Post job

Qsource jobs

- 20 jobs
  • Medical Record Retrieval Operations Specialist

    Blue Cross Blue Shield of Minnesota 4.8company rating

    Remote or Eagan, MN job

    About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have This position will coordinate and implement activities supporting accurate and timely document management, adherence to tight project timelines, and protection of PHI. The Medical Record Retrieval Specialist will support the team by requesting, retrieving, processing, tracking and organizing incoming Medical Records which will be reviewed by the clinical and/or coding teams. Your Responsibilities Manage and maintain Medical records repository. Ensure accurate and timely record uploads, compliance with processes to protect PHI, and effective tracking of records and record requests. Retrieval of medical records via fax, mail, remote electronic medical record access or onsite visits at the provider location. Assist internal team and provider groups to troubleshoot any logistical or technical issues regarding records requests, retrieval or storage. Effectively communicate with team members and external providers to ensure adherence with challenging project timelines. Identify process issues and contribute to the design of solutions. Proactively implement process improvements. Complete additional tasks as required to support the project. Required Skills and Experience 3+ years of related experience. All relevant experience including work, education, transferable skills, and military experience will be considered. Recent document management experience. This includes knowledge and skills in using Adobe Pro, scanners, flash drives, navigating a shared drive and/or document repository, using software to track record requests, receipts and maintaining an issues log. Team player with ability to build and maintain relationships with cross-functional business partners, external partners, and others. Highly developed interpersonal communication skills. Strong organizational skills, ability to prioritize responsibilities with attention to detail. Must be self-motivated, able to take initiative, and work independently with minimal oversight to meet timelines, strong follow-through skills and a solutions-oriented attitude. Detail oriented, with the ability to organize and track information and documents. Ability to work under pressure and meet multiple deadlines. Experience in using Microsoft Office: Excel, Word, etc. Adobe Pro and demonstrated ability to learn/adapt to computer-based tracking and data collection tools. Proficient with navigating and retrieving clinical information from an electronic medical record. Knowledge of clinical documentation layout and experience with Medical Records. Ability to Travel. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience Associates Degree in Health Information or related field. Recent Health Care or Health Plan experience. RHIT Certification. Experience with Medical Records or in a Clinical setting. Experience in using Adobe Pro. Experience in using Microsoft Access. Experience in using multiple software programs to complete a process. Role DesignationHybrid Anchored in Connection Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote. Compensation and Benefits$21.00 - $26.25 - $31.50 Hourly Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: **********************************. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
    $31.5 hourly Auto-Apply 7d ago
  • Federal Employee Program Service Representative

    Blue Cross Blue Shield of Michigan 4.8company rating

    Remote job

    Ready to help us transform healthcare? Bring your true colors to blue. Federal Employee Program Member Advocate Remote work available Full Time Compensation: Starting at $20.51/hour ($40,000/year) Opportunities for continued salary growth as skills progress Annual raise/bonus based on performance. Blue Cross and Blue Shield of Massachusetts is the largest health care provider in the Commonwealth. The Federal Employee Program is Blue Cross Blue Shield of Massachusetts's largest single account. At Blue Cross Blue Shield of Massachusetts, our company promise is to always put our members first. Our mission is the relentless pursuit of quality, affordable, and equitable healthcare with an unparalleled consumer experience. As a Member Advocate, you will be at the heart of the consumer experience and a critical team member to support our mission. What you'll do Member Advocates work in a structured and supportive call center environment and are one of the most important positions at BCBSMA. You will be enrolled in a phased new hire training program to teach you everything you need to know about the health insurance industry. We will help you develop the skills and knowledge for a successful career to make a positive impact to Federal Employees. This is a fast-paced service center environment. No two members, problems, or resolutions are the same. We're looking for someone who is up for the challenge to be an expert and master the role by exceeding productivity, customer service, and performance measurements. As a call center employee, you'll be available to our members when they need us most. Our call center is open Monday, Tuesday, Wednesday, and Friday, 8:30am - 4:30pm EST (Thursdays 8:30-5:30) We offer flexible, remote working opportunities as well as additional training and development as you grow your career. Member Advocates usually spend most of each week taking calls with members, with specific time dedicated to learning and development, and research. The more you learn, the more you'll have opportunities to grow your career. What you bring Our Member Advocates are the kind of people who create a plan and take charge in situations where others feel lost. They deliver an exceptional member experience by taking ownership of members' issues, relieving their stress while guiding them to a resolution. We're looking for people who are: Proactive, solution-oriented decision makers Planners, multi-taskers, and expert problem solvers Analytical and critical thinkers - able to anticipate and address future needs. Able to multitask and thrive in a fast-paced, high-pressure environment. Curious, committed to learning and gathering information. Effective communicators and able to translate complicated concepts into simple terms. Emotionally intelligent and able to empathize and understand our members' needs and respond with compassion and guidance. Committed to answering members' questions and solving their problems to help them get back to enjoying their lives as quickly and effortlessly as possible. Empowered to provide members with peace of mind that their current issue is resolved and that none are on the horizon. What we bring As a FEP Member Advocate, you are the face of our company, and at BCBSMA we believe it's important to ask for your input on anything from member solutions to workspace design. We are rooted in the community we serve and are committed to helping all members and Massachusetts residents lead healthier lives. Join our team to enjoy: Flexible remote working solutions Recognition and rewards for high performance and improvement Internal career pathing with individual mentorship, networking, and events Employee resource groups for employees with shared backgrounds or the desire to learn more about their colleagues. All are welcome at our ERGs! Best in class health, wellness, and 401(k) retirement benefits among many others! Paid holidays, vacation, personal, and wellness time Paid volunteer and service opportunities Tuition reimbursement Required Qualifications: High school diploma or equivalent required 1 year customer service experience in insurance or financial services 6+ months experience frequently communicating (minimum 60% of time) with customers by phone, email, and/or in person. Technology savvy with strong working knowledge of computer software applications and operating systems with the ability to learn quickly and navigate through multiple systems simultaneously. Preferred Qualifications Experience in fast-paced contact center environment highly preferred Proficient in keyboarding and ability to type. Minimum Education Requirements: High school degree or equivalent required unless otherwise noted above LocationHinghamTime TypeFull time Hourly Range: $20.51 The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability. This job is also eligible for variable pay. We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees. Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. WHY Blue Cross Blue Shield of MA? We understand that the confidence gap and imposter syndrome can prevent amazing candidates coming our way, so please don't hesitate to apply. We'd love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It's in our differences that we will remain relentless in our pursuit to transform healthcare for ALL. As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you'd like to be a part of, we'd love to hear from you. You can also join our Talent Community to stay “in the know” on all things Blue. At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.
    $40k yearly Auto-Apply 22d ago
  • Underwriting Support Specialist

    Blue Cross Blue Shield of Michigan 4.8company rating

    Columbus, OH job

    The Underwriting Support Specialist I primarily performs review and entry of new business submissions, as well as provides assistance to the underwriting support services staff to promote timely renewal preparation and policy and endorsement issuance. Reviews, updates and distributes incoming bureau experience modification worksheets. RESPONSIBILITIES/TASKS: Reviews and enters new business submissions: Retrieves incoming submissions from UH Submissions email mailbox. Retrieves incoming Loss Control Analysis requests Checks reservation system for prior receipt of submission. Enters account information, including names, addresses, FEIN, agency and effective date. Enters classifications, payroll and experience mod to rate submission. Consults loss control maps for appropriate system entry of loss control zone. Reviews three-year evaluation of past loss experience noting source and trends, body part, length of service, age of EE, location/department and identifying large losses Completes analysis and files into the Duck system to assign to Loss Control Department Files submission correspondence on OnBase. Communicates completed submission and/or submission issues to underwriters. Handles endorsement transactions for LWMMI accounts per underwriter instructions Handles all new business issues and renewals for LWMMI account per underwriter instructions Reviews, updates and distributes bureau experience modification worksheets: Accesses bureau systems to retrieve worksheets. Compares worksheet experience mod date and factor with experience mod factor and dates in Diamond and updates if appropriate. Distributes mod worksheets to appropriate to support staff. Files experience mod worksheets and corresponding written communication on OnBase. Exports all Account Current Agency Bills and email direct to Agency contacts Assists in new business, renewal, endorsement and cancellation data entry and policy issuance as needed to provide support to the underwriting support services team. Assists in preparing meeting materials for monthly renewal meetings. Assists in other areas of processing as requested. This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. EMPLOYMENT QUALIFICATIONS: EDUCATION: High school diploma or G.E.D required. Additional college and/or insurance related course study desirable. Combinations of relevant education, certifications, and experience may be considered in lieu of a degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged. EXPERIENCE: Two years office or clerical support experience in an insurance environment Experience or previous knowledge of worker's Clerical experience in the workers' compensation line of business preferred. Completed relevant educational studies may be considered in lieu of experience. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: Ability to learn insurance practices/procedures. Excellent verbal and written communication Ability to organize daily work responsibilities and meet deadlines. Basic knowledge with insurance systems such as policy, billing and/or claims systems. Accurate math and data entry skills. Effective problem solving and attention to detail skills. Ability to work effectively both independently and as a team is essential. Knowledge of computers and standard software programs such as Microsoft Windows including spreadsheet applications and Microsoft Word. Excellent customer service skills WORKING CONDITIONS: Work is performed in an office setting with no unusual hazards. The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description. PAY RANGE: “Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $33,900 and $64,200.” We are an Equal Opportunity Employer. We will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract. #LI-CH1 #CIG
    $33.9k-64.2k yearly Auto-Apply 60d+ ago
  • Underwriter - Environmental Insurance (Hybrid)

    Blue Cross Blue Shield of Michigan 4.8company rating

    Remote or Westerville, OH job

    Century Insurance Group is a premier provider of excess and surplus lines insurance and is a division of AF Group, whose brands are premier providers of innovative, specialty insurance solutions nationwide. We manage business across three distinct segments - core commercial, specialty lines underwriting and specialized programs. We underwrite general liability, commercial property, and multi-peril insurance for small and mid-sized businesses through a select network of general agents and brokers. SUMMARY: This is an environmental underwriter role small to mid-size non-admitted market. Reviews, analyzes, approves, or rejects complex business within letter of authority. Serve as liaison with company personnel regarding company business opportunities and problem resolution. The preferred residency for this hybrid role is in or near Westerville, Ohio. RESPONSIBILITIES / TASKS: Calculates, prepares and develops premium quotations using corporate underwriting guidelines within letter of authority Determines underwriting eligibility for prospective policyholders and develops appropriate pricing for new business, renewals, and endorsements Analyzes and reviews prospective accounts for insurability and accepts or rejects within letter of authority. Supports agency relationships. Supports agency plans in cooperation with other staff. Addresses agents' and policyholders' concerns/needs. Develops new business and retention of existing business in a given territory or region. Explains and emphasizes benefit of workers' compensation insurance products and services to customers (agents and policyholders). Works with all internal departments to resolve problems and maintain company relations. Participates as necessary on special committees and task forces. Interprets and develops territory reports which reflect the status of the territory. Participates in promotional plans for both Century Insurance Group and agent activities. Analyzes and reviews production and loss information for agents. Prepares periodic reports as requested Researches and coordinates responses to agents, policyholders and regulatory entities Analyzes agency performance and develop corrective action plans as needed to correct poor performance. Analyze accounts to determine exposure and proper pricing Gathers competitive and product information from the field Responsible for profitability of territory. Trains agency employees on the use of company specific automation systems Reviews loss trends and develops action plans to correct problem areas Supports schedule for large account service plans with claims, loss control, premium audit, and other departments as needed Provides input for agency advisory council meetings Assists in the development of regional goal. This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required. EMPLOYMENT QUALIFICATIONS: EDUCATION: Bachelor's degree in marketing, insurance or related field. Combinations of relevant education and experience in the following areas may be considered in lieu of a degree: Underwriting, marketing, loss prevention, and/or auditing. Continuous learning required, as defined by the Company's learning philosophy. Certification, or progress toward, highly preferred and encouraged. EXPERIENCE: One-year of relevant experience which provides the necessary skills, knowledge and abilities is required. Agency management and marketing experience preferred or with proper education, successful completion of the trainee program. SKILLS/KNOWLEDGE/ABILITIES REQUIRED: Ability to exercise good judgment in evaluating and determining the proper pricing for prospective policyholders using corporate underwriting guidelines by accepting or rejecting risks for the purposes of issuing workers' compensation insurance coverage Ability to initiate insurance transactions in compliance with all policies, procedures, legal and ethical guidelines. Ability to negotiate while establishing a personal rapport and maintaining an effective working and client relationship. Knowledge of workers' compensation insurance and the independent agency system. Ability to apply creative and persuasive techniques to generate new, and maintain, existing business and ability to be creative when presented with unique situation. Ability and proficiency in the use of computers and company standard software. Strong interpersonal skills and ability to create and maintain mutually beneficial relationships. Ability to work with minimum supervision and balance demands of a field position by supporting agents while keeping current with underwriting workload. Ability to perform other assignments at locations outside the office. Ability to support agency relationships and to make sound underwriting decisions. knowledge of appropriate jurisdictional workers compensation laws Ability to calculate expected pricing, dividends, and premium quotations for agents and policyholders Ability to analyze territory or region in order to identify problems and take the appropriate corrective action Ability to comprehend the consequences of various problem situations and address them or refer them for appropriate decision making. Ability to effectively exchange information clearly and concisely, and present ideas, reports, facts and other information, and respond to questions as appropriate. Ability to analyze and solve practical problems which deal with a variety of variables. Ability to make and implement competent, independent decisions and to build consensus. Ability to understand and implement audit procedures and processes for agencies. Ability to relocate. WORKING CONDITIONS: Work is performed in the office and occasionally in the field with minimal hazards. Minimal travel is required with occasional overnight stays. May be required to lift and carry computer equipment and other marketing promotional items weighing up to 35 lbs. Must be willing and able to relocate. PAY RANGE: Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $52,700 and $88,,300. The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description. We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract. #LI-TM1 #CIG
    $52.7k-88k yearly Auto-Apply 48d ago
  • Manager, Provider Finance

    Blue Cross Blue Shield of Minnesota 4.8company rating

    Remote or Eagan, MN job

    About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have The Manager of Provider Finance leads a team of associates in one or more core functional areas to align provider reimbursement and strategy with corporate strategic initiatives. This role allocates resources within the teams, manages projects and strategic initiatives, coaches associates in their development, facilitates operational efficiency, and fosters collaboration across the division. Your Responsibilities Lead a team of associates tasked with aligning one or more core functional areas with corporate strategic direction. Serve as a subject matter expert to internal and external stakeholders on topics related to provider reimbursement including contract negotiations, corporate workgroups, specifically in alignment with one or more core functional areas. Researches, analyzes, and interprets data from internal and external sources to inform strategies for provider reimbursement & contracts Manages and amends relevant audit and internal control processes related to provider reimbursement and contracts. Conducts performance evaluation, and is responsible for managing employees, including skill and career development, policy administration, coaching on performance management and behavior, employee relations and cost control. The Manager of Provider Finance will also have oversight for one or more of the following core functional areas: Fee For Service Team Responsible for the design, development, and delivery of financial models and payment methodologies used in fee for service provider contracts and negotiations Network Implementation Team Responsible for system configuration, strategic design, and auditing required to support fee for service contracts and strategic initiatives Budgets & Settlements Team Responsible for the budgeting, forecasting, settlements and related reporting to support provider networks and strategic reimbursement. Required Skills and Experience 5+ years of related professional experience. Experience should be in a significant role in the health plan and/or healthcare insurance industry. All relevant experience including work, education, transferable skills, and military experience will be considered. 3 years experience managing teams involving multiple team members including task assignment, collaborating with key customers (internal or external), managing team and customer relationships and managing project deliverables with demonstrated coaching and mentoring skills. Knowledge of healthcare payment methodologies and coding protocols required. This includes but is not limited to: RBRVS, MS- and APR DRGs, EAPGs/APCs, CPT/HCPCS, ICD, healthcare coding protocols and government healthcare programs. Specific experience with financial modeling, auditing, forecasting, and budgeting in a healthcare environment. Strong oral and written communication skills. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience Bachelor's degree. Role DesignationHybrid Anchored in Connection Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote. Compensation and Benefits$115,000.00 - $155,300.00 - $195,600.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: **********************************. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
    $115k-155.3k yearly Auto-Apply 28d ago
  • Financial Applications Associate (Detroit-Hybrid)

    Blue Cross Blue Shield of Michigan 4.8company rating

    Remote or Detroit, MI job

    The Financial Applications Associate performs core technology functions including business and systems analysis, application development, and process improvement. Serve as a technical liaison between business areas and the IT organization to translate requirements into viable solutions. Identify, document, and communicate system and process changes necessary to enhance system performance and operational efficiency. Contribute to the identification, analysis, and recommendation of technical process improvement initiatives with working knowledge of finance accounting practices. Design, create, and implement technical solutions that address business needs. Support the development and maintenance of one or more low to moderately complex business systems and applications. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Business Analysis Conduct data gathering and analysis to understand business strategy requirements. Contribute to business short and long-term planning sessions and provide direction to ensure understanding of business goals and direction. Provide input from a business perspective. Evaluate ongoing department activity and propose new tools or technologies. Assist in the business process redesign and documentation as needed for new technology. Application Development Assist in the application development process to ensure application software is delivered on time and within budget. Ensure all system development lifecycle processes and standards are followed. Design, code, test, debug, document, implement and maintain moderately complex business applications. Provide ongoing maintenance of applications. Maintain existing reporting and process automation tools. Systems Analysis Analyze system defects and conduct root cause analysis. Develop system solution by preparing and evaluating alternative workflow solutions. Perform release management and end to end testing of systems changes. Identify, investigate, resolve and escalate problems a needed. Gather data to support recommendations to address problems. Procure additional technical assistance to help in problem resolution. Process Improvements Work on small to medium sized moderately complex process improvement initiatives supporting the business customer(s)/service(s). Analyze and evaluate business requirements and current processes and interfaces to identify gaps and areas of improvement. Develop process requirements and recommendations and communicate for the implementation of technical business solutions. Other Duties and Responsibilities Design and develop reports and data delivery to accommodate changing business requirements. Investigate, resolve and escalate problems. Adhere to policies and procedures supporting audits to ensure compliance with regulatory requirements. EDUCATION AND EXPERIENCE Bachelor's degree in related field such as Information Systems, Data Management, Computer Science, and/or Finance preferred. One (1) year of relevant technical or business work experience required. Experience in managing projects required. Demonstrated knowledge preferred in: system development life cycle process design, re-engineering, and organization transformation, Six Sigma, CMMI or ITIL computer programming languages QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. OTHER SKILLS AND ABILITIES Basic knowledge of business operations and systems requirement processes. Strong technical, analytical, systems skills. Display innovation in identifying, proposing, and overseeing the execution of business solutions. Written and verbal communication skills; interpersonal skills. Ability to provide technical or business guidance to clients, both internal and external. Ability to work independently, or within a team environment. Other related skills and/or abilities may be required to perform this job. ADDITIONAL INFORMATION The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. This job description does not constitute a contract for employment. All qualified applicants will receive consideration for employment with regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.
    $44k-65k yearly est. Auto-Apply 6d ago
  • Senior IAM Engineer

    Blue Cross Blue Shield of Minnesota 4.8company rating

    Remote or Eagan, MN job

    About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have Blue Cross and Blue Shield of Minnesota is looking for a Senior Identity and Access Management (IAM) Engineer to join our team! The Senior IAM Engineer is a technical expert who is responsible for Leading identity architecture and enforcement initiatives enterprise-wide. They will work with multiple platforms, operating systems, servers, and applications across the organization and ensure their security, stability, recoverability, and accessibility. They also analyze and evaluate customer requirements, plan and test systems, and document the framework and standards for integration and implementation. They may function as a lead or a mentor for other engineers and participate in or lead cross-functional initiatives and projects. Your Responsibilities Lead SSO integrations and Zero Trust identity enforcement Develops moderate to highly complex infrastructure interactions, such as architect JIT access, just-enough privilege, and identity lifecycle governance to ensure the security, stability, recoverability, and access to systems and information. Tracks industry trends and maintains knowledge of new technologies to better serve the enterprise architecture needs. Designs, implements, and manages Identity Governance and Administration (IGA) platform to ensure secure and compliant access to applications and data Develops and documents the framework for integration and implementation for changes to technical standards. Build CI/CD identity automation and logging pipelines Engineer modern authentication (FIDO2, passwordless) Participates in the RFP process to evaluate and select vendor solutions. May have accountability for project execution and resource allocation. Conducts detailed analysis and study of customer requirements for new or existing projects to determine feasibility, cost and time required, and compatibility with current systems and hardware capabilities. Advises on enterprise-wide infrastructure systems growth requirements, capabilities, and constraints to ensure the long-term functionality and operation standards. Participates in or leads cross-functional initiatives on the development and implementation of enterprise-wide major installations, upgrades and process changes. Facilitates knowledge sharing by creating and maintaining detailed, comprehensive documentation and diagrams. Assists manager in facilitating resource allocation to ensure appropriate staffing levels. Performs systems support activities and may include required participation in an on-call rotation for support of systems outside of normal business hours. Shares feedback with the manager as requested or deemed appropriate, and may make recommendations for performance reviews. Assists manager in facilitating goal accomplishment by providing work direction to assigned employees and by monitoring the status of work on a daily basis. Oversees and evaluates the work of contractors and vendors to ensure quality services. Provides coaching or mentoring to junior engineers and lead complex deployments Required Skills and Experience 5+ years of IAM engineering. All relevant experience including work, education, transferable skills, and military experience will be considered. Cloud Service Provider Certification (e.g., AWS Cloud Practitioner, Azure Fundamentals, etc.) - required within 1 year of employment Deep experience with modern authentication protocols Programming languages such as PowerShell, SQL and C# Advanced level knowledge of infrastructure design, implementation, administration, planning, developing. Advanced level knowledge of technical, business, and industry. Very strong oral and written communication and presentation skills. Very strong human relations skills to effectively interact with leadership and management, peers, business partners and vendors. Highly skilled at systems, creative, critical and analytical thinking, decision making and problem solving. Advanced or specialized understanding of the standards and deliverables to ensure integrity of the systems engineering process. Highly skilled at influencing and motivating individuals and teams. Certifications: AZ-500, SC-100, CISSP-ISSAP helpful Preferred Skills and Experience Bachelor's Degree. In-depth knowledge of BCBS computer methodologies. Advanced knowledge of multiple business areas. Technical Certification Participation in user groups (ACM, IEEE). Advanced knowledge of automation best practices, including the design, implementation, and continuous improvement of automated workflows to enhance efficiency, reliability, and security across identity and access management processes. Programming language experience with JavaScript. Role DesignationHybrid Anchored in Connection Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote. Compensation and Benefits$100,000.00 - $135,000.00 - $170,000.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: **********************************. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
    $100k-135k yearly Auto-Apply 40d ago
  • Associate Business Analyst- Accounting Systems (Detroit- Hybrid)

    Blue Cross Blue Shield of Michigan 4.8company rating

    Remote or Detroit, MI job

    The Associate Business Analyst position is responsible for conducting comprehensive analysis to identify accounting-focused solutions that address finance business needs. Serve as a liaison between the business area and the IT organization as needed. Diagnose process gaps, validate requirements, and recommend improvements. Utilize requirements gathering and process analysis methods to document accounting workflows, procedures, and system needs. Perform detailed reviews of accounting requests for system enhancements, reporting functionality, and data solutions. Translate business requirements into clear technical specifications that enable appropriate system and application changes. Support one or more low to moderately complex business processes. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Business Analysis Interacts with staff of various business units within the Enterprise to conduct business analysis of problem to be solved; clearly documents business need and change management documents. Assists with the identification of solution alternatives and communicates with other areas of the business and Information Systems as the advantages and disadvantages of each alternative are reviewed and a solution recommendation is made in collaboration with the appropriate business unit(s). Analyzes issues related to systems or data, identifies problems and documents specific business, data or system requirements. Works with various partners to determine system impacts, dependencies or additional requirements. Provide complete Business, Functional and Technical Requirements documentation that can be signed off by Business Unit subject matter experts and key decision makers. Facilitate meetings and requirements gathering utilizing various collaborative communication methods, such as teleconferencing, video conferencing and webinars. Monitors and validates production data to ensure data accuracy and completeness. Basic knowledge of finance processes. Application Development May Perform basic to advanced configuration changes in business systems and support data validation and system testing. Support the strategy, development and ongoing management of system workflows. Systems Analysis Ability to learn and understand data flow and system integrations to assist with troubleshooting software. Works with team to determine test approach and to translate requirements into test plans and test cases. Coordinates and facilitates execution of user acceptance testing. Responsible for validating technical changes for quality where system testing is not required. Maintains up-to-date technical and practical knowledge and understanding of systems analysis, system testing, and corporate internal processes and procedures. Process Improvements Triage and work issues, system enhancements, testing, and systems implementations. Completes change requests between business units, development, testing, quality control, and vendor management in coordinating information for proposed system enhancements or data changes and delivers to system implementation. Performs peer reviews for system configuration ensuring conformity to standards and quality. Assists team with estimates on requested system modifications or new system initiatives. Other Duties and Responsibilities Works closely and in combination with Developers, Test Analysts, and Systems Support Technicians. Develop and deliver appropriate documentation targeted to meet the needs of a variety of staff members. Ability to work effectively in a team environment and manage multiple priorities and ensure on time delivery. Maintains confidentiality. Prepares status and management reports as required. EDUCATION AND EXPERIENCE Bachelor's degree in related field, such as Finance, Accounting, Information Systems, and/or Data Management preferred. One (1) year of relevant technical or business work experience required. Experience in managing projects required. Demonstrated knowledge preferred in: system development life cycle process design, re-engineering, and organization transformation, Six Sigma, CMMI or ITIL computer programming languages QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. OTHER SKILLS AND ABILITIES Basic knowledge of business operations and systems requirement processes. Strong technical, analytical, systems skills. Display innovation in identifying, proposing, and overseeing the execution of business solutions. Written and verbal communication skills; interpersonal skills. Ability to provide technical or business guidance to clients, both internal and external. Ability to work independently, or within a team environment. Other related skills and/or abilities may be required to perform this job. ADDITIONAL INFORMATION The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. This job description does not constitute a contract for employment. All qualified applicants will receive consideration for employment with regard to, among other grounds, race, color, religion, sex, national origin, sexual orientation, age, gender identity, protected veteran status or status as an individual with a disability.
    $56k-70k yearly est. Auto-Apply 6d ago
  • Specialty Insurance - Senior Program Manager (AF Specialty)

    Blue Cross Blue Shield of Michigan 4.8company rating

    Remote job

    Role provides oversight of property and casualty programs via a delegated underwriting authority model. Responsible for maintaining strong partnership with the MGAs/MGUs/ program administrators, delivering operational excellence, ensuring adherence to underwriting guidelines, and alignment with the overall business strategy. The Senior Program Manager will serve as the primary point of contact between the MGA/MGU/program administrator and internal stakeholders, driving collaboration, profitability, and growth across the business portfolio. The Senior Program Manager will also serve as a mentor and trainer for other program managers. ESSENTIAL DUTIES AND RESPONSIBILITIES Other duties may be assigned. Manage complex program performance and profitability by monitoring key performance indicators, creating action plans when needed, handling underwriting referrals, and driving improvements in challenged segments through coordination with program administrators. Lead product development for the complex programs by building and maintaining underwriting guidelines, forms lists, letters of authority, and standards and procedures for those exceptions outside of the guidelines. Perform annual underwriting audits for all assigned programs, prepare audit reports, and ensure compliance with all recommendations made in accordance with division standards for timeliness. Partnering with key support units, including Finance, Actuarial, Claims, Legal, Compliance, Reinsurance, and Corporate Underwriting to analyze issues, identify solutions, and drive execution on challenges faced by the company, program administrators, and customers. Manage assigned relationships with program administrators, including regular visits. Support data collection needed for reinsurance placements, data calls, filings, or any other projects or requests. Support the writing of new programs and develop product or service enhancements for existing programs. Monitor and update premium and profitability projections Negotiate commission structures with program administrators Mentor and train other program managers EDUCATION AND EXPERIENCE Relevant combination of education and experience may be considered in lieu of degree. Bachelor's degree in insurance, business or a related field is required. Advanced insurance certification preferred. Minimum ten years of Property and Casualty experience, preferably in an underwriting and/or product development role. Minimum at least five years of program management via delegated underwriting authority or program administrator experience. Experience working with form/rate development and filing functions for programs is desired Certification or progress toward certification is highly preferred and encouraged. Continuous learning, as defined by the Company's learning philosophy, is required. QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. OTHER SKILLS AND ABILITIES Proficient with analyzing complex business problems. Excellent analytical, organizational and problem-solving skills. Highly entrepreneurial - comfortable within a culture that is fast-paced and dynamic Strong intellectual curiosity and desire to help others solve problems. Capable of influencing program administrator decision-making. Strong knowledge in commercial property and casualty underwriting. Knowledge of activities, practices and terminology of the commercial property and casualty insurance industry and relevant legal and administrative procedures. Ability to negotiate and establish a personal rapport with opposing parties, and to resolve conflicts in a professional manner. Ability to analyze and interpret financial and management data. Thorough knowledge of budget preparation and financial management. Ability to develop and implement effective and efficient recommendations. Self-directed in achieving closure on deliverables. Collaborative and team oriented. Excellent verbal and written communication skills. Demonstrated drive, determination, and persistence to achieve annual revenue targets. Presentation skills and confidence to present division and product in one-on-one settings or to large gatherings. A commitment to total customer satisfaction. ADDITIONAL INFORMATION The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. This does not constitute a contract for employment. WORKING CONDITIONS: Work is performed remote in a virtual home office with minimal hazards. Travel for team meetings, industry events or corporate functions. The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description. Pay Range - Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $121,500 and $230,700 (P4D). We are an Equal Opportunity Employer. We will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract. #LI-TM1 #AFG
    $121.5k-230.7k yearly Auto-Apply 19d ago
  • Senior Automation Engineer - Linux OS

    Blue Cross Blue Shield of Minnesota 4.8company rating

    Remote or Eagan, MN job

    About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact you will have Blue Cross and Blue Shield of Minnesota is seeking a Senior Automation Engineer to join our Infrastructure Operations team. In this role, you will leverage your expertise in Linux Operating Systems to design, implement, and optimize automation solutions that enhance system reliability and efficiency. The Senior Automation Engineer is responsible for designing, developing, and implementing automation solutions to optimize operations across technology and business environments. This role focuses on improving efficiency, reliability, and compliance through automation of processes, systems, and workflows. The engineer will work with various tools and platforms to build and maintain scalable automation solutions that reduce manual effort and operational costs. Your Responsibilities Design, develop, and implement complex automation solutions to streamline infrastructure and business processes. Analyze existing workflows and automation solutions, identify opportunities for improvement, and optimize them to enhance efficiency and scalability. Develop and maintain reusable automation frameworks, scripts, and components for scalability and maintainability, including creating process documentation and designing workflows. Integrate automation into enterprise platforms, across multi-cloud environments, and advanced CI/CD pipelines to support operational and development needs. Ensure and establish compliance, governance, and security standards are met across all automation solutions. Monitor, troubleshoot, and optimize automation workflows to ensure reliability and performance. Collaborate with stakeholders and cross-functional teams to gather requirements, validate processes, communicate automation strategies and benefits, and deliver complex automation projects. Maintain and upgrade automation platforms, ensuring high availability, disaster recovery, and alignment with business objectives. Stay current with emerging automation technologies and best practices to continuously enhance capabilities. Develop and execute testing strategies to validate automation solutions. Required Skills and Experience 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered. Cloud Service Provider Certification (e.g., AWS Cloud Practitioner, Azure Fundamentals, etc.) - required within 1 year of employment Essential Candidate Qualities: Creative thinking, strong communication skills, creativity, curiosity, self-motivated, time managements skills Configuration and administration experience with: Windows OS, Active Directory System Center Configuration Manager (SCCM), Ansible Automation, Redhat, AWS or Azure Cloud Knowledge, experience, and familiarity with: Kubernetes Cluster Management High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience Virtualization (Hyper-V, VMware) and containerization (Kubernetes, OpenShift) Familiarity with cloud migration tools Certifications in AWS, Azure, Dell, or HP infrastructure Role DesignationHybrid Anchored in Connection Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote. Compensation and Benefits$100,000.00 - $135,000.00 - $170,000.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: **********************************. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
    $100k-135k yearly Auto-Apply 13d ago
  • Internship Corporate Events HYBRID in Lansing MI

    Blue Cross Blue Shield of Michigan 4.8company rating

    Remote or Lansing, MI job

    Are you looking for an internship where you will work with a group of dynamic insurance professionals who are committed to social responsibility, making workplaces safe, and making a difference? If so, consider building your skills and starting your career with AF Group. Interns will work with employees throughout the organization to attain business objectives in the areas of insurance operations and corporate functions. Interns will gain exposure to agents, policyholders, health care providers, claimants, attorney and other AF Group staff and customers, as directed by business needs. Diverse knowledge of insurance company operations will be beneficial. Check out the Internships at Emergent Holdings video to learn more. : Performs duties related to the major functional areas of Corporate Events and administration Performs administrative tasks associated with meetings and events, such as event design research, event sourcing, budget creation, attendee registration and event materials creation. Will assist onsite at event. Attends unit, departmental, and corporate meetings as assigned. Shows learning and both personal and professional growth and understanding of responsibilities. Gains an understanding of how Emergent Holdings runs and how Workers Compensation Insurance and Medicare works. Shows punctuality, professionalism, and a positive attitude when completing assignments. Manages multiple deadlines. Completes miscellaneous assignments as assigned. Uses company software applications to complete assignments. Maintains confidentiality. Responds to internal and external customer inquiries. Performs other related duties which may not be specifically listed in the position description, but which are within the general occupational series and responsibility level typically associated with the employee's class of work. EMPLOYMENT QUALIFICATIONS: Have status as a sophomore, junior or senior as of the end of the spring term (or be enrolled in an applicable graduate program.) Have status as a rising freshman, at least 18 years-old, who is enrolled in or has completed a vocational insurance-related program, with some college credits. Hold a cumulative grade point average of 3.0 or better as of the most recent grading period. Be able to work full-time during normal business hours for this summer and part-time throughout the remainder of the school year (May through May). Be available to begin employment between mid-May. EDUCATION OR EQUIVALENT EXPERIENCE: Currently enrolled and active in any educational degree program that aligns with our various businesses. EXPERIENCE: With proper education credentials no experience necessary. Previous work experience preferred. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: Detail orientated Excellent oral and written communication skills. Excellent working knowledge of computers and company standard software; Internet research experience strongly preferred. Ability to proofread documents for spelling, grammar and punctuation. Ability to perform necessary mathematical computations. Ability to comprehend consequences of various situations and make appropriate individuals aware of same for decision making. Ability to exchange information clearly and concisely and to present ideas, report facts and other information. Ability to establish workflows, manage multiple projects and meet necessary deadlines while maintaining composure during stressful situations occurring because of workloads and/or deadlines. Ability to maintain confidentiality. WORKING CONDITIONS: Work is performed in an office setting with no unusual hazards. The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description. Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $18 and $33. We are an Equal Opportunity Employer. We will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.
    $28k-35k yearly est. Auto-Apply 60d+ ago
  • Manager - Provider Analytics

    Blue Cross Blue Shield of Minnesota 4.8company rating

    Remote or Eagan, MN job

    About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have In this role, you will assist in developing the vision, strategy, and operational leadership for Blue Cross Blue Shield of Minnesota's provider analytics suite. This leader will build data driven solutions with measurable impacts, including targeted financial measures, network performance, and optimization, primarily focusing on supporting value-based programs and general provider enablement. Your Responsibilities Responsible to manage and shape the strategy and execution for the provider analytics team while serving multiple stakeholders across the organization. Lead the development of strategic provider and network analytics across multiple complex operating environments. Formulate and align analytic capabilities with business unit strategies. Directly lead and manage a team of analytical professionals specializing in network optimization, value-based analytics, ancillary services analytics, provider contracting analytics, and ad hoc analytics, while also driving the development and growth of these teams. Lead provider analytics to support network development and contracting by identifying business opportunities, evaluating financial performance, and proactively analyzing medical expense trends to uncover future opportunities. Lead the ongoing development of analytic capabilities within the enterprise to enable enhanced client solutions through improved data reporting. Provide expert guidance, analytics, and consultative support on cost-of-care initiatives, driving actions for continuous improvement and cost efficiency. Identify and address analytical gaps between the current state and industry best practices, implementing solutions to deliver measurable business value. Collaborate closely with IT to enhance the integrated data warehouse, aligning improvements with strategic and business needs while ensuring data and reporting consistency throughout the organization. Partner closely with our technology teams to enhance analytic capabilities, streamline workflows, and modernize our technology stack. This initiative that supports both internal and external stakeholders. Develop clear, well-organized project-specific documentation that includes, at a minimum, the analytic methods used, key decision points, and any caveats, with sufficient detail to support comprehension and replication. Share development and process knowledge with analysts to maintain consistency and continuously build a strong analytical foundation within the organization. Align the team's priorities with the company's strategic direction and industry trends. Ensure the team's knowledge, skills, and abilities are sufficient to meet current and evolving needs. Oversee team assignments to ensure effective resource allocation, foster skill and career development, administer policies, and conduct goal setting and performance reviews. Required Skills and Experience 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered 3+ years of provider analytics experience (or comparable experience within the healthcare industry) Knowledge of analytic tools such as Tableau, PowerBI, SSRS, or similar Demonstrated ability to present complex technical information to non-technical audiences and to senior decision-makers Demonstrated experience in consultative collaboration, teamwork, project management and cross functional communication High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience Bachelor's or Master's degree Experience in public health, healthcare informatics, statistics, or related fields Proficiency in a programming language (SQL, R, Python, Visual Basic, etc.) Value Based Program knowledge Databricks experience Direct or indirect management experience Role DesignationHybrid Anchored in Connection Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote. Compensation and Benefits$115,000.00 - $155,300.00 - $195,600.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: **********************************. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
    $115k-155.3k yearly Auto-Apply 60d+ ago
  • Systems Engineer - Jira

    Blue Cross Blue Shield of Minnesota 4.8company rating

    Remote or Eagan, MN job

    About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have Blue Cross and Blue Shield of Minnesota is seeking a Systems Engineer with strong Jira platform experience to join our Business Operations Technology team. In this role, you will collaborate closely with Scrum Masters and business stakeholders to ensure projects are accurately configured, aligned, and maintained across the organization. The Systems Engineer is responsible for the execution of standards and guidelines that drive the design of technology solutions including implementing solutions requiring integration of multiple platforms, operating systems, servers and applications across the enterprise. Performs analysis and evaluation of customer technical and analytical requirements. Plans, develops, tests and documents systems and provides follow up to ensure success of the environment. Responsible as a technical resource in at least one critical service or technology and applies knowledge in at least one area. Your Responsibilities Conducts detailed analysis and study of customer requirements for new or existing projects to determine feasibility, cost and time required, and compatibility with current systems and hardware capabilities. Develops and documents the framework for integration and implementation for changes to technical standards. Develops moderate to complex infrastructure interactions to ensure the security, stability, recoverability, and access to systems and information. Participates in cross-functional initiatives on the development and implementation of enterprise-wide major installations, upgrades and process changes. Facilitates knowledge sharing by creating and maintaining detailed, comprehensive documentation and diagrams. Provides technical guidance to others as appropriate. Tracks industry trends and maintains knowledge of new technologies to better serve the enterprise architecture needs. Performs systems support activities and may include required participation in an on-call rotation for support of systems outside of normal business hours. Participates in structured cross-functional processes including architecture, change, risk, resiliency, incident, problem, CMDB, and asset management. Required Skills and Experience 3+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered. Cloud Service Provider Certification (e.g., AWS Cloud Practitioner, Azure Fundamentals, etc.) - required within 1 year of employment Demonstrated knowledge of infrastructure design, implementation, administration, planning, developing Demonstrated knowledge of technical, business, and industry. Strong oral and written communication and presentation skills. Strong human relations skills to effectively interact with leadership and management, peers, business partners and vendors. Skilled at systems, creative, critical and analytical thinking, decision making and problem solving. Demonstrated understanding of the standards and deliverables to ensure integrity of the systems engineering process. Knowledge of internal area applications. Demonstrated skills at hands-on communication, collaboration and leadership. Skilled at influencing and motivating individuals and teams. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience Bachelor's degree. Knowledge of BCBS computer methodologies. Advanced knowledge of multiple business areas. Technical Certification. Role DesignationHybrid Anchored in Connection Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote. Compensation and Benefits$88,600.00 - $117,400.00 - $146,200.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: **********************************. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
    $88.6k-117.4k yearly Auto-Apply 12d ago
  • Senior Internal Auditor

    Blue Cross Blue Shield of Michigan 4.8company rating

    Remote or Boston, MA job

    Ready to help us transform healthcare? Bring your true colors to blue. As a valued member of the Audit and Risk Management (ARM) team, the Senior Internal Auditor will lead and execute a variety of financial, operational, and risk-based audits as well as advisory and consulting engagements. This role is a key contributor to the organization, providing critical assurance that risks are being managed effectively. The ideal candidate will be a proactive and analytical professional who thrives in a collaborative, cross-functional environment. This position offers significant exposure to diverse areas of the company and direct interaction with key stakeholders. Further, this role will be asked to use data analytics tools and techniques to enhance audit testing, identify emerging risks, and drive automation and efficiency in audit processes. This role is eligible for our Flex persona What you'll do: Conduct or support Model Audit Rule (MAR) and other audits, in compliance with established policies, plans, procedures and governmental regulations to ensure effectiveness of financial and operational controls. May also perform related IT control test-work or participate in projects for other Internal Audit teams as needed. Provide support for key financial and operational areas impacting financial reporting and risk-based audits of these areas (e.g. Enrollment, Premiums, Claims Operations, Provider Enrollment and Pricing, Accounting, and Information Technology areas). Drive value-add advisory and consulting engagement as needed. Suggest and execute ideas for enhancing operational efficiency, in alignment with the Company's commitment to quality assurance and continuous improvement methodology, including the use of automation and analytics. Assist in developing control consciousness in the business units audited. Assist with or coordinate regulatory, compliance, or operational readiness assessments. Provide ongoing communication regarding audit status and findings to audit leadership and business area management. Identify and communicate areas of risk and communicates those risks effectively to Internal Audit management. Conduct regular follow up with business leads to ensure that outstanding items are resolved. Assist in preparing audit communications, reports and supporting documentation related to findings and value-added recommendations that promote effective and efficient solutions to business issues and risks. Support multiple, concurrent projects with extremely tight deadlines, reporting to different project team leaders. We're looking for: The ability to work independently on complex projects and as part of a project team. Effective time management skills, including the ability to handle multiple project assignments and deadlines simultaneously and track/monitor project issues. The ability to identify risks and formulate proposed action steps to be discussed with Internal Audit management. Someone who develops positive relationships with peers, leaders, and external parties to influence positive outcomes and ensure resolution of audit issues. Effective written and verbal communication skills. Strong analytical and problem-solving skills. What you bring: Bachelor's degree in Accounting, Business, or related field is required; graduate degree is a plus. 2-4 years of internal audit experience is required within finance and/or operations; experience in public accounting or a healthcare background preferred but not required. Experience with data visualization tools (Tableau, Power BI, others), SQL, and/or SAS programming language for data extraction and manipulation. Certifications in Internal Auditing (CIA) and auditing Information Systems (CISA) is preferred. CPA, or candidate working toward CPA designation, is preferred but not required. Working knowledge of/experience with general internal control requirements, and general understanding of business operations, financial and information technology procedures, and controls. Excellent oral and written communication skills, effective report writing and presentations. Project management skills with demonstrated experience in meeting project timelines and deliverables and the ability to handle multiple project assignments simultaneously. Demonstrated ability to work independently and as part of a project team Proficient with Microsoft Office applications including Word, Excel, Access, Power Point, and Visio. Experience with AuditBoard and/or ACL is a plus. What you'll gain: Perks of the job include a healthy work-life balance (37.5 weekly hours), significant autonomy, flexibility in remote work arrangements, competitive benefits, and a culture of learning and development. This role provides a unique vantage-point to understanding the entire organization and an opportunity to make a tangible impact on its success. We are embarking on a journey to discover ways in which automation can influence our work, and this role will play a key part in identifying those opportunities. Minimum Education Requirements: High school degree or equivalent required unless otherwise noted above LocationBoston, HinghamTime TypeFull time Salary Range: $87,390.00 - $106,810.00 The job posting range is the lowest to highest salary we in good faith believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the posted range, and the range may be modified in the future. An employee's pay position within the salary range will be based on several factors including, but limited to, relevant education, qualifications, certifications, experience, skills, performance, shift, travel requirements, sales or revenue-based metrics, and business or organizational needs and affordability. This job is also eligible for variable pay. We offer comprehensive package of benefits including paid time off, medical/dental/vision insurance, 401(k), and a suite of well-being benefits to eligible employees. Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law. WHY Blue Cross Blue Shield of MA? We understand that the confidence gap and imposter syndrome can prevent amazing candidates coming our way, so please don't hesitate to apply. We'd love to hear from you. You might be just what we need for this role or possibly another one at Blue Cross Blue Shield of MA. The more voices we have represented and amplified in our business, the more we will all thrive, contribute, and be brilliant. We encourage you to bring us your true colors, , your perspectives, and your experiences. It's in our differences that we will remain relentless in our pursuit to transform healthcare for ALL. As an employer, we are committed to investing in your development and providing the necessary resources to enable your success. Learn how we are dedicated to creating an inclusive and rewarding workplace that promotes excellence and provides opportunities for employees to forge their unique career path by visiting our Company Culture page. If this sounds like something you'd like to be a part of, we'd love to hear from you. You can also join our Talent Community to stay “in the know” on all things Blue. At Blue Cross Blue Shield of Massachusetts, we believe in wellness and that work/life balance is a key part of associate wellbeing. For more information on how we work and support that work/life balance visit our "How We Work" Page.
    $87.4k-106.8k yearly Auto-Apply 7d ago
  • Senior Business Analyst

    Blue Cross Blue Shield of Minnesota 4.8company rating

    Remote or Eagan, MN job

    About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have This position is responsible for the analysis, development, support, reporting and coordination of business workflow automation and to implement efficient business processes at an enterprise level. Your Responsibilities Conducts in-depth research and analysis. Identifies trends, emerging issues and recommends best practices to ensure maximum results and develops metrics. Documents metrics and process changes. Effectively analyzes, designs, develops, tests, debugs, implements, maintains and/or enhances new or existing systems through reporting and documentation. Participate in and coordinate individual projects and related activities to ensure project progresses on schedule. Maintains adequate communication regarding project status, risks, issues, and priorities with project sponsors and leadership. Acts as a liaison with internal partners and external partners to identify opportunities and needs and researches/develops implementation plans for meeting these needs. Responsible for representing the customer and/or stakeholder (internal/external) while collaborating with business and technical units. Serves as senior subject matter expert associated with content, processes, and procedures. May lead project teams and may provide training to lower level staff to achieve project milestones and objectives. Required Skills and Experience 5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered. Advanced collaborative, interpersonal, oral and written communication skills and demonstrated ability to develop accurate and appropriate communications. Advanced ability to communicate to all levels of management. Advanced research, analytical and problem solving skills. Advanced skills in Microsoft Excel, Word, and Access. Strong ability to make decisions based on analysis and business needs. Advanced ability to bring a different perspective to situations and challenge the status quo. Project management skills. Proven ability to work independently with guidance in only the most complex situations. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience Bachelor's degree. Working knowledge of SAP, Visio, or other software programs. Role DesignationHybrid Anchored in Connection Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote. Compensation and Benefits$88,600.00 - $117,400.00 - $146,200.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: **********************************. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
    $88.6k-117.4k yearly Auto-Apply 32d ago
  • Director of Value Performance Submissions and Analytics

    Blue Cross Blue Shield of Minnesota 4.8company rating

    Remote or Eagan, MN job

    About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have The Director of Value Performance Submissions and Analytics leads a high performing team directing and influencing risk adjustment and quality programs decision making, overseeing data and information collection, overseeing data presentations to stakeholders through reports and dashboards, and responsible for government submissions across BCBS MN's government programs - Medicare, Medicaid, and Affordable Care Act (ACA). This position is responsible for supporting all data-driven initiatives of our risk adjustment and quality programs to support our corporate goals, while leading, mentoring and motivating a diverse team of business and data analysts. This director-level role requires coordination with multiple stakeholders to implement and execute the accurate, complete, and truthful submission of data to multiple entities including vendors performing activities or analyses on our behalf, third-party data collection and submissions entities, and government bodies such as CMS, HHS, and DHS. Your Responsibilities Develop, lead, and provide strategic direction for a high performing team responsible for maintaining, executing, and evaluating initiative impacts using the risk adjustment and quality analytics models across ACA Commercial, Medicare, and Medicaid. Develop, lead, and provide strategic direction for a high performing team responsible for the execution and day-to-day management of data submissions for ACA Commercial, Medicare, and Medicaid risk adjustment and quality programs. Design and execute complex analytic strategies - including benchmarking, prevalence tracking, cohort stratification, predictive modeling, and suspecting logic leading to accurate risk adjustment scores and supporting quality measure gap closure. Direct data preparation for analytic efforts by establishing data quality and accuracy standards; approving system improvements to enhance overall quality of data; championing the resolution of critical issues as appropriate; and reviewing complex or high-profile data sets. Oversee the development, implementation, and automation of business and reporting strategies by partnering with key stakeholders to ensure their design, planning, and implementation needs are being met while ensuring alignment with strategic business objectives; reviewing and approving results and roadmaps as appropriate; ensuring compliance with standards and guidelines for data reports, visualizations, and/or interactive Business Intelligence (BI) reports; and sharing insights with stakeholders on key findings. Direct research, analyses, and interpretation of risk adjustment and quality data and provide technical assistance to other departments including Underwriting, Government Programs, Finance, Network Management, Health Management, Sales and Marketing, Legal, and Senior Staff. Responsible for synthesizing complex findings into clear, compelling narratives that support strategic decision-making and stakeholder alignment. Review and maintain processes to assess and prevent data loss that may impact risk adjustment accuracy or quality programs. Engage, participate, and present in risk adjustment and quality strategic planning activities by partnering with internal stakeholders to develop strategies, goals, objectives and initiatives that align to corporate and divisional priorities. Provides leadership and oversight with responsibility for key employment decisions including selection, onboarding, performance management, coaching skill and career development, policy administration, employee relations, and cost control. Required Skills and Experience Accepting this director level position at BCBSMN requires signing an Employee Confidentiality, Intellectual Property Assignment and Restrictive Covenants Agreement as a condition of employment. 7+ years of related professional experience, with 3+ years of management experience. All relevant experience including work, education, transferable skills, and military experience will be considered. Excellent knowledge of Medicare Advantage and/or the ACA marketplace and understanding of CMS initiatives and reasoning. Advanced knowledge of Microsoft SQL Server and its BI tools (SSIS, SSRS), with strong data capabilities to interpret complex data and develop strategic data-driven recommendations Strong knowledge of data visualization software. Exceptional creative thinking, problem-solving, and critical thinking skills. Excellent communication, collaboration, consultation, presentation, and interpersonal skills. Clearly and effectively communicates technical concepts, issues, and solutions to non-technical audiences. Ability to lead others and build relationships. Demonstrated delegation and management skills. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience Master's degree in Finance, Mathematics, Computer Science, Health Science or Data Science. Experience leading Risk Adjustment submission teams in a Health insurance companies, Healthcare providers, Healthcare technology add regulators (CMS, department of health, etc) and consulting companies. Experience leading HEDIS data collection and submissions. Knowledge of statistical software (R or SAS). Role DesignationHybrid Anchored in Connection Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote. Compensation and Benefits$132,300.00 - $178,600.00 - $224,900.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: **********************************. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
    $132.3k-178.6k yearly Auto-Apply 35d ago
  • Principal Risk Adjustment Healthcare Analyst

    Blue Cross Blue Shield of Minnesota 4.8company rating

    Remote or Eagan, MN job

    About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have Blue Cross and Blue Shield of Minnesota is hiring a Principal Healthcare Analyst on our Risk Adjustment team in Eagan, MN. The Principal Healthcare Analyst - Risk Adjustment is responsible for leading analytical insights to develop and implement strategic business solutions through research, auditing, and data analysis. This role leverages deep expertise in Risk Adjustment and healthcare data-primarily Medicare Advantage, Medicaid, and ACA Commercial-identifying trends and communicating insights to senior stakeholders across the enterprise. The ideal candidate will have experience in Risk Adjustment methodologies, clinical coding, and healthcare programs (Medicare Advantage, Medicaid, ACA Commercial), as well as proficiency in SQL, Power BI, and presenting findings to diverse audiences. Acting as a Content Expert and Business Lead, this position drives strategic initiatives and influences decision-making at Blue Cross Blue Shield of Minnesota. Success in this role requires a combination of industry knowledge, programming and data skills, and strong statistical and analytical capabilities. The Principal Healthcare Analyst will make significant contributions that shape strategic decisions and improve organizational performance. Your Responsibilities Uses databases for analysis and dissemination of information. Performs complex analysis of data. Researches, analyzes data, applies statistical methods when appropriate, and provides interpretation of outcomes. Identifies issues to be researched, determining affected areas, estimating the impact and contributing to the resolution. Leads teams to develop analytic approaches, measurement plans, data analysis, and report results on health care utilization, expenditures, outcomes, and benchmarks. Initiates actions to discover new analyses that will contribute to the strategic needs of Blue Cross Blue Shield of Minnesota. Works with leadership to understand and interpret the impacts to cost and quality of proposals using relevant data sources and analytic methods. Helps drive the implementation of new products and systems by providing actionable information and recommendations that evaluate the impact of the proposed products and systems. Represents the division on corporate projects and may have leadership roles on these teams. Independently manages issues that may arise on multiple tasks or projects with limited or no management involvement. Acts as a resource and/or mentor for other members of the department and company on business issues and may be responsible for training and guidance of other employees. Formulates strategic recommendations and present findings to management and external clients. Serves as an analytic consultant who can explain complex measurement or analysis techniques and results in layman's terms. Required Skills and Experience 7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered. 5 years experience analyzing and modeling data involving outcomes and utilization, using various statistical software and computer programming (SQL and Power BI). Proficiency in Microsoft software applications such as Word, PowerPoint, Excel, Access. Demonstrated ability to design, evaluate and interpret complex data sets. Demonstrated ability to handle multiple tasks with competing priorities. Demonstrated analytic and problems solving skills. Excellent written and verbal communication skills, with the ability to interpret and communicate analytical information to both individuals and groups in a clear and concise manner. Demonstrated ability to present complex technical information to non-technical audiences and to senior decision-makers. Demonstrated ability to work effectively both independently and in a team setting with individuals having diverse professional backgrounds including business, technical and/clinical. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience At least 3 to 5 years of experience working in healthcare analytics with a focus on Risk Adjustment is strongly preferred. Experience supporting multiple payers or lines of business (Medicare Advantage, Medicaid, ACA Commercial). Familiarity with clinical coding (ICD-10-CM) and revenue cycles. Design, maintain and automate Power BI / SQL based dashboards and standard reports for leadership. Experience developing and maintaining dashboards (via Power BI) showing risk adjustment activities performance across multiple lines of business. Provide ad-hoc analysis to support business cases, audit responses, and reporting. Knowledge of managed care and healthcare claims preferred. Bachelor's degree. Role DesignationHybrid Anchored in Connection Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote. Compensation and Benefits$100,000.00 - $135,000.00 - $170,000.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: **********************************. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
    $100k-135k yearly Auto-Apply 2d ago
  • Principal Solutions Architect

    Blue Cross Blue Shield of Minnesota 4.8company rating

    Remote or Eagan, MN job

    About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have Blue Cross and Blue Shield of Minnesota is looking for a Principal Solutions Architect to join our team! In this role, you will support our MDM (Master/Membership Data Management) systems and other claims systems. The Principal Solutions Architect is responsible for overseeing the design and implementation of data solutions across the enterprise. They will work closely with the senior data solutions architects to ensure that data solutions are aligned with the overall IT strategy and meet industry standards. The Principal Solutions Architect will also be responsible for leading the development of data governance policies and procedures to ensure that data is managed and used effectively. The Principal Solutions Architect is responsible for ensuring that data solutions are designed and implemented in a way that supports the company's long-term goals. Their work is essential to the company's ability to effectively leverage data to improve its operations and decision-making. Your Responsibilities Promote and support the use of cloud computing architecture and recommend the best cloud technology for building secure, reliable, cost-efficient, high-performance, and operationally sound applications for the Enterprise Data Platform on Amazon Web Services (AWS). Drive solutions with alignment to the enterprise strategy and enterprise architecture roadmap, collaborating with program and project managers, product owners, and enterprise architects. Mentor and coach delivery teams on reusable pattern designs and configurable frameworks, ensuring the effective execution of technology-driven business solutions across initiatives. Translate business information and technical requirements into an architectural blueprint that outlines solutions to achieve business objectives. Own the principles and services used to develop a technical cloud strategy, oversee cloud migration efforts, examine workload architectures, and provide guidance and recommendations on addressing high-risk issues. Design configurable frameworks and identify patterns for building robust data pipelines. Stay up to date with the best practices of AWS services and solutions and industry trends. Present findings, recommendations, and proof of concepts (POC) to the team, leadership, and stakeholders. Oversee and consult on project and foundational data analysis, data design and modeling, and architectural reviews while ensuring quality and compliance to the enterprise data strategy. Research and maintain awareness of current and emerging process, policy, and technology solutions related to Information Technology and overall strategy. Mentor and educate others in data architecture principles through the project development life cycle. Required Skills and Experience 7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered. Expertise in designing complex to highly complex application programs and systems. Strong understanding of the complete data analytics stack and workflow, from ETL to data platform design to BI and analytics tools. Strong database, data warehouse, and data processing skills. Conceptual knowledge of common BI and data exploration tools (e.g., SAS, Power BI, SQL). Experience and understanding of large-scale infrastructure-as-a-service platforms (e.g., Amazon AWS) and its security architecture. Excellent oral and written communication and presentation skills, with strong hands-on communication, facilitation, collaboration, and leadership skills. Ability to effectively interact with leadership and management, peers, business partners, and vendors. Creative, critical, and analytical thinking, decision-making, and problem-solving skills. Strong skills in influencing and motivating individuals and teams, with the ability to influence stakeholders in the decision-making process. Familiarity with licensing, contracting, and pricing structures for software and vendor solutions. AWS Solution Architect certification. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience Bachelor's Degree in Computer Science, Information Technology, or Engineering Healthcare experience highly preferred Other certifications (e.g., Data Modeling and Data Warehousing). Knowledge of data integration tools and technologies (e.g., Glue). Knowledge of orchestration tools like Stonebranch, Airflow, etc. Master Data Management Systems Role DesignationHybrid Anchored in Connection Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote. Compensation and Benefits$115,000.00 - $155,300.00 - $195,600.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: **********************************. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
    $115k-155.3k yearly Auto-Apply 60d+ ago
  • Principal Treasury Analyst

    Blue Cross Blue Shield of Minnesota 4.8company rating

    Remote or Eagan, MN job

    About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You Will Have The Principal Treasury Analyst will support all aspects of enterprise Treasury activities. This includes but is not limited to strategic treasury recommendations, assessment of capital markets, treasury performance management, development of treasury strategies, liquidity management across the enterprise, and development of treasury board-related content. The Principal Treasury Analyst will work on multiple simultaneous projects at any given time. The Principal Treasury Analyst will report directly to the Treasury Director. Your Responsibilities Participate in and assist with efficient cash management and cash forecasting of all corporate cash assets to ensure appropriate liquidity is available for operations and strategic purposes. Participate in and assist with strategies to efficiently utilize capital and ensure capital is optimized across the enterprise. This includes assessment of balance sheet management and internal rate of return. Participate in and assist with develop capital market strategies by assessing enterprise needs and market conditions. This includes use of lines of credit, bank facilities, and/or bonds. Participate and assist with management of investor relation activities including analysis preparations and management presentations for financial partners, stakeholders, and all bond debt holders. Participate and assist with the daily cash positioning, accounting and reconciliation of enterprise bank accounts. Conducts industry, market, and company research. Develops financial models for short-term investment opportunities and strategic initiatives. Participate in and assist with the preparation and presentation of the annual enterprise rating agencies process, including but not limited to the analysis of financial and operating information. Provides financial, analytical, and project management support for financial and operational due diligence processes. Assist with the development of analytics, peer comparisons, management reporting, and key performance indicators (KPIs). Participate in and assist with the preparation of monthly, quarterly, and annual reports, including budget/forecasting cycles. Adhere to conducting work through development and approved policies, processes, and controls to ensure compliance and to mitigate risks for the organization. Supports team members in the creation of presentation materials for senior management and executive leaders. Establish, develop, and maintain effective relationships with and treasury contact network to maximize the flow of information and enhance the research process. Knowledge of all Enterprise treasury & investment policies and guidelines and their applicability to relevant entities. Provide research and decision support related to special projects as needed. Continuously look for methods of improvement. Mentoring of junior staff. Required Skills and Experience 7+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered. Knowledge of financial markets, enterprise treasury, investments, risk management and subsequent best practices. Strong communication and collaboration skills to ensure Treasury and Investment objectives are communicated and understood. Knowledge of banking and investment legal and regulatory environment. Strong written and verbal communication skills with the ability to present complex treasury, investment, and accounting information clearly to senior management. Exceptional organizational and time management ability, with flexibility to handle a variety of challenging responsibilities and change priorities as needed. Well-developed analytical and problem-solving skills, including understanding of complex investment concepts. Ability to interact effectively with internal and external customers. Requires strong computer skills in Bloomberg Analytics, FactSet, TMS systems (i.e., Kyriba) and Microsoft Access, Excel and Word. High school diploma (or equivalency) and legal authorization to work in the U.S. Preferred Skills and Experience Bachelor's degree. MBA or advanced degree in Finance or Finance-related area of study. CFA, CTP, CPA, FRM, and/or CRMP Demonstrated knowledge in financial industry and insurance industry. Knowledge of NAIC, SEC, and IRS rules and regulations. Role DesignationHybrid Anchored in Connection Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week - most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote. Compensation and Benefits$100,000.00 - $135,000.00 - $170,000.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about what we have to offer, please review our benefits page. Equal Employment Opportunity Statement At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: **********************************. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.
    $100k-135k yearly Auto-Apply 60d+ ago
  • Senior Auditor II - HYBRID

    Blue Cross Blue Shield of Arizona 4.8company rating

    Remote or Phoenix, AZ job

    Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions. At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements: Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month Onsite: daily onsite requirement based on the essential functions of the job Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week. This position is hybrid within the state of AZ only. This hybrid work opportunity requires residency, and work to be performed, within the State of Arizona. PURPOSE OF THE JOB Plans, performs, reports, and follows up on audit assignments to ensure that within appropriate economic limitations: financial statements and reports comply with corporate policy, internal accounting controls are effective in promoting efficiency and protecting assets of Company, and operational policies promoting well-being of Company are enforced. QUALIFICATIONS REQUIRED QUALIFICATIONS Required Work Experience 3 years of experience in accounting and/or auditing Required Education High School Diploma or GED in general field of study Required Licenses N/A Required Certifications N/A PREFERRED QUALIFICATIONS Preferred Work Experience 3 years of healthcare experience 10 years of experience in accounting or audit Preferred Education Bachelor's or master's degree in business or related field of study Preferred Licenses N/A Preferred Certifications Certified Public Accountant (CPA) Certified Internal Auditor (CIA) Certified Information Systems Auditor (CISA) ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES LEVEL 1 - Senior Internal Auditor I Formulate plans for performing audit assignments. Recommend areas for future audit efforts. Prepare or revise audit programs to accomplish audit objectives and perform field work accordingly. Prepare time budgets for completion of various audit steps. Draft audit reports and document audit work and compile audit work-papers to support audit results and conclusion. Review report draft findings and recommendations with company management. Evaluate responses to reports to determine reasonableness and suggest follow-up actions. Participate in project teams as necessary. Assist Internal Audit management and external auditors as required. Assist teams in meeting project deadlines. Keep current with developments in field of expertise. Level 2 - Senior Internal Auditor II Assist IA manager with special projects. Conduct the Annual Risk Assessment. Lead the annual external audit coordination. Participate in interdepartmental teams as directed by IA manager. Work closely with other departments resolving questions or discrepancies. Level 3 - Senior Internal Auditor III Perform continuous risk assessments as needed to determine where audit efforts should be focused. Assist leads and managers in formulating audit plan for presentation to the board Perform sensitive high level projects Analyze and assess the controls environment of the business processes in accordance with the audit program. Assist other junior level auditors as needed. Be seen as the SME of the IA department ALL LEVELS Each progressive level includes the ability to perform the essential functions of any lower levels and assist / mentor employees in those levels. The position has an onsite expectation of 1 day per week and requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements. Perform all other duties as assigned. COMPETENCIES REQUIRED COMPETENCIES Required Job Skills (Applies to All Levels) Intermediate PC proficiency Intermediate proficiency in spreadsheet, database and word processing software Required Professional Competencies Analytical skills to support independent and effective decisions Prioritize tasks and work with multiple priorities, sometimes under limited time constraints. Perserverance in the face of resistance or setbacks. Effective interpersonal skills and ability to maintain positive working relationship with others. Verbal and written communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts. Working knowledge of HIPAA and privacy requirements Maintain confidentiality and privacy Analytical knowledge necessary to generate reports based on available data and then make decisions based on reported data Required Leadership Experience and Competencies N/A PREFERRED COMPETENCIES Preferred Job Skills Advanced PC proficiency Advanced proficiency in spreadsheet, database and word processing software Use of IDEA software Preferred Professional Competencies Identify solutions to meet customer needs Work with ambiguous and conflicting information while keeping focused on the end goal. Preferred Leadership Experience and Competencies N/A Our Commitment AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group. Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.
    $66k-87k yearly est. Auto-Apply 18d ago

Learn more about Qsource jobs

Jobs from similar companies

Jobs from similar companies you might want to view.

Most common jobs at Qsource

Zippia gives an in-depth look into the details of Qsource, including salaries, political affiliations, employee data, and more, in order to inform job seekers about Qsource. The employee data is based on information from people who have self-reported their past or current employments at Qsource. The data on this page is also based on data sources collected from public and open data sources on the Internet and other locations, as well as proprietary data we licensed from other companies. Sources of data may include, but are not limited to, the BLS, company filings, estimates based on those filings, H1B filings, and other public and private datasets. While we have made attempts to ensure that the information displayed are correct, Zippia is not responsible for any errors or omissions or for the results obtained from the use of this information. None of the information on this page has been provided or approved by Qsource. The data presented on this page does not represent the view of Qsource and its employees or that of Zippia.

Qsource may also be known as or be related to QSOURCE and Qsource.