and Privacy Statement Carefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at Solventum are conditioned on your acceptance and compliance with these terms. Please access the linked document by clicking here, select the country where you are applying for employment, and review. Before submitting your application you will be asked to confirm your agreement with the terms.
    $160.3k-195.9k yearly Auto-Apply 15d ago
  • Electro-Mechanical Controls Engineer (Automation Engineer Lead Analyst) - Express Scripts

    The Cigna Group 4.6company rating

    Remote or Newark, DE job

    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._
    $98k-122k yearly est. 60d+ ago
  • Managed Care Resident - Express Scripts - Remote (Physician Engagement)

    Cigna 4.6company rating

    Remote job

    The Pharmacy Graduate will participate in a 12-month post-PharmD training program with a primary focus on Physician Engagement, including but not limited to; the use of digital applications, data, and insights to enable informed provider decisions. The Physician Engagement Pharmacy Resident will gain managed care proficiency through in-depth longitudinal rotations and as well as enterprise-wide exploratory rotations, while delivering clinical support to the Provider Engagement, Data and Analytics, and Physician Innovation teams. LOCATION: VIRTUAL RESPONSIBILITIES Recommend medications, including initiation, continuation, discontinuation, and alternative therapies based upon established protocols. Utilize Express Scripts' multiple data analytics programs and tools to monitor and analyze trends in providers prescribing patterns. Collaborates with client, client's Express Scripts' account team and others to optimize opportunities to inform and influence providers. The goal is to improve clinical and financial outcomes and support trend management including appropriate promotion of generic and formulary prescribing toward client and Express Scripts' strategic goals. Provide clinical support for Physician Innovation teams' research and development efforts, predictive capabilities, and reporting and outcomes processes. Activities and discussions to gain knowledge of Pharmacy Benefit Management (PBM) services, including claims processing, coverage reviews, pharmacy networks, formulary management, and client management. Effectively participate in and contribute to staff meetings, committees and departmental work groups to share best practices, improve processes and/or other items relating to provider engagement. Provide patient and health care professional education and medication information. Design and present education and/or training activities via newsletter publications, clinical journal clubs, and department in-service opportunities. Minimum Requirements: 4th year (Graduation year) or PharmD. degree from an ACPE-accredited college or school of pharmacy Pharmacy Licensure in any US State (within 90 days of residency start) Proficiency in Microsoft office, specifically Microsoft excel and PowerPoint Proficiency in written and verbal communications Strong career interest in Managed Care pharmacy Required: Please upload or email per instructions for each: CV - Upload/attach to Workday application. Letter of Intent (max 300 words; Explain why you are interested in our program and managed care) - Upload/attach to Workday application. Any recommendation letters - Upload/attach to Workday application Deadline for application for this program is 12/31/2025 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 21 - 36 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. We want you to be healthy, balanced, and feel secure. That's why 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) with company match, 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, visit Life at Cigna Group. 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.
    $30k-35k yearly est. Auto-Apply 60d+ ago
  • Early Careers - Analytics Consultant Senior Intern

    Health Care Service Corporation 4.1company rating

    Chicago, IL job

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** This ten-week paid internship is located in Chicago, IL **What Are Your Responsibilities?** This position is responsible for actively participating in an internship program that leverages your skills, knowledge, and capabilities as a member of the Data and Analytics Solutions team, while exposing you to different methodologies and tools. This role will assist with applying emerging technologies to assist with developing best-in-class systems and solutions for our clients and members. Working closely with cross-functional teams in both our business and technical areas the Intern is responsible for learning specific aspects of the processes, programs, and technology. Additional project support, administrative tasks, and ad hoc requests to support business needs. This role will also need to: + Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. + Maintain complete confidentiality of company business. + Maintain communication with management regarding development within areas of assigned. + responsibilities and perform special projects as required or requested. + Create a final internship PowerPoint presentation to share with department leadership covering the internship experience, the assigned project over the course of the summer, including the results along with any solutions or recommendations that can be leveraged by the department in the future. **What Do You Need To Be Successful?** + Analytical mindset and excellent problem-solving skills Innovation, creativity and out-of-the-box thinking. + Enthusiasm to enhance your own professional and personal development Entrepreneurial spirit and initiative to handle business problems. + Strong communication skills. + Crave continuous learning and participate in knowledge exchange with peers. + Passion and desire to learn the ins and outs of the health care industry. + Demonstrated interpersonal skills including verbal and written communication Strong analytical skills. + Practical, developed PC skills, especially Excel, Word, and Access. **What Are the Requirements You Must Meet?** + Pursuing a Master's degree or higher in Analytics, Computer Science, Statistics, Mathematics, or related field with comparable programming experience + Graduation date between December 2026 and June 2027 + A minimum GPA of 3.0/4.0 + Availability to work 10 weeks during the summer (June - August) + Unrestricted authorization to work in the United States. **_(Currently, we are not offering this program to students on a visa)_** **What Does the Internship Program Entail?** + Formal Intern Orientation to build business and industry acumen. + Challenging real-world hands-on projects. + Weekly networking opportunities among interns and company leaders. + Professional development workshops. + Volunteer activities. \#LI-Hybrid \#LI-JT1 \#hcscintern **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $19.65 - $43.74 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $31k-39k yearly est. 53d ago
  • Business Unit Specialist- Evernorth

    The Cigna Group 4.6company rating

    Remote or Bloomfield, CT job

    As a Business Unit Specialist, you will help ensure the accuracy and integrity of revenue‑cycle related data within the patient management system. You will support operational excellence by coding inventory, validating payer configurations, and maintaining contract and fee‑schedule setups. Your work will strengthen billing accuracy, streamline processes, and enhance the overall performance of business operations. **Responsibilities** + Set up and maintain revenue‑cycle files in the patient management system, ensuring accuracy and consistency across all data elements. + Load, validate, and update payer configurations, including contracts, reimbursement structures, and fee schedules. + Code and maintain inventory records to support billing and operational workflows. + Collaborate with internal teams to resolve discrepancies, improve processes, and support project initiatives. + Assist with special projects and system updates as assigned. + Ensure documentation integrity and maintain organized, accurate records. + Contribute to process improvement efforts by identifying trends and recommending solutions. **Required Qualifications** + Experience with data entry, revenue cycle workflows, or billing operations. + Proficiency in Microsoft 365. + Strong analytical and problem‑solving skills. + Ability to work independently with strong attention to detail. **Preferred Qualifications** + Knowledge of home infusion operations or medical billing practices. + Familiarity with payer reimbursement rules and fee‑schedule setup. + Strong communication skills and ability to collaborate across teams. + Project management experience. 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 23 - 39 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 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._
    $70k-89k yearly est. 6d ago
  • Sr. Federal Markets Account Manager (D.C. Area- Remote)

    Healthcare Services 4.1company rating

    Remote or Murray, UT job

    Thank you for your interest in joining Solventum. Solventum is a new healthcare company with a long legacy of solving big challenges that improve lives and help healthcare professionals perform at their best. At Solventum, people are at the heart of every innovation we pursue. Guided by empathy, insight, and clinical intelligence, we collaborate with the best minds in healthcare to address our customers' toughest challenges. While we continue updating the Solventum Careers Page and applicant materials, some documents may still reflect legacy branding. Please note that all listed roles are Solventum positions, and our Privacy Policy: *************************************************************************************** applies to any personal information you submit. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Description: Federal Markets Account Manager (D.C. Area- Remote) 3M Health Care is now Solventum At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers' toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you. The Impact You'll Make in this Role As a(n) Sr, Federal Markets Accounts Manager (DC Remote) you will have the opportunity to tap into your curiosity and collaborate with some of the most innovative and diverse people around the world. Here, you will make an impact by focusing on the Defense Health Agency, Veteran Health Affairs, Indian health and other Federal Clients Foster enduring relationships with federal clients to drive growth in current and future program management efforts. Advise on strategic opportunity planning, including growth strategies and new initiatives across key government accounts (DoD, VA, CMS, IHS). Deliver actionable insights from federal projects to support organic growth and program expansion. Leverage cross-functional internal networks-sales, marketing, technical, manufacturing, and engineering-to ensure program success and elevate customer satisfaction. Analyze evolving client needs and competitor offerings to inform short-, mid-, and long-term strategic planning. Represent the organization at industry events and proactively engage stakeholders in the Washington, D.C. area to cultivate relationships and uncover new opportunities. Your Skills and Expertise To set you up for success in this role from day one, Solventum requires (at a minimum) the following qualifications: Bachelor's Degree or higher from an accredited university with 4 years of experience OR High School Diploma/GED from an accredited institution and a minimum of (8) years of experience in operations in a private, public, government or military environment AND In addition to the above requirements, the following are also required: Working at a level of proficiency with Microsoft suite such as Excel, Word, and PowerPoint Experience with briefing Executive Level/General Officer personnel, compiling briefings and status reports. Must be able to pass a government background check for a position of Public Trust Additional qualifications that could help you succeed even further in this role include: Master's degree with business-related concentration. Minimum of ten (10) years of combined experience in sourcing, government contracts, defense contracts, federal regulations, and/or supplier/vendor management in a private, public, government or military environment Change Management experience, including ability to lead change effectively. Expert knowledge of strategic sourcing methodology, procurement processes, and systems. Strong analytical, problem-solving skill, influencing, communication skills. Experience leading contract negotiations. Leadership experience. Ability to work as a member of and/or lead a professional team. Advanced level of writing and computer skills, effective communication, and facilitation skills. Ability to multi-task and handle large and sometimes complex workload under time constraints. Proven results and process oriented. Work location: Remote within 50 miles of D.C. Area and willing to travel to in person engagements Travel: May include up to up to 50% domestic travel Relocation Assistance: Is not authorized Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status). Supporting Your Well-being Solventum offers many programs to help you live your best life - both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope. Onboarding Requirement: To improve the onboarding experience, you will have an opportunity to meet with your manager and other new employees as part of the Solventum new employee orientation. As a result, new employees hired for this position will be required to travel to a designated company location for on-site onboarding during their initial days of employment. Travel arrangements and related expenses will be coordinated and paid for by the company in accordance with its travel policy. Applies to new hires with a start date of October 1st 2025 or later.Applicable to US Applicants Only:The expected compensation range for this position is $160,284 - $195,903, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate's relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: *************************************************************************************** of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties. Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process. Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers. Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain *****************. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains. Please note, Solventum does not expect candidates in this position to perform work in the unincorporated areas of Los Angeles County.Solventum is an equal opportunity employer. Solventum will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status. Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly. Solventum Global Terms of Use and Privacy Statement Carefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at Solventum are conditioned on your acceptance and compliance with these terms. Please access the linked document by clicking here, select the country where you are applying for employment, and review. Before submitting your application you will be asked to confirm your agreement with the terms.
    $65k-87k yearly est. Auto-Apply 42d ago
  • Pharmacist-In-Charge- Specialty Pharmacy Onsite Orlando - Evernorth

    The Cigna Group 4.6company rating

    Remote or Maitland, FL job

    Join ProHealth as a Pharmacist In-Charge (PIC) at our Maitland, Florida location and lead pharmacy operations to ensure compliance, quality, and exceptional patient care. This role combines leadership with hands-on clinical and operational responsibilities, supporting a high-volume specialty pharmacy environment. Responsibilities + Oversee pharmacy operations to maintain compliance with state board and regulatory requirements. + Perform hands-on clinical and operational pharmacist duties to ensure smooth workflow. + Develop and enforce site-level policies and procedures that promote safe and cost-effective medication use. + Implement and monitor Key Performance Indicators (KPIs) for specialty pharmacy performance. + Collaborate with physicians and healthcare teams to optimize drug therapy and patient outcomes. + Manage prior authorizations, billing, and reimbursement processes for specialty medications. + Ensure accurate documentation in EMR systems and CarepathRx's DromosPTM platform. + Provide clinical consultations and therapeutic recommendations for complex patient cases. + Lead and mentor clinical pharmacists and pharmacy students, fostering a culture of excellence. + Maintain confidentiality and uphold CarepathRx's core values in all interactions. Qualifications Required: + B.S. degree in Pharmacy or Doctor of Pharmacy (PharmD). + Active Florida Pharmacist license and ability to register as PIC. + Minimum 2 years of experience in specialty pharmacy services. + Proficiency in Microsoft Suite and pharmacy software systems. + Strong clinical knowledge and ability to manage complex therapies. + Excellent communication, leadership, and organizational skills. Preferred: + Certified Specialty Pharmacist (CSP) or willingness to obtain certification. + Experience in health system specialty pharmacy operations. + Multiple state pharmacist licenses or willingness to obtain additional licenses. + Familiarity with pharmacoeconomic programs and performance improvement initiatives. 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._
    $96k-123k yearly est. 6d ago
  • Early Careers - Associate Business Intelligence Engineer Senior Intern

    HCSC 4.5company rating

    HCSC job in Chicago, IL

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. Job Summary This is a ten-week paid internship located in Chicago, IL What Are Your Responsibilities? This position is responsible for actively participating in an internship program that leverages your skills, knowledge, and capabilities as a member of the BI Solutions team, while exposing you to different methodologies and tools. This role will assist with applying emerging technologies to assist with developing best-in-class systems and solutions for our clients and members. Working closely with cross-functional teams in both our business and technical areas the Intern is responsible for learning specific aspects of the processes, programs, and technology. Additional project support, administrative tasks, and ad hoc requests to support business needs. This role will also need to: * Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. * Maintain complete confidentiality of company business. * Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested. * Create a final internship PowerPoint presentation to share with department leadership covering the internship experience, the assigned project over the course of the summer, including the results along with any solutions or recommendations that can be leveraged by the department in the future. What Do You Need To Be Successful? * Preferred: Strong Analytical skills and Analytical mindset * Preferred: Familiarity with Cloud Platforms, BI tools, and languages like Python, * Excellent problem-solving skills and innovative, creative out-of-the-box thinking, is a strong plus, * Experience working in Human Resources or SHRM Certification is a strong plus, * Enthusiasm to enhance your own professional and personal development, * Initiative to handle business problems and participate in knowledge exchange with peers, * Strong communication skills, * Passion and desire to learn the ins and outs of the health care industry, * Demonstrated interpersonal skills including verbal and written communication, and * Practical, developed PC skills, especially Excel, Word, Teams, and Access What Are the Requirements You Must Meet? * Pursuing a master's degree in data science, data analytics, business analytics, statistics, industrial/organizational psychology, computer science, or related field with comparable programming experience * Graduation date between December 2026 and June 2027 * A minimum GPA of 3.0/4.0 * Availability to work 10 weeks during the summer (June - August) * Unrestricted authorization to work in the United States. (Currently, we are not offering this program to students on a visa) What Does the Internship Program Entail? * Formal Intern Orientation to build business and industry acumen * Challenging real-world hands-on project * Weekly networking opportunities among interns and company leaders * Professional development workshops * Volunteer activities #LI-Hybrid #LI-JT1 #hcscintern Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! Pay Transparency Statement: At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************** The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. HCSC Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. Base Pay Range $19.65 - $43.74 Exact compensation may vary based on skills, experience, and location.
    $31k-37k yearly est. Auto-Apply 48d ago
  • Claim Technician

    Health Care Service Corporation 4.1company rating

    Quincy, IL job

    At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development. **Job Summary** Under Supervision, This Position Is Responsible For Processing Complex Claims Requiring Further Investigation, Including Coordination Of Benefits And Resolving Pended Claims. Required Job Qualifications: * High School diploma or GED. * Data entry and/or typing experience. * Clear and concise written and verbal communication skills. * Experience processing medical claims. Preferred Job Qualifications: * Referral preference given to applicants able to take and meet testing criteria. * Must have trained on the six-eight-week Blue Chip claims processing system or have the ability to fully complete the six-eight-week Blue Chip Training class. * Knowledge of medical terminology and CPT, HCPCS, and ICD9 coding. * Knowledge of coordination of benefits principles and terminology. * Experience with multi-tasking and prioritizing. **Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!** **Pay Transparency Statement:** At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting ************************************* . The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. **HCSC Employment Statement:** We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. **Base Pay Range** $17.75 - $25.66 Exact compensation may vary based on skills, experience, and location. **Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities.** **Join our Talent Community. (******************************************** PA8v\_eHgqFiDb2AuRTqQ)** For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren't afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you'll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at ************** to request reasonable accommodations. Please note that only **requests for accommodations in the application process** will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2025 Health Care Service Corporation. All Rights Reserved.
    $17.8-25.7 hourly 11d ago

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HCSC may also be known as or be related to HCSC, Health Care Service, Health Care Service Corporation, HEALTH CARE SERVICE CORPORATION, Health Care Service Corporation Illinois State Pac, Nfp and Blue Cross And Blue Shield Of Illinois, Montana, New Mexico, Oklahoma...