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HCSC jobs in Richardson, TX - 187 jobs

  • Infrastructure Service Delivery Analyst

    HCSC 4.5company rating

    HCSC job in Richardson, TX

    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 SummaryThis position is responsible for building and supporting observability, monitoring and alerting solutions within the Medicare Technology Operations domain and the systems they interact with. They work closely with the development and operations teams to build and maintain robust monitoring that will ensure the high availability and optimal performance of enterprise level services. The Infrastructure Service Delivery Analyst is responsible for monitoring, troubleshooting, and resolving any issues that arise, as well as implementing automation and improvement initiatives to optimize system performance. 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 degree and 2 years in Information Technology OR Technical Certification and/or College Courses and 4 year Information Technology experience OR 6 years Information Technology experience. * Knowledge of ITIL v3 framework * Knowledge of ITSM systems * Knowledge of all Infrastructure technologies, including monitoring and event management technologies * Experience with monitoring and logging tools such as Dynatrace, Splunk, Prometheus, or Grafana * Experience with Compute, DBMS, Storage, Middleware, including Server, OS, Virtualization, and Container technologies * Excellent communication and collaboration skills to work effectively with cross-functional teams * Strong problem-solving and troubleshooting experience, with the ability to analyze and resolve complex technical issues * Supplier management * Infrastructure domain knowledge * Continuous improvement * Incident management * Knowledge of required technologies (incl 3rd party solutions) * Problem Management / RCA * Customer service oriented * Adaptability and ability to introduce / manage change * Drive conflict management in high pressure situations * Performance / metrics-driven decision making Preferred Job Qualifications: * Knowledge of containerization technologies (Docker, Kubernetes) and orchestration tools * Experience with cloud native services (AWS and/or Azure) and related observability patterns * Familiarity with continuous integration/continuous deployment (CI/CD) pipelines * Proficiency in scripting languages such as Python, Shell, or Perl a plus #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$61,500.00 - $136,100.00 Exact compensation may vary based on skills, experience, and location.
    $61.5k-136.1k yearly Auto-Apply 12d ago
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  • Sr Business Solutions Consultant

    HCSC 4.5company rating

    HCSC job in Richardson, TX

    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.
    $82.7k-149.3k yearly Auto-Apply 34d ago
  • Health Advocate Concierge, Customer Service

    Health Care Service Corporation 4.1company rating

    Richardson, TX 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** Responsible For An Integrated Member Experience. Responsible For Providing Concierge Guidance And Answering Questions From Members And Providers For Medical, Behavioral Health And Prescription Benefits And Claims. Assisting Members In Assessing Tools, Health Partner Options, And Setting Provider Appts Through Their Choice Of Communication Whether It Be Phone, Webchat, Or Written. The Incumbent Is A Subject Matter Expert And May Handle Projects And Assist In Training Others. They Are Responsible For Navigating The Healthcare System And Helping The Member Reach Optimal Health By Collaborating With Clinicians From Medical, Behavioral Or A Pharmacist. Required Job Qualifications: * Associate with 2 years OR, a Bachelor's with 1 year, OR 3 years of concierge-oriented customer service experience * Experience emphasizing plan of care, assisting customers to select in-network providers, and train customers on tools. * Knowledge of medical terminology. * Experience building trust and providing concierge level of service. * Clear and concise verbal and written communication skills, including motivational interviewing to interact with the members and physicians. * Attention to detail and strong documentation skills. * Web and PC proficiency. Preferred Job Qualifications: * Associate degree in Health Science or Health Studies or Bachelor's degree. * Knowledge of HCSC customer service systems, processes, and products of the operational area. * 3 years of concierge-oriented customer service experience in an insurance environment. * Clinical or social work expertise. * Experience in coordinating medical services. * Knowledge with health benefit plans and the insurance industry. **This role will start in our Richardson, TX office, however, does have the possibility of a flex schedule after 6-12 months which is 1 week in office, 2 weeks work from home after training and based on performance. The schedule can fall within Monday -Friday 8am-6pm CST and is based on business needs.** **\#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** $18.46 - $37.84 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.
    $18.5-37.8 hourly 4d ago
  • Wound Healing Area Clinical Leader (Dallas, Phoenix)

    Healthcare Services 4.1company rating

    Dallas, TX 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: 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 Solventum enables clinicians to not just treat wounds, but to advance healing. To support that, you will act as a strategic clinical advisor, partnering with internal Solventum teams and key customers to drive best practices and deliver advanced education. You will lead priority customer engagements, provide escalated clinical and technical consultation, and support economic value discussions with evidence-based data. We seek an experienced clinical leader - the ideal candidate will demonstrate a strong track record of leadership, wound care clinical acumen, relationship development, and presentation skills. As a Wound Healing Area Clinical Leader, 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: Acting as strategic advisor to internal Solventum teams on wound care clinical strategy and industry best practices Collaborating with sales leadership to identify opportunities to educate and upskill teams and individuals on clinical or technical consultative practices Presenting compelling data and clinical application during priority planned customer engagements Building and maintaining relationships with key healthcare customers to ensure customer loyalty and satisfaction Engaging alongside local teams to plan & lead comprehensive customer education events Directly interacting with customers who require escalated consultation on clinical or technical on-label scenarios Serving as a consultative partner to various internal business stakeholders on clinical and/or technical matters Supporting economic objection handling with customers by articulating evidence-based clinical efficacy and the connection to economic value Aiding in resource management for conversions/evaluations Maintaining clinical/technical relevance through ongoing continuous learning and participation in professional associations Driving Requirements: This position requires the use of a personal vehicle for company business and participation in Solventum's Fixed and Variable Reimbursement (FAVR) program. As a condition of employment, candidates must successfully complete a pre-hire motor vehicle record (MVR) review and maintain ongoing eligibility, including compliance with Solventum's driver policy, insurance requirements, and annual policy sign-off. Ongoing monitoring of motor vehicle history will be conducted. 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 AND two (2) years of healthcare experience in a hospital, home health, or long-term care environment OR High School Diploma/GED from AND four (4) years of healthcare experience in a hospital, home health, or long-term care environment AND In addition to the above requirements, the following are also required: Experience with Microsoft Office applications (i.e. Excel, Power Point, Outlook) Current, valid Driver's License. Additional qualifications that could help you succeed even further in this role include: Current certification(s): RN, CWOCN, CWCN, CWS, CCM, PT, DPT Bachelor's in Nursing (BSN) Strong understanding of clinical value drivers across hospital care areas and alternative sites of care Excellent organizational and time management skills Understanding of the principals of adult learning Demonstrated analytical, problem solving, project management, and implementation skills Proven ability to cultivate strong internal and external collaborative relationships Experience with public speaking and technical presentations Additional Requirements In this role, you may be required to enter healthcare or other third-party facilities. Those facilities may, in turn, require you to possess certain licenses, vaccinations, and/or other credentials or qualifications (collectively “prerequisites to entry”) for regulatory, safety, or other business reasons. All information will be kept in accordance with applicable law and Solventum policies. In order to respond to the prerequisites to entry, Solventum may share your information with the providers of medical screens, vaccinations, or verifications as well as the healthcare or other third-party facilities requiring the prerequisites to entry. Work location: Remote Travel: Field-based role, with up to 75% overnight travel expected (may vary based on region) Relocation Assistance: May be 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 $152,150 - $196,900, 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.
    $152.2k-196.9k yearly Auto-Apply 5d ago
  • Medical Director (Appeals)

    Health Care Service Corporation 4.1company rating

    Richardson, TX 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 Assigned Aspects Of Medical Policies And Programs. Performs Medical Appeal Reviews And Interacts With The Provider Communities For Assigned Areas. **JOB REQUIREMENTS:.** + Physician (M.D. or D.O) with a current and unrestricted physician license in a state or territory of the United States + Maintain Board Certification by a specialty board approved by the American Board of Medical Specialties, National Board of Physicians and Surgeons, or the Advisory Board of Osteopathic Specialists + 5 years of clinical experience + Analytical and communication skills + Strategic thinking skills + Proficiency in computer skills (including software applications such as Microsoft Office Product and Lotus Notes) needed for electronic documentation of case reviews **PREFERRED REQUIREMENTS** : + Board Certifification in Oncology, Physical Medicine and Rehabilitation, Surgical, Plastic Surgeon, or + 3 years Managed Care experience This is a Telecommute (Remote) role: Must reside withing 250 miles of the office or anywhere within the posted state. INAK \#LI-AK1 **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** $187,700.00 - $348,600.00 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.
    $187.7k-348.6k yearly 39d ago
  • Assistant General Counsel - Contracting

    Health Care Service Corporation 4.1company rating

    Richardson, TX 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
  • Field Service Coordinator, RN - Dallas and Tarrant Counties, TX

    Unitedhealth Group 4.6company rating

    Irving, TX job

    At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us to start Caring. Connecting. Growing together. If you are located in or within commutable driving distance from the Dallas and Tarrant Counties in the TX market, you will have the flexibility to work remotely* as you take on some tough challenges. This is a Field Based role with around 75% travel in the field and with a Home-Based office. Primary Responsibilities: Assess, plan and implement care strategies that are individualized by patients and directed toward the most appropriate, at least restrictive level of care Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services Manage the care plan throughout the continuum of care as a single point of contact Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include: Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays Medical Plan options along with participation in a Health Spending Account or a Health Saving account Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage 401(k) Savings Plan, Employee Stock Purchase Plan Education Reimbursement Employee Discounts Employee Assistance Program Employee Referral Bonus Program Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.) More information can be downloaded at: uhgbenefits You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: Current and unrestricted RN license in the state of Texas 2+ years of experience working within the community health setting or in a health care role Familiarity with Microsoft Office, including Word, Excel and Outlook High-speed internet at place of residence Valid US driver's license, access to reliable transportation and the ability to travel up to 75% in assigned regions to visit Medicaid members in their homes and/or other settings, including community centers, hospitals, nursing facilities or providers' offices Preferred Qualifications: 1+ years of experience with long-term care services and support, Medicaid or Medicare Ability to create, edit, save and send documents, spreadsheets and emails Knowledge of the principles of most integrated settings, including federal and State requirements like the federal home and community-based settings regulations *All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $28.3-50.5 hourly 4d ago
  • Sr AWS Cloud Engineer

    Health Care Service Corporation 4.1company rating

    Richardson, TX 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 implementing AWS integration solutions. This individual will work directly with business partners and other IT team members to understand desired system requirements and to deliver effective solutions within the SAFe Agile framework methodology. The Sr AWS Cloud Engineer will participate in all phases of the development and system support life cycle. Primary responsibilities are to design and implement AWS cloud integration solutions that will interact with the TriZetto Facets software package. The ideal candidate is a technologist that brings a fresh perspective and passion to solve complex functional and technical challenges in a fast-paced and team-oriented environment. In this role, you will work with business and technical experts to implement quality software engineering solutions and best practices. You will participate in the collaborative architectural refinement, software design and realization of products that support the strategic technology needs to support the organization. As a full stack engineer, you have the breadth of knowledge in computer science, a problem-solving mentality and a desire to learn. You are comfortable working within a technical capacity across many of the sectors including core development on platform, data processing and report generation. The FSE will be working in a team that demands technical excellence and whose members are expected to hold each other accountable in the overall success of the output. Focus for this team is on the delivery of innovative solutions to complex problems. **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 in CS, IT or related field AND 10 years of software development experience, OR 14 years' experience in related field. + **10 + years in MS SQL Server.** + **Experience in AWS services including AWS Step function, Lambda (using Node.js),** SNS, SQS, Eventbridge, API Gateway etc + ETL experience using SSIS or Python/Spark using AWS Glue + Experience with Docker. + Experience in RESTful API services + **Experience with Terraform,** experience with setting up CI/CD pipelines is a plus + **Experience with** **Angular.** + Experience with NoSQL Databases such as MongoDB/DynamoDB + Experience with containers such as Open Shift/ Kubernetes, Docker + Experience in SDLC, including testing and deployment + Working knowledge of scripting languages + Be passionate about resolving user pain points through great design + Be open to receiving feedback and constructive criticism + Experience in the Agile methodology + Good understanding of Medicare/Medicaid Healthcare data + Demonstrate mentality of building well architected applications for Cloud. + Demonstrate mentality of quality being owned by the entire team. + Can identify code defects and work with other developers to address quality issues in product code. + Passion for finding bottlenecks and thresholds in existing code through the use of automation tools. + Contribute to automation pyramid and integrate with CI/CD tools for continuous validation. + Passion for continuing education and improving code quality. + Able to articulate clear business objectives aligned to technical specifications and work in an iterative agile pattern daily. **Preferred Job Qualifications:** + Experience with Databricks. + Experience with OpenShift. + Experience with Kafka + **Experience with scripting in C#.NET using the .NET Framework** + Experience working with databases such as Aurora and PostGres. + Experience with Apache Airflow. + Experience with AWS API Gateway. + Experience in Healthcare. + Experience in Healthcare Claim or Enrollment functions. + Experience supporting Medicare technology platforms \#INCR \#LI-BS1 \#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** $130,800.00 - $242,800.00 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.
    $130.8k-242.8k yearly 60d+ ago
  • Government Programs Care Manager III

    Health Care Service Corporation 4.1company rating

    Richardson, TX 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 to provide care coordination to members via telephonic and/or field-based care management to inform and educate them on health care programs to address their personal health needs, engaging the member in discussion of adherence to personal health goals, responding to inquiries from members, and supporting clinical operations with provider and member activities. This position will be required to complete member telephonic and/or field-based health screenings, comprehensive health assessments and care planning duties which may require visits to members' homes and/or facilities to support complex and specialty populations **Required Job Qualifications:** + Registered Nurse (RN) with 2 years direct clinical care to the consumer in a clinical setting or , unrestricted Licensed Professional Counselor (LPC, TX), or Licensed Master Social Worker (LMSW, TX), Licensed Clinical Professional Counselor (LCPC, IL) or Licensed Clinical Social Worker (LCSW, IL & NM) Licensed Marriage and Family Therapist **(LMFT, IL** & **NM),** Licensed Professional Clinical Counselor (LPCC, NM), Licensed Independent Social Worker (LISW, NM), or Licensed Mental Health Counselor {LMHC, NM) with 2 years of clinical practice experience. + Current, valid, unrestricted license in the state of operations (or reciprocity). For compact licensee changing permanent residence to state of operations, you must obtain active, unrestricted RN licensure in the state of operations within 90 days of hire. + Plus 3 years' wellness or managed care experience presenting clinical issues with members/physicians. + Knowledge of the health and wellness marketplace and employer trends. + Verbal and written communication skills including discussing medical needs with members and interfacing with internal staff/management and external vendors and community resources. + Analytical experience including medical data analysis. + PC proficiency to include Word, Excel, and PowerPoint, database experience and Web based applications. + Current unrestricted driver's license, transportation and applicable insurance. + Ability and willingness to travel within assigned territory. **Preferred Job Qualifications:** + 3 years direct clinical experience. + Patient education experience. + Condition Management experience. + Bilingual in English and Spanish. + Experience in managing complex or catastrophic cases. + Certification in Case Management, Training, Project Management or nationally recognized health care certification. + Government Programs experience. + Population Management. **Telecommute:** This is a Telecommute (Remote) role: Must reside within 250 miles of the office or anywhere within the posted state. \#LI-TELECOMMUTE \#LI-SG1 **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** $26.90 - $59.35 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.
    $26.9-59.4 hourly 60d+ ago
  • Staff Actuary

    Health Care Service Corporation 4.1company rating

    Richardson, TX job

    At CareAllies, 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. The Staff Actuary uses statistics, financial theory, mathematics, and basic financial and actuarial principles to assess the impact of company decisions or situations. They have an in-depth knowledge of at least one market or business segment and operate with a high level of autonomy for daily purposes of pricing, underwriting, statistics, reserving, forecasting and other actuarial functions. This position can communicate complicated concepts, information, and recommendations regarding process, data, analysis, and results, while catering information to different audiences as needed. As necessary, position manages small projects with limited interaction outside Actuarial department. **Required Job Qualifications:** * Bachelor 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). * At least 3 years of actuarial experience. * 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. * Actuarial experience in the health insurance or related field * Pharmacy or Medicare experience is a plus Please note that this role is **HYBRID** with an in-office requirement of 3 days a week. \#LI-LK1 \#LI-Hybrid \#INJLF **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 CareAllies, 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, a minimum of 15 days' of 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 full-time employees. The salary 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:** $82,700.00 - $149,300.00 Exact compensation may vary based on skills, experience, and location.
    $82.7k-149.3k yearly 39d ago
  • Early Careers - SDG Implementation Analyst Intern

    Health Care Service Corporation 4.1company rating

    Richardson, TX 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 can be in Chicago, IL or Richardson, TX **What Are Your Responsibilities?** This intern position may include researching, analyzing and gathering data to support the implementation of new or renewing accounts, new legislation, and products across the enterprise. The intern may work cross-functionally with internal stakeholders to coordinate the implementation. In this role you may be responsible for assisting with managing implementation project activities of low to moderate complexity. You may also gather, organize, analyze, and interpret marketing, legislative, financial, and operating data. You may also: + Support multiple priorities across projects and work with the implementation team to complete tasks on time. + Interact one-on-one and in group settings with departmental/inter-departmental team members to identify issues, gather data, brainstorm, prioritize, discuss analytic approach, and share findings. + Support projects, form, and maintain key partnerships with other/related HCSC business areas. + Communicate with team, management, and key stakeholders to keep them informed of project deliverables, status updates and issue resolution. + Assist in preparing reports and presentations as directed to support the overall delivery and execution of client, business, and operational requirements. + Work to ensure that appropriate materials raising awareness, providing education and training, reports, and deliverables are prepared and delivered to appropriate account executives, clients, and HCSC management as needed. 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. + Perform responsibilities and 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?** + Adaptable communication style + Ability to forecast issues and risks + 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 bachelor's degree in business administration, marketing, healthcare administration, or a similar field. + 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** $18.46 - $37.84 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.
    $18.5-37.8 hourly 7d ago
  • Pharmacy Underwriter

    HCSC 4.5company rating

    HCSC job in Richardson, TX

    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 will be responsible for the analysis and pricing of renewal and RFP business in the ASO Pharmacy space. Required Job Qualifications: * Bachelor Degree OR 4 years experience in managed care or network management involving independent work and judgment. * Plus 3 years project management experience including leading and planning projects. * Managed care/network management database experience including knowledge of information flow. * PC proficiency to include Word, Excel and PowerPoint. * Clear and concise verbal and written communication skills including interpersonal and presentation skills. * Self- starter, meet deadlines, manage multiple tasks/projects, work in a team environment Preferred Job Qualifications: * Pharmacy or Medical underwriting experience * Knowledge of state and federal network management legislation and regulations Please note that this role is HYBRID with an in-office requirement of 3 days a week #LI-LK1 #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 $45,000.00 - $100,100.00 Exact compensation may vary based on skills, experience, and location.
    $45k-100.1k yearly Auto-Apply 31d ago
  • Physical Therapist Assistant, PTA Licensed - DeSoto area

    Unitedhealth Group Inc. 4.6company rating

    DeSoto, TX job

    Explore opportunities with DFW Home Health Arlington, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As the Physical Therapist Assistant you will perform treatment and provide exercise instruction and patient education aimed at improving/enhancing the patient's well-being while following the established plan of care. Primary Responsibilities: * Responsible for following all state specific laws governing the provision of physical therapy in home care, to follow the treatment set only as defined by the supervising PT; to perform only those procedures that he/she is qualified and trained to perform and to make all recommendations for changes in the plan of care to the supervising Physical Therapist * Instructs and aids patients in active and passive exercise, muscle re-education, gait, functional, ADL, transfer, safety, and prosthetic training * Observes, records, and reports to the supervising PT, the nurse supervisor, and/or the physician the patient's response to treatment and changes in the patient's condition. Coordinates care with the other members of the healthcare team as appropriate * Instructs patient, family, caregiver, and other members of the health care team in the areas of therapy within the scope of the physical therapy assistant You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current, licensed, registered, or certified to assist in the practice of physical therapy in state of practice * Current CPR certification * Current driver's license and vehicle insurance, access to a dependable vehicle, or public transportation * Ability to function in any home situation regardless of age, race, creed, color, sex, disability, or financial condition of the client * Available to work a weekend rotation Preferred Qualifications: * Ability to perform physical tasks required for patient care, including lifting, transferring, and assisting with mobility Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.41 to $41.83 per hour based on full-time employment. We comply with all minimum wage laws as applicable. #LHCJobs At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
    $23.4-41.8 hourly 2d ago
  • Sr Mgr Pharmacy Underwriting

    Health Care Service Corporation 4.1company rating

    Richardson, TX 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** Interpret and describe BCBS products and financial arrangements as well as those provided by competitors. Interact with BCBSA and member plans. **Required Job Qualifications:** * Bachelor Degree and 5 years' experience underwriting small and/or large accounts and dealing directly with key customers, consultants and/or brokers **OR** 6 years of experience underwriting small and/or large accounts and dealing directly with key customers, consultants and brokers. * 3 years of underwriting of higher complexity cases (if responsibility includes one or more of the following segments: large/major/national/and or special accounts (Labor Union, Student Health, IL Hospital, Co-operatives, Private Exchange, etc.) or OR Demonstrated capability to meet required job responsibility. * Successfully demonstrated skills and experience in underwriting and pricing of various funding options and products and making sound decisions. * Operational knowledge of renewal and prospective group health underwriting processes and procedures. * Knowledge of underwriting methodologies including mathematical and financial group health underwriting funding. * Extensive experience applying consortium procedure and pricing (if applicable). * Extensive experience and knowledge of managed care/health care, group insurance products and group health underwriting financial arrangements and knowledge of state and federal legislation to underwriting practices and making sound decisions. * Work management skills in prioritizing and assigning work and project assignments. * Demonstrated highly effective Presentation skills for addressing customers and senior management. * Demonstrate skills for developing presentations, building and maintaining positive relationships internally and externally, interacting with representatives of large and strategic accounts, coordinating initiatives across departments, interacting with senior management, lead staff. * Project management skills and experience, including designing and leading projects. * Verbal and written communication skills, including correct grammar, appropriate word choice, precisions, structure, and appropriate tone and level of detail for audience. * Interact with BCBSA and member plans. * Interpret and describe BCBS products and financial arrangements as well as those provided by competitors. * Successfully demonstrated interpersonal skills in establishing and maintaining positive business relationships. * Independent judgment and problem resolution skills. * Work and project management skills including the ability to multi-task, prioritize, and manage time and workload to meet deadlines. * PC proficiency to include Word and Excel. * Successfully demonstrated skills and experience in presenting to external clients. * Process management and process improvement experience and skills to identify and implement process changes. **Preferred Job Qualifications:** * Pharmacy Underwriting experience * Experience leading pharmacy underwriters Please note that this role is **HYBRID** with an in-office requirement of 3 days a week \#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** $100,000.00 - $180,700.00 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.
    $100k-180.7k yearly 31d ago
  • Executive Director, Actuarial

    Health Care Service Corporation 4.1company rating

    Richardson, TX 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** The Executive Director, Medicare Part D Actuarial will lead the actuarial function for Medicare Part D products, including Individual MAPD and PDP, with end-to-end accountability for product strategy, pricing, and financial performance. The Executive Director provides actuarial leadership across product strategy, benefit design, formulary and pharmacy network strategies, and is responsible for Medicare Part D bid development and submission, quarterly forecasting, monthly close support, and bid audits. This position reports to the DSVP, Pharmacy Finance and Actuarial and serves as a key strategic partner to senior leaders across Pharmacy, Product, Finance, Compliance, and Operations. The role also acts as the primary actuarial point of contact for external vendors and consultants. **Key Responsibilities:** **_Medicare Part D Product & Pricing Leadership_** - Lead actuarial strategy for Individual MAPD and PDP products, ensuring financial sustainability, regulatory compliance, and competitive market positioning. - Provide actuarial leadership on product strategy and component strategies, including benefits, formulary, rebate, network, and mail, balancing affordability, growth, and margin objectives. - Partner cross-functionally with Pharmacy, Product, Finance, Compliance, and Operations to align actuarial assumptions with enterprise strategy. **_Bid Development & Financial Management_** - Oversee end-to-end Medicare Part D bid development and submission, including pricing, assumptions, documentation, and internal governance approvals. - Lead quarterly forecast updates and support monthly close activities, ensuring accuracy, transparency, and alignment between actuarial projections and financial results. - Provide actuarial support for annual PBM market checks and negotiations. - Identify key financial risks and opportunities, proactively communicating insights and recommendations to executive leadership. **_Market Intelligence & Strategic Insights_** - Lead Medicare Part D market intelligence, including competitor analysis, CMS policy changes, regulatory guidance, and industry trends. - Translate market insights into actionable recommendations for product design, pricing strategy, and long-term Medicare positioning. Audit, Governance & Compliance - Serve as actuarial lead for CMS bid audits, internal audits, and financial audits, ensuring defensibility of assumptions, data integrity, and timely responses. - Establish and maintain strong actuarial governance, controls, and documentation standards to support regulatory and audit requirements. **_Vendor & External Partner Management_** - Act as the primary actuarial point of contact for external actuarial vendors and consultants. - Oversee vendor scope, deliverables, timelines, and quality, ensuring alignment with business objectives and regulatory expectations. - Leverage external partnerships to enhance modeling sophistication, analytics, and strategic decision-making. **_Leadership & Talent Development_** - Lead, mentor, and develop a high-performing actuarial team supporting Medicare Part D. - Foster a culture of accountability, collaboration, and continuous improvement, with a focus on developing future actuarial leaders. - Set clear priorities, performance expectations, and development plans aligned with organizational goals. **JOB REQUIREMENTS:** * Bachelor's degree in business, Finance, Actuarial Science, Mathematics, Economics, Computer Science or Management Information Systems. * 10 years of data, transactional application-based knowledge or group health underwriting experience * 10 years of management experience, including overseeing two or more departments led by managers. * Experience in leading one or more major (multi year) group insurance implementation projects * Experience in leading one of the following: Actuarial Systems or Applications and systems related teams including testing, building, and writing requirements. * Experience in quality and auditing and system testing (including creating test scripts) * Experience planning skills including: Setting goals at a position appropriate level, long term planning (one year or longer), budget and expense management, creating staffing models for up to 2 years, establishing department vision * Problem solving, negotiation skills, and organizational alignment * Clear and concise verbal and written communication skills. Experience presenting to all levels of management including audiences with diverse communications preferences *Overseeing the annual budget and allocating resources for various projects and operational needs. *Translating needs and initiatives into compelling business cases. *Conducting cost-benefit analyses to justify investments and ensure ROI. **PREFERRED JOB REQUIREMENTS:** - Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, or a related field; advanced degree preferred. - FSA designation. - 10+ years of progressive actuarial experience, including significant leadership responsibility in Medicare Part D. - Deep expertise in Medicare Part D pricing, bid development, forecasting, and regulatory requirements. - Strong strategic influence, executive presence, and financial acumen. - Strong understanding of pharmacy benefit economics, including formulary and network strategy impacts. - Proven experience leading CMS bid audits and financial audits, and partnering with external actuarial firms. - Demonstrated ability to communicate complex actuarial and financial concepts clearly to senior leaders and non-technical stakeholders. \#LI-TR1 \#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** $161,500.00 - $299,700.00 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.
    $161.5k-299.7k yearly 12d ago
  • Home Health Clinical Triage Specialist - Part-Time - Weekends

    Unitedhealth Group Inc. 4.6company rating

    Dallas, TX job

    Explore opportunities with Lafayette Home Office, a part of LHC Group, a leading post-acute care partner for hospitals, physicians and families nationwide. As members of the Optum family of businesses, we are dedicated to helping people feel their best, including our team members who create meaningful connections with patients, their families, each other and the communities we serve. Find a home for your career here. Join us and embrace a culture of Caring. Connecting. Growing together. As a T Home Health Clinical Triage Specialist, you'll be an integral part of the interdisciplinary team and as such is responsible for the excellent delivery of care through triage calls after hours and on holidays. Must be available to work weekends. Primary Responsibilities: * Receive calls from patients and/or family members and respond appropriately and assess problems focusing on the delivery of high quality, patient-focused, compassionate care * Assess patient status and intervene as indicated by the patient's condition and established protocols * Timely and accurate documentation of calls received within the electronic medical records system including the processing of workflow associated with the clinical record * Knowledge of basic triage protocols and best practices to guide and address the needs of patients in a crisis situation * Coordinating with the agency on-call nurses to deliver high quality nursing care and schedule nursing assessments as required in a timely manner to meet the needs of the patients and families * Ensure appropriate education regarding all updates/processes in the electronic medical record, relative state and federal regulations, documentation processes and needs, etc. by attending mandatory educational offerings and in-services * Facilitates orientation of new personnel as assigned * Exhibits exemplary and timely communication skills when assessing or educating patients/caregivers, performing telephone triage, or collaborating with fellow healthcare professionals * Serves as a consistent example of dedication to patient advocacy, customer service, integrity, and superlative nursing practice You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: * Current, unrestrictive Registered Nurse licensed in all states of practice * 2+ years RN experience * 1+ years of direct patient care in a hospice, home health, or oncology setting * Proven ability to work flexible hours and independently Preferred Qualification: * Registered Nurse Compact licensure Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $28.27 to $50.48 per hour based on full-time employment. We comply with all minimum wage laws as applicable. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
    $28.3-50.5 hourly 19d ago
  • Lead Data Science Product Mgr

    Health Care Service Corporation 4.1company rating

    Richardson, TX 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** We are looking to hire a Lead Data Science Product Manager for The AI Innovation Lab at HCSC. The AI Lab is focused on application of leading-edge AI technologies to the business challenges of HCSC, and the product manager of this team owns key responsibilities such as stakeholder engagement, product prioritization, scoping, execution, and delivery on a portfolio that focuses primarily on Generative AI applications. This is an exciting opportunity to lead the adoption of AI to transform one of HCSC's core capabilities and drive tremendous impact for our customers and members. At the largest customer-owned and not-for-profit health insurer and fourth largest health insurer overall in the United States, you will have the opportunity to work with massive datasets to drive revenue growth, improve our operational and member-facing processes, and affect how healthcare is delivered to our 17 million members. An ideal candidate is someone who has a demonstrated track record of leading or delivering analytical projects and products with measurable value, can see the big picture and effectively communicate with executives, has an ability to explain complex technical concepts to non-technical audiences, and has a laser-focused customer and user-centric mindset. Day-to-day tasks include engaging senior and executive leadership in the domain area to understand their most significant business challenges, designing new AI products and solutions to automate or enable better decision making to address these challenges, building long-term product roadmaps, scaling and delivering on those products by working within cross-functional data science, IT, and business teams, and providing overall product leadership for one or more of our machine learning and AI initiatives. Successful candidates will also have indirect leadership over data scientists and engineers assigned to these initiatives. Note that while this position requires an understanding of data science, machine learning, and AI and its applications, it does not require "hands on" technical work such as coding. We are looking for a businessperson who has a strong technical background that can lead and indirectly influence both IT and business teams to scale and deploy models in a complex organizational environment. The AI Innovation Lab works within the context of the broader AI Solutions team at HCSC. The role reports to the Senior Director of Product Management for AI Solutions. There are many different domains (or thematic units) within AI Solutions, with topics that include Claims and Payment Integrity, Member Engagement, Utilization Management, Document Intelligence, Risk Stratification, and the AI Innovation Lab. Generally, one (or sometimes two) product managers are assigned for each different domain area. **Required Job Qualifications:** * Bachelors degree and 5 years of work experience in a mathematical, statistical, computer science, engineering, physics, economics or related quantitative field OR Actuarial credential or Masters degree and 4 years of work experience in an advanced mathematical, statistical , engineering, physics or related quantitative field OR Ph.D. and 2 years of work experience in a mathematical, statistical, computer science, engineering, physics, economics or related quantitative field OR 8 years of work experience in an advanced mathematical, statistical , engineering, physics or related quantitative field * Must demonstrate proficiency in at least four of the following six areas: 1) data analysis and relational-style query languages; 2) machine learning and/or statistical modeling; 3) data visualization; 4) a high-level programming language; 5) Generative AI; 6) understanding of healthcare. * Strong learning and growth mindset * Customer-focused * Strong interpersonal, verbal and written communication skills * A track record of independently delivering or leading the delivery of multiple complex analytics or data science projects **Preferred Job Qualifications:** * Previous product management experience * Experience with Generative AI and other cutting edge AI technologies (e.g., agentic AI) is strongly preferred. * Previous experience working with insurance claims systems and/or healthcare experience * Experience with Iterative / Agile / Scrum development *Experience successfully implementing at-scale A.I. solutions in cloud environments \#LI-MK1 \#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** $110,000.00 - $198,600.00 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.
    $110k-198.6k yearly 60d+ ago
  • Sr Systems Analyst - FACETS

    HCSC 4.5company rating

    HCSC job in Richardson, TX

    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 SummaryWe are seeking a motivated and collaborative Systems Analyst to provide skilled leadership on complex assignments/projects. This position is responsible for designing enhancements and new business applications and/or information systems solutions through integration of technical and business requirements; serving as technical designer to identify best solution and resulting technical specifications within limits of code environment; linking Business Analyst needs and Architect definition to technical solutions. Additionally, they will focus on providing thought leadership within the systems analysis space, and will work on projects that require broader understanding of the business. 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 Degree and 4 years Information Technology OR Technical Certification and/or College Courses and 6 year Information Technology experience OR 8 years Information Technology experience. * Knowledge of application configuration * Strong Understanding of Relational Databases * Requirements definition & management * Data modeling knowledge. * Proven advanced SQL skills (or other relevant back-end data query languages). * Excellent organizational skills with the ability to handle multiple projects and timelines with minimal supervision. * Strong knowledge of data analysis techniques; strong critical thinking skills. * Strong Understanding of SDLC Methodology - Agile / Scrum / Iterative Development * System Performance management * Problem solving and analytical thinking * Excellent verbal, written, interpersonal skills, including functional documentation skills. Preferred Job Qualifications: * Bachelor Degree in Computer Science or Information Technology related * Medicare Claims Payment Services * Experience with Jira * Knowledge of Cloud computing / SaaS / IaaS / PaaS technologies * Experience in data management assessment, analysis, and implementation * Healthcare/Healthcare insurance industry knowledge * Service Oriented Architecture - SOAP / REST * Web Technologies - HTML/CSS/Java/ASP.Net/PHP/Ruby/C# * Experience with Python #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$90,900.00 - $164,200.00 Exact compensation may vary based on skills, experience, and location.
    $90.9k-164.2k yearly Auto-Apply 21d ago
  • Per-Diem Pharmacy Technician

    Unitedhealth Group 4.6company rating

    Greenville, TX job

    **Explore opportunities with CPS,** part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind **Caring. Connecting. Growing together.** **About the Facility:** Glen Oaks Hospital is a 54-bed, The Joint Commission accredited, private behavioral health hospital located in Greenville, Texas. For nearly 30 years, Glen Oaks Hospital has been a leader in the field of mental health and chemical dependency care, and our staff is dedicated to researching the latest treatment approaches and applying this to our overall treatment philosophy. CPS Solutions-Optum has partnered with the hospital to manage the day-to-day operations of the pharmacy. This position is an employee of CPS Solutions-Optum. **Pharmacy Hours:** The pharmacy is open Monday-Friday 7:00am - 3:00pm, with limited morning hours on Saturday and Sunday. **Primary Responsibilities:** + Preparing, delivering, and restocking medications to the various units/departments + Data / order entry + Obtaining the necessary medications to stock the Omnicell machines, including unit-dose packaging of bulk tablets and capsules + Performs routine checks for medication outdates + Maintains pharmacy cleanliness in accordance with safety and regulatory standards + Assist with additional pharmacy duties as needed You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. **Required Qualifications:** + Registered, or the ability to become registered, as a pharmacy technician in the State of Texas + Pharmacy Technician license must be in good standing + National Certification through PTCB **Preferred Qualifications:** + 1+ years of hospital experience + Proficient computer skills including experience using Microsoft Word + Effective communications skills; verbal and written Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $16.15 to $28.80 per hour based on full-time employment. We comply with all minimum wage laws as applicable. _At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._ _UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._ _UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
    $16.2-28.8 hourly 4d ago
  • Early Careers - Customer Service Business Analyst Intern

    HCSC 4.5company rating

    HCSC job in Richardson, TX

    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 can be located in Chicago, IL or Richardson, TX What Are Your Responsibilities? The Customer Service Business Analyst Intern position is responsible for actively participating in an Internship program that leverages your skills, knowledge and capabilities within the Customer Service division 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. The Customer Service Business Analyst 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? * Prior related technical internship or work experience is a plus * Volunteerism or leadership experience is a plus * Eagerness to learn, grow and contribute * Demonstrated interpersonal skills including clear and concise verbal and written communication * Strong analytical and problem-solving skills * Be coachable and open to feedback * Have a professional presence * Results-oriented with a continuous improvement mindset and an ability to grasp new and unfamiliar concepts * Strong organizational and multi-tasking skills with the ability to prioritize and support multiple projects * Practical, developed PC skills, especially Office 365 and virtual team collaboration tools (MS Teams, Word, SharePoint, etc.) What Are the Requirements You Must Meet? * Pursuing a bachelor's degree in business, data analytics, information technology, information systems, computer science or other related degree * Graduation date between December 2026 - June 2027 * A minimum GPA of 3.0/4.0 * Availability to work ten 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 $18.46 - $37.84 Exact compensation may vary based on skills, experience, and location.
    $18.5-37.8 hourly Auto-Apply 6d ago

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