Tufts Health Plan jobs in Boston, MA - 131 jobs

A healthcare company seeks a Director of Workforce Capacity Planning to lead strategic workforce capacity initiatives across various operations. The ideal candidate will have extensive experience in workforce management and management roles. Responsibilities include developing capacity plans, demand forecasting, and communicating analysis insights effectively. The role offers competitive compensation in the range of $168,000 - $231,000 per year, along with a bonus incentive plan. Join us to make a real impact on patient care and consumer experiences. #J-18808-Ljbffr

A healthcare service provider is seeking a Director for its Next Best Action (NBA) Platform to lead the architecture of a real-time decisioning platform. This role demands a seasoned leader with at least 12 years of software engineering experience, expertise in real-time APIs, and a strong track record in machine learning integration. The ideal candidate will guide cross-functional teams and ensure decision outputs are traceable and compliant with regulations. This position offers a salary range of $189,400 to $260,500 annually, along with competitive benefits and a bonus incentive plan. #J-18808-Ljbffr

Pay Range: $64,600.00 - $96,800.00 Please email HR_Talent_************************** if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We're dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. Why this job matters: Perform daily operations of provider education as it pertains to Risk Revenue and Quality department. Execute the development, implementation, and maintenance of departmental policies, procedures, and programs. What you will do: Coordinate with ACOs on common strategies to improve quality, coding, and health equity. Work with the analytics team to set metrics to measure the success of the program and monitor progress of individual providers. Works with the analytics team and ACO leadership to identify providers who would benefit from a provider education program and prioritize engagement. Takes feedback from ACO and internal leadership to focus on areas of educational need and improve process Stays up-to-date on the latest ICD-10 guidelines, OIG Letters, CMS guidance, and Coding Clinics and is able to relay that information internally and externally. Creates training material to distribute externally to ACOs. Works with the coding education manager to improve accuracy and ensure material has relevance to organizational goals. Provide virtual and/or onsite presentations on chart reviews and various topics related to quality improvement to clinicians, staff, and leadership. Works with the internal and external teams to develop individualized presentations and plans for providers. Ability to analyze risks in documentation, billing, and quality and implement a plan to mitigate those risks through intervention. Utilize analytical thinking to assess coding data and trends. Review basic analytic reports to evaluate coding accuracy and efficiency. Present analytic findings and insights during provider training sessions to inform and improve coding practices Works with the coding education manager to maintain a schedule of provider education visits to maintain a routine in order to provide timely feedback to clinicians. Execute the development, implementation, and maintenance of departmental policies, procedures, and programs. Perform other duties as assigned. What you need to succeed: CPC and CRC coding certification from AAPC, CCS coding certification from AHIMA Three to five years of experience in provider education, HCC coding, and care management years provider education experience 3+ years of experience in healthcare. Proven analytic experience using Microsoft Excel, database query capabilities and ability to evaluate data at various levels of detail Strong and effective decision-making skills Excellent organizational skills and ability to successfully prioritize multiple tasks Proficiency with Microsoft Suite of products (i.e., Word, Excel, PPT, etc.) Ability to effectively interact with all levels of the organization Excellent verbal and written communication skills, with ability to convey complex or technical information in an effective manner Proficiency in ICD/10-CM medical coding Advanced analytical skills, with the ability to interpret and synthesize basic data sets Knowledge of business process improvement techniques and strategies Negotiation skills Presentation skills Ability to effectively navigate ambiguous situations with limited direction The extras: Bachelor's degree or an equivalent combination of education and experience Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit ************************************************************** to view the "Know Your Rights" poster.

Become a part of our caring community and help us put health first The Market Vice President of Pharmacy Professional Practice will be responsible for pharmacy practice related compliance of CenterWell Pharmacy, encompassing Traditional, Specialty, and Community pharmacies throughout the United States. The Market Vice President makes certain the pharmacy and its operations comply with all applicable federal, state and local laws and regulations, as well as ensuring internal policies and procedures meet or exceed industry standards, , and are followed and communicated timely to all affected employees. The Market Vice President will work collaboratively with operational, legal, compliance, and engineering stakeholders to accomplish business initiatives while ensuring pharmacy practice compliance. The Market Vice President will serve as a subject matter expert in pharmacy practice compliance with extensive knowledge in regulations of Boards of Pharmacy, DEA, FDA, and other applicable healthcare and pharmacy regulatory agencies. The Market Vice President will report directly to the SVP of CenterWell Pharmacy/CenterWell Specialty Pharmacy and will lead a team consisting of Pharmacists-In-Charge, Directors, and Professionals to ensure pharmacy practice compliance. This position can be located anywhere within the lower 48 states and does not require relocation, however travel to pharmacies, industry conferences, and internal meetings is required. Key Responsibilities Ensures pharmacy practice compliance with all federal, state, local, and Board of Pharmacy regulations. Provides guidance and strategy on responses to regulatory agency inquiries (Boards of Pharmacy) Ensures all pharmacies are appropriately licensed and registered with Boards of Pharmacy, DEA, and other applicable regulatory agencies. Ensures all pharmacy associates are appropriately licensed and registered in their respective jurisdictions to perform required tasks of the pharmacy. Oversees pharmacy policy and ensures all policies and procedures are appropriate and reviewed regularly Oversees team that is responsible for Prescription Drug Monitoring Reporting and related compliance Oversees pharmacy accreditation (ACHC, NABP, URAC) ensuring that required accreditations are obtained and maintained. Oversees team responsible for pharmacy associate professional development (ex. obtaining pharmacy technician licenses, providing continuing education, etc.) Oversees team responsible for pharmacy management system user access Establishes guidelines to comply with the policies and procedures, applicable statutes, and regulations and implement corrective action plans, when needed. Sets and ensures consistent application of additional internal standards to help a company stand out in the industry Verifies legality and compliance of pharmacy practice related items Responsible for oversight of training and education programs and conducts audits to monitor compliance Influences and collaborates with operational peers related to intradepartmental coordination, development and implementation of strategic plans, and business outcomes, weighing risk and compliance with business operations Develops and implements strategic plans for the scope of management that are aligned with the Segment or Business strategy Functions as a key leader on the Pharmacy Leadership team, with the ability to be a strategic thought-partner and to synthesize and communicate complex ideas Providing strategic leadership to a high-performing team of Pharmacy professionals; grow the team by recruiting, hiring, developing, and retaining high-caliber talent Required Qualifications Bachelor's degree in Pharmacy or PharmD. Min 5 years' experience leading pharmacy practice/compliance for a large pharmacy Active pharmacist license for the state of employment Extensive experience in Pharmacy, particularly home delivery pharmacy or managed care environment 5 or more years of management/people leadership experience Deep knowledge of pharmacy practice regulatory compliance requirements (BOP, DEA, FDA, etc.) Working knowledge of privacy and HIPAA regulations and USP guidance Experience in providing guidance for clinical operational aspects of pharmacy Ability to manage clinical decision-making aspects within the pharmacy Ability to participate in federal prescription programs Working knowledge of Medicare Part B and Part D Coverage Determinations (chapters 6 and 18) Must be passionate about contributing to an organization focused on continuously improving consumer experiences Use your skills to make an impact Preferred Qualifications Master's degree Additional Information Travel While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $223,800 - $313,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 02-28-2026 About us About CenterWell Pharmacy: CenterWell Pharmacy provides convenient, safe, reliable pharmacy services and is committed to excellence and quality. Through our home delivery and over-the-counter fulfillment services, specialty, and retail pharmacy locations, we provide customers simple, integrated solutions every time. We care for patients with chronic and complex illnesses, as well as offer personalized clinical and educational services to improve health outcomes and drive superior medication adherence. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options ************************************************************* #J-18808-Ljbffr

Become a part of our caring community and help us put health first Make a meaningful impact every day as a CenterWell Home Health nurse. You'll provide personalized, one-on-one care that helps patients regain independence in the comfort of their homes. Working closely with a dedicated team of physicians and clinicians, you'll develop and manage care plans that support recovery and help patients get back to the life they love. As a Home Health Registered Nurse, you will: * Provide admission, case management, and follow-up skilled nursing visits for home health patients. * Administer on-going care and case management for each patient, provide necessary follow-up as directed by the Clinical Manager. * Confer with physician in developing the initial plan of treatment based on physician's orders and initial patient assessment. Provide hands-on care, management and evaluation of the care plan and teaching of the patient in accordance with physician orders, under Clinical Manager's supervision. Revise plan in consultation with physician based on ongoing assessments and as required by policy/regulation. * Coordinate appropriate care, encompassing various healthcare personnel (such as Physical Therapists, Occupational Therapists, Home Health Aides and external providers). * Report patient care/condition/progress to patient's physician and Clinical Manager on a continuous basis. * Implement patient care plan in conjunction with patient and family to assist them in achieving optimal resolution of needs/problems. * Coordinate/oversee/supervise the work of Home Health Aides, Certified Home Health Aides and Personal Care Workers and provides written personal care instructions/care plan that reflect current plan of care. Monitor the appropriate completion of documentation by home health aides/personal care workers as part of the supervisory/leadership responsibility. * Discharge patients after consultation with the physician and Clinical Manager, preparing and completing needed clinical documentation. * Prepare appropriate medical documentation on all patients, including any case conferences, patient contacts, medication order changes, re-certifications, progress updates, and care plan changes. Prepare visit/shift reports, updates/summarizes patient records, and confers with other health care disciplines in providing optimum patient care. Use your skills to make an impact Required Experience/Skills: * Diploma, Associate or Bachelor Degree in Nursing * Minimum of one year nursing experience preferred * Strong med surg, ICU, ER, acute experience * Home Health experience a plus * Current and unrestricted Registered Nurse licensure * Current CPR certification * Strong organizational and communication skills * Valid driver's license, auto insurance and reliable transportation. Pay Range * $54.00 - $75.00 - pay per visit/unit * $84,600 - $116,300 per year base pay Scheduled Weekly Hours 1 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $84,600 - $116,300 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Pay Range: $54,400.00 - $71,400.00 Please email HR_Talent_************************** if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We're dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. What you will do: Respond to member phone calls and conduct outreach calls to identified members; facilitate problem resolution through research. Refer call to appropriate resources in a timely manner. Promote health management programs and provide community resources available to members; utilize engagement skills and motivational interviewing techniques to enroll members in programs. Maintain supportive communication with the member via the member's channel preference (phone, web, e-mail, mail); provide education, monitor and reporting compliance, identify gaps in care, and adjust the plan as needed. Consult with internal clinical staff as needed when assessment or gaps in care indicate increasing severity of the member's condition requiring more intense monitoring and intervention. Consult with other clinical staff (dietician, behavioral health clinician, medical director) on an as needed basis. Participate in ongoing quality improvement initiatives and overall department efficiencies. Assist team with department initiatives and projects. Perform other duties as assigned. What you'll need to succeed: Associate's or Bachelor's degree in Business Management, Healthcare Administration, or Unrestricted Rhode Island LPN or LVN Nursing License; or an equivalent combination of education and experience Two to four years' experience in a health-related position The extras: Engagement and sales skills necessary for enrolling members into health management programs Persuasive skills required to negotiate, develop, influence, motivate, and move others through the stages of behavior change Interpersonal skills in order to interact effectively with internal and external customers Ability to research data, identify trends and recommend appropriate actions Detail oriented Ability to work successfully in a matrix environment Demonstrated written and verbal communications skills Ability to exercise sound judgment Ability to establish and maintain strong working relationships with various stakeholders Ability to organize work efficiently to meet established time and quality standards Good organization skills Good time management skills Proficiency with Microsoft Suite of products; i.e., Word, Excel, PPT, etc Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit ************************************************************** to view the "Know Your Rights" poster.

Pay Range: $64,600.00 - $96,800.00 Please email HR_Talent_************************** if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We're dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. What you will do: Pharmacy Benefit Expertise Serve as a subject matter expert on pharmacy benefit design and trend management; respond to inquiries regarding prescription coverage and member utilization. Cross-Functional Collaboration Work with internal teams (Sales, Marketing, Customer Service & Care Management) to triage and research customer needs, analyze market dynamics, and integrate strategies into the pharmacy benefit toolkit. Employer Group Support Deliver in person presentations and program performance updates; analyze data and track adoption of benefit options and coordinate cost-saving initiatives across departments. PBM Partnership, Program Optimization & RFP Compliance Collaborate with PBM and internal teams to enhance reporting tools, optimize programs, and ensure compliance with benefit design and regulatory requirements. Gather and validate data for RFPs, ensuring accurate, timely responses to assigned questions. Claims Adjudication Oversight Review pharmacy benefit rules, resolve coverage issues, and ensure accurate adjudication of claims in alignment with benefit design. Administrative & Communication Management Support P&T Committee functions, manage internal requests and member outreach, and facilitate communication between pharmacists and providers for care coordination. In Person Presentations and Department Meeting Must have the ability to work onsite for internal department meetings and offsite for external client meetings and presentations. Additional Responsibilities Perform other duties as assigned to maintain high-quality, cost-effective pharmacy benefit operations. What you'll need to succeed: Knowledge of formularies, drug rebate contracts, and pharmacy benefit design Knowledge of cost containment and utilization review strategies Analytical skills specific to pharmacy utilization management and/or project management. Strong communication, interpersonal and presentation skills. Proficient in Microsoft Office applications (i.e. Excel, PowerPoint) The extras: Combination of education and applicable experience Three to five years' experience in managed care or a pharmacy or related healthcare field. Specific knowledge and exposure to prescription drugs, pharmacy benefits, utilization review, cost containment strategies, and emerging technology. Experience with group level presentation and financial analysis reporting on pharmacy trends and benefit performance. Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit ************************************************************** to view the "Know Your Rights" poster.

Pay Range: $73,500.00 - $110,300.00 Please email HR_Talent_************************** if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We're dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. Why this job matters: Supervise the daily work of staff to ensure adherence to quality standards, deadlines, and proper procedures. Oversee key performance items measured in service levels and account performance guarantees. Provide performance management oversight and employee development. Manage workflow of department; implement corporate or departmental policies, procedures, and service standards. Assist in external audits preparation and follow up. Assist with completing RFP (request for proposal) responses related to performance guarantees. What you will do: Coordinate the workflow and operations of the performance monitoring team. Provide direction and guidance to staff. Review and evaluate work and prepare performance reviews. Direct the day-to-day operations of the performance monitoring team in its efforts to monitor the key performance items measured in the service level program, and account performance guarantees. Investigate declines in performance and oversee resolution with key operational areas to improve performance on account performance guarantees. Oversee implementation of account performance guarantee reporting. Oversee analysis of reporting and data capabilities to develop and implement selections of possible account performance guarantees that are measurable, achievable and consistent with internal standards and reporting capabilities. Develop and update standard contract language regarding the methodology used to measure and report the guarantees. Ensure that reports are generated, analyzed and provided to the account via BCBSRI Sales department where such guarantees exist. Collaborate with internal areas to identify existing guarantees and transition all accounts to standard guarantees where possible. Notify appropriate vendor manager of changes in guarantees that relate to vendor PGs/ SLAs. Assist with completing performance guarantee-related responses to RFPs. Update and maintain a database/tracking system to monitor performance issues identified through non-regulatory external audits and performance monitoring reports. Facilitate the resolution of all issues identified. Communicate performance issues with potential negative impact to internal departments. Perform other duties as assigned. What you need to succeed: A combination of education and related work experience Three to five years' experience in auditing and/or account performance function Knowledge of health care financing, operational functions and auditing requirements Knowledge of Blue Cross Blue Shield Association requirements related to operational performance Understanding of contractual agreements and effects on operational performance Ability to set and maintain quality standards Ability to develop and maintain effective and collaborative working relationships Strong and effective decision-making skills Strong organizational and time management skills Proficiency with Microsoft Suite of products (i.e., Word, Excel, PPT, etc.) The extras: Bachelor's degree in Business Administration, Accounting, Finance, or related field, or an equivalent combination of education and experience Supervisory experience or experience leading a team Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit ************************************************************** to view the "Know Your Rights" poster.

Become a part of our caring community and help us put health first Join Humana's Financial Planning & Analysis team, part of the CFO team, which drives aggregate financial results and insights across primarily Individual Medicare Advantage (MA). This team serves as a central hub for financial strategy and analysis, with connections to enterprise-wide and total Insurance perspectives. The Actuarial Analytics/Forecasting Principal role offers flexibility in responsibilities, significant exposure to senior leadership, and strong potential for upward mobility. We seek candidates who are willing to think creatively, challenge assumptions, voice opinions on key drivers and ranges, and contribute to a culture of continuous improvement and healthy debate. The Actuarial Analytics/Forecasting Principal analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium, and long‑term financial and competitive position. The Actuarial Analytics/Forecasting Principal provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. The Actuarial Analytics/Forecasting Principal ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost‑effective resolutions for data anomalies. Works with senior executives to develop and drive segment or enterprise‑wide functional strategies. Advises one or more areas, programs, or functions and provides recommendations to senior executives on matters of significance, and as an advanced subject matter expert competent to work at very high levels in multiple knowledge and functional areas across the enterprise. Use your skills to make an impact Required Qualifications Bachelor's degree, in some instances a Master's or Doctorate's degree 10 or more years of technical experience 2-5 years of project/people leadership FSA or ASA plus relevant advanced degree, recent and relevant work experience, and/or other relevant professional designations MAAA Strong communication skills Experience in more than two functions (e.g., modeling, pricing, rate filing, reporting & analysis, reserving or trending) Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Medicare Advantage pricing and forecasting experience Experience working with aggregate financials across insurance products or enterprise‑level financial planning Demonstrated ability to challenge existing assumptions and propose creative solutions Additional Information Humana is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, or veteran status. For more information on Humana careers, please visit Humana Careers (******************************** Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $156,600 - $215,400 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole‑person well‑being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short‑term and long‑term disability, life insurance and many other opportunities. Application Deadline: 01-30-2026 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our *************************************************************************** #J-18808-Ljbffr

Pay Range: $64,600.00 - $96,800.00 Please email HR_Talent_************************** if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We're dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. What you will do: 2 - 3 Days On-Site in Providence, RI Collaborate with appropriate stakeholders to track, measure, report and evaluate vendor classification status, Tier II program and any additional data related strategies adopted for the program. Identify and attend engagement opportunities to ensure a comprehensive vendor pool Manage, review and respond to inquiries from various internal channels Work with the marketing and communications teams to maintain and update relevant content on the company's intranet and website Identify qualified, prospective small and prospective vendors that are representative of a comprehensive enterprise ecosystem, inclusive of certified non-traditional suppliers, socially disadvantaged, small and historically underutilized enterprises and facilitates introductory discussions with procurement associates and/or business owners Develop relationships with internal stakeholders to ensure understanding of and engagement with supplier engagement & innovation initiatives and provide consultative support to internal business owners to design, streamline, and manage the engagement with vendors. Work with internal and external stakeholders to assist in the development of a supplier engagement & innovation training, mentoring and networking program Seek out, identify and execute on participation of local events and opportunities (i.e. trade shows, markets, educational seminars, web tutorials etc.) Perform other duties as assigned. What you'll need to succeed: Bachelor's degree in business management, communications, or related field; or an equivalent combination of education and experience Five or more years of experience in supply chain management, supplier engagement, small business support, data analytics Strategic and critical thinking skills Strong analytical skills and ability to interpret the data to communicate trends and best practices Strong business acumen and political savvy Strong negotiation skills Strong problem-solving skills Ability to work effectively with a wide variety of people in individual and group settings Strong organizing skills, with the ability to prioritize and respond to shifting deadlines and work independently Strong time management skills Strong attention to details Ability to manage diverse and deadline-oriented workflow Work effectively with a diverse workforce Travel required The extras: Experience building relationships with business and business stakeholders Knowledge of BCBSRI business activities or previous healthcare industry experience Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit ************************************************************** to view the "Know Your Rights" poster.

Pay Range: $57,500.00 - $86,200.00 Please email HR_Talent_************************** if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We're dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. Why this job matters: Meet financial reporting deadlines for internal management and external agencies. Interpret how to apply accounts to financial statements and other internal and external reporting mechanisms. What you will do: Prepare monthly financial statements. Utilize accounting knowledge to properly classify accounts into assets, liabilities and reserves for balance and for the income statement and to classify accounts into premiums, claims, administrative experience and investment income. Prepare journal entries, account analysis, reconciliations and written analysis for entry into the general ledger. Reconcile and analyze account balances to ensure accuracy of general ledger. Provide written analysis for comparative periods. Prepare work papers for annual completion of audited GAAP and SAP financial statements and accompanying footnotes. Prepare supporting schedules, copy source documents and print internal reports to support the amounts reflected in the financial statement and footnotes. Complete internal management reports such as product profitability, census reports, rating surveys, etc as required. Aggregate financial data to meet the form specifications and to ensure that totals foot to account for all financial statement categories. Participate in department initiatives and projects. Perform other duties as assigned. What you need to succeed: Bachelor's degree in Accounting, Business, Management or related field, or an equivalent combination of education and work experience Three to five years experience in accounting, financial analysis and reporting capacity Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations Ability to compute rates, ratios, and percentages and minimally interpret and draw conclusions from numerical data Ability to read documents and identify the issue Ability to apply sound Accounting application to carry out work duties Ability to resolve problems involving several concrete variables in non-standard situations Advanced analytical skills, with the ability to interpret and synthesize complex data sets Good business acumen and political savvy Knowledge of business process improvement techniques and strategies Excellent verbal and written communications skills Negotiation skills Presentation skills Decision-making skills Good problem solving skills Ability to interface with employees at all levels Ability to effectively navigate ambiguous situations with limited direction Excellent organizational skills and ability to successfully prioritize multiple tasks Ability to handle multiple priorities/projects The extras: Experience with Solomon General Ledger, Excel, Word and Report Writer Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit ************************************************************** to view the "Know Your Rights" poster.

Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity No Late Nights! Make Lives Better Including Your Own. If you want to work in an environment where you can become your best possible self, join us! You'll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness. Full suite of health insurance, life insurance and retirement plans are available and vary by employment status. Part and Full Time Benefits Eligibility Medical, Dental, Vision insurance 401(k) Associate assistance program Employee discounts Referral program Early access to earned wages for hourly associates (outside of CA) Optional voluntary benefits including ID theft protection and pet insurance Full Time Only Benefits Eligibility Paid Time Off Paid holidays Company provided life insurance Adoption benefit Disability (short and long term) Flexible Spending Accounts Health Savings Account Optional life and dependent life insurance Optional voluntary benefits including accident, critical illness and hospital indemnity Insurance, and legal plan Tuition reimbursement Base pay in range will be determined by applicant's skills and experience. Role is also eligible for team based bonus opportunities. Temporary associates are not benefits eligible but may participate in the company's 401(k) program. Veterans, transitioning active duty military personnel, and military spouses are encouraged to apply. To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year. The application window is anticipated to close within 30 days of the date of the posting. Responsibilities Operates a dish washing machine to clean dishes, glasses, cups, trays, silverware, and other food service equipment. Dishwashers keep all food prep and service areas sanitary, empty garbage, and sweep/mop kitchen floors. Responsible for overall cleanliness of the kitchen. Assists with prep as needed. Brookdale is an equal opportunity employer and a drug-free workplace.

Become a part of our caring community and help us put health first The Medical Social Worker participates in the interdisciplinary care provided to home health patients. The Medical Social Worker functions to evaluate and develop a plan of care personalized to fit the patient's emotional and social needs. The Medical Social Worker provides direction and supervision of the Social Worker Assistant as required and when involved in the patient's plan of care. The Medical Social Worker works within CenterWell Home Health's company-specific policy and procedures, applicable healthcare standards, governmental laws, and regulations. * Assesses the patient's social and emotional state as it relates to his or her illness or injury, needs for care and his or her response to such treatment, and adjustments to care. * Assesses any relationships of the patient's medical and nursing needs in the home setting, financial resources, and available community resources. * Provides any appropriate action to obtain available community resources to assist in resolving issues that may be impeding the patient's recovery. * Instructs patients and families in treating and coping with social and emotional response connected with Provides ongoing assessment of patient and family needs and responses to teaching * Assists the physician and other health team members in understanding the significant social and emotional factors related to the patient's health Participates in the development and periodic re-evaluation of the physician's Plan of Care for the patient. * Observes, records, and reports changes in patients' condition and response to treatment to the Clinical Manager and the Participates in the discharge planning process * Participates as a member of the interdisciplinary care team in care coordination activities and acts as a resource to other health team members in the identification and resolution of patient needs * Supervises instructs and evaluates the performance of the Social Work Assistant (BSW) to assure that all medical social services are provided to patients in compliance with Company, government, and professional standards * Maintains and submits documentation as required by the company and/ or facility including any case conferences, patient/physician community contacts, visit reports progress notes, and confers with other health care disciplines in providing optimum patient. Use your skills to make an impact Required Skills/Experience * Masters or doctoral degree from a school of social work accredited by the Council on Social Work Education. * Social Worker licensure in the state of practice; if required by state law or regulation. * A valid driver's license, auto insurance, and reliable transportation are required. * Proof of current CPR certification * Minimum of one year of experience as a social worker in a health care setting, home health, and/or hospice. * Knowledge of and the ability to assist with discharge planning needs, and to obtain community resources (housing, shelter, funeral/memorial service arrangements, legal, information and referral, state/federal financial and medication programs, and eligibility. * Excellent oral and written communication and interpersonal skills. * Must read, write and speak fluent English. * Knowledge of medications and their correct administration. * Ability to organize tasks, develop action plans, set priorities, and function under stressful situations. * Ability to be flexible in work hours and travel locally. * Ability to communicate effectively with patients and their family members and at all levels of the organization. * Maintains current licensure certifications and meets mandatory continuing education requirements. * Must read, write and speak fluent English. * Must have good and regular attendance. * Performs other related duties as assigned. * Valid driver's license, auto insurance and reliable transportation. Scheduled Weekly Hours 1 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $64,400 - $87,100 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers benefits for limited term, variable schedule and per diem associates which are designed to support whole-person well-being. Among these benefits, Humana provides paid time off, 401(k) retirement savings plan, employee assistance program, business travel and accident. About Us About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers - all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives. About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Pay Range: $98,100.00 - $163,400.00 Please email HR_Talent_************************** if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We're dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. What you will do: Lead the extraction and analysis of health care data for specific studies and corporate initiatives related to the Total Cost of Care. Lead data intensive projects related to data exchanges with contracted clinical vendors; Serve as a technical resource to department staff and management on technical issues; Develop and improve automated processes to increase the efficiency and accuracy of work products. What you'll need to succeed: Develop deep understanding of claims, eligibility and provider data to support clinical vendor implementations and ongoing relationships. Perform data extraction and mapping activities in alignment with vendor program specifications. Collaborate with vendors to define necessary inbound data elements and facilitate their integration into BCBSRI data structures. Drive data discussions to ensure “minimum necessary” data is provided to fully support clinical programs. Present and defend data requirements at internal Data Governance Committee. Triage data discrepancies and expeditiously resolve inconsistencies. Perform complex analytical work of health care data. Utilize data to provide insights about customers and prospects to support the growth of various market segments. Initiate and lead data intensive projects; translate quantitative findings into practical insights through the interpretation of data, trends and other sources. Prepare project results or recommendations for a wide range of audiences using written reports and presentation exhibits/graphics. Conduct special data extraction and analysis studies. Summarize results and provide recommendations where appropriate. Design, implement, and maintain various databases as assigned; develop reporting capabilities and ensure data quality and documentation is adequate. Identify areas where operational efficiency can be improved through enhanced automation. Collaborate with technical staff on implementation of enhancements. Communicate necessary changes and enhancements to all internal/external customers. Represent the organization at external meetings. Provide recommendations and input to new contract provisions for performance guarantees. Respond to various Requests for Implementation as requested by marketing staff. Perform special studies as needed. Perform other duties as assigned. Bachelor's degree in Computer Science, Mathematics, Economics, or related field; or an equivalent combination of education and experience Seven to ten years health data analysis, business analysis, software application, database design, and technical documentation experience, preferably in the health insurance industry Successfully pass the Wolfe Spence Programmer Aptitude test Knowledge of claims processing and membership processing for all BCBSRI lines of business The extras: Knowledge of applied statistics Knowledge of econometric modeling Knowledge of marketing analytic principles and modeling Experience utilizing competitive intelligence Knowledge of CPT-4 and ICD-9 coding and covered benefits Understanding of SAS programming, spreadsheet, and database software and other application development tools Knowledge of general mathematical principals Working knowledge of Business Objects and Windows Understanding of micro and mainframe computer systems Strong business acumen and political savvy Ability to lead and manage projects Ability to collaborate while dealing with complex situations Ability to think creatively and to drive innovation Ability to motivate, lead and inspire a diverse group to a common goal/solution with multiple stakeholders Ability to convert business strategy into action-oriented objectives and measurable results Strong negotiating, influencing, and consensus-building skills Ability to mentor, coach and provide guidance to others Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit ************************************************************** to view the "Know Your Rights" poster.

Pay Range: $73,500.00 - $110,300.00 Please email HR_Talent_************************** if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We're dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. What you will do: Conduct pre and post payment review of inpatient admissions, outpatient services, and other procedures to assess the appropriateness and continuity of care. Apply all aspects of the medical review function, including pre-authorization, concurrent review, screening for quality-of-care issues, and discharge planning. Document rationale for medical decisions made. Identify at-risk members who would benefit from health management programs through comprehensive health assessments. Monitor and evaluate patient's plan of care and identify potential issues through telephonic outreach. Recommend appropriate interventions. Promote member and provider satisfaction. Provide continuity and consistency of care by building positive relationships between member and family, physicians, provider, care coordinator, and health care plan. Represent corporation in a responsible and professional manner. Participate in department initiatives and projects. Perform other duties as assigned. What you'll need to succeed: Active and unrestricted RN license issued by a state participating in the Nurse Licensure Compact (NLC) Three to five years acute medical or clinical experience or experience in utilization reviewed. Valid Driver's License (On-site only) Understanding of utilization review techniques including all aspects of the medical review function, including pre-authorization, concurrent review and discharge planning Understanding of health care delivery system access points and services Correct application of health care management guidelines Ability to navigate the healthcare delivery system Advanced analytical skills, with the ability to interpret and synthesize complex data sets Good business acumen and political savvy Knowledge of business process improvement techniques and strategies Excellent verbal and written communications skills Negotiation skills Presentation skills Decision-making skills Good problem-solving skills Ability to interface with employees at all levels Ability to effectively navigate ambiguous situations with limited direction Excellent organizational skills and ability to successfully prioritize multiple tasks Ability to handle multiple priorities/projects The extras: Bachelor's Degree in Nursing Certified Case Management certification, Certified Professional Utilization Review certification Experience working in a managed care/health maintenance organization Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit ************************************************************** to view the "Know Your Rights" poster.

**Become a part of our caring community and help us put health first** The Provider Analytics organization's vision is to improve member healthcare through innovative analytics and actionable insights, which empower members, and providers to drive higher quality, lower cost of care, and improved health outcomes. Provider Analytics develops and applies actionable analytics and insights, which are integral to business needs, to drive informed provider network strategy and is looking for an Informaticist 2 to join their team. The Informaticist 2: + Designs and constructs models to estimate impact of contractual changes tied to ancillary and industry leading innovative care delivery models + Collates, models, interprets and analyzes data in order to identify, explain, and influence variances and trends + Explains variances and trends and enhances modeling techniques + Utilizes multiple data sources such as SQL, Power BI, Excel, etc., to create advanced analytics to facilitate contracting initiatives + Uses a consultative approach to collaborate effectively with the markets, and other customers, building productive cross-functional relationships + Extracts historical data, performs data mining, develops insights to drive provider contracting strategy and reimbursement terms for National Ancillary Contracting + Develops tools and automates processes to model financial implications of ancillary contracted rate changes, including changes in capitated arrangements In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include: + Medical Benefits + Dental Benefits + Vision Benefits + Health Savings Accounts + Flex Spending Accounts + Life Insurance + 401(k) + PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time + And more **Use your skills to make an impact** **Required Qualifications** + 3+ years of demonstrated healthcare analytical experience + 1+ years SQL experience + 1+ years' experience in data visualization (ie. Power BI, Tableau, etc.) + Experience in compiling, modeling, interpreting and analyzing data in order to identify, explain, influence variances and trends + Experience in managing data to support and influence decisions on day-to-day operations, strategic planning and specific business performance issues + Possess a working knowledge and understand department, segment and organizational strategy **Preferred Qualifications** + Bachelor's Degree in analytics or related field + Advanced Degree + Understanding of healthcare membership, claims, and other data sources used to evaluate cost and other key financial and quality metrics **Additional Information** Work at Home/Remote Requirements **Work-At-Home Requirements** + To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate. + Wireless, Wired Cable or DSL connection is suggested. + Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.) + Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Our Hiring Process** As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging, and/or Video Interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone or computer. You should anticipate this interview to take approximately 10-15 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. \#LI-LM1 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $73,400 - $100,100 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 01-21-2026 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Pay Range: $52,600.00 - $78,900.00 Please email HR_Talent_************************** if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We're dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. What you will do: Assist in the development, maintenance, and preparation of dashboards, reports, and supporting materials, ensuring accuracy, completeness, and alignment with Finance Operations requirements. Support Finance project and governance processes, including intake tracking, documentation review, data validation, and preparation of materials for governance meetings. Maintain logs and governance documentation to ensure compliance with established standards. Assist and maintain benchmarking and reference materials to support continuous improvement efforts within Finance Operations. Compile comparative analyses and support the development of reporting tools. Assist in the preparation of financial and operational information needed for internal reviews, leadership presentations, and corporate reporting using spreadsheets, charts, and presentation graphics. Support department initiatives and projects related to operating model updates, workflow improvements, and financial process enhancements. Assist with the preparation of financial data on a routine basis, and monitor and evaluate on a routine basis for management reporting/review. Support investigation of deviations from expectations and assist in recommending adjustments. Conduct mathematically based analyses to provide financial and operational information to Finance leadership. Analyze data using quantitative methods and apply appropriate analytical techniques. Assist team with department initiatives and projects. Perform other duties as assigned. What you'll need to succeed: Bachelor's degree in Finance, Accounting, Business Administration, Economics, or related field; or an equivalent combination of education and work experience One to three years' experience in financial analysis, business operations, quantitative analysis, or related work (internships accepted). Familiarity with Workday Finance or other ERP systems. Experience supporting financial governance, budgeting, or operations reporting a plus. Knowledge of financial statement analysis Knowledge of managerial accounting Understanding of mathematical theories and methodologies Ability to research data, identify trends and recommend appropriate actions High level of attention to detail, accuracy and quality - both in analysis and in the visual presentation of information Strong communication skills, including the ability to develop a clear narrative or “story” around financial and operational insights Ability to translate data into clear, concise, and visually effective presentations, dashboards, or exhibits that enhance understanding for leadership audiences Strong proficiency with technology and an ability to quickly learn, navigate, and apply new systems, tools, and applications (e.g. Workday, collaboration platforms, data tools, etc.) Ability to work successfully in a matrix environment Ability to exercise sound judgment and maintain confidentiality Demonstrated initiative in finding solutions to complex or sensitive issues Ability to establish and maintain strong working relationships with various stakeholders Ability to organize work efficiently to meet established time and quality standards Good organization skills Good time management skills Advanced skills in Microsoft Excel, PowerPoint, and other analytical and presentation tools Proficiency with Microsoft Suite of products, i.e., Word, SharePoint, Co-Pilot etc. Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit ************************************************************** to view the "Know Your Rights" poster.

Pay Range: $127,600.00 - $212,500.00 Please email HR_Talent_************************** if you are a candidate seeking a reasonable accommodation for the application and/or interview process. At BCBSRI, our greatest resource is our people. We come from varying backgrounds, different cultures, and unique experiences. We are hard-working, caring, and creative individuals who collaborate, support one another, and grow together. Passion, empathy, and understanding are at the forefront of everything we do-not just for our members, but for our employees as well. We recognize that to do your best work, you have to be your best self. It's why we offer flexible work arrangements that include remote and hybrid opportunities and paid time off. We provide tuition reimbursement and assist with student-loan repayment. We offer health, dental, and vision insurance as well as programs that support your mental health and well-being. We pay competitively, offer bonuses and investment plans, and are committed to growing and developing our employees. Our culture is one of belonging. We strive to be transparent and accountable. We believe in equipping our associates with the knowledge and resources they need to be successful. No matter where you're at in the organization, you're an integral part of our team and your input, thoughts, and ideas are valued. Join others who value a workplace for all. We appreciate and celebrate everything that makes us unique, from personal characteristics to past experiences. Our different perspectives strengthen us as an organization and help us better serve all Rhode Islanders. We're dedicated to serving Rhode Islanders. Our focus extends beyond providing access to high-quality, affordable, and equitable care. To further improve the health and well-being of our fellow Rhode Islanders, we regularly roll up our sleeves and get to work (literally) in communities all across the state-building homes, working in food pantries, revitalizing community centers, and transforming outdoor spaces for children and adults. Because we believe it is our collective responsibility to uplift our fellow Rhode Islanders when and where we can, our associates receive additional paid time to volunteer. Must be able to work in the office 2 days a week in Providence, RI Why this job matters: The Senior Enterprise Data Architect will serve as the strategic and technical leader responsible for designing and governing the enterprise's next-generation data architecture. This role will focus on unifying data across multiple operational and analytical domains (such as clinical, claims, provider, demographic, and engagement data) to support advanced analytics, personalization, and enterprise decision-making. This role will establish the conceptual, logical, and physical architecture needed to deliver a holistic and longitudinal view, working closely with internal stakeholders and external vendor engineers. The ideal candidate brings deep expertise in modern cloud data platforms, specifically Snowflake, data warehousing, ELT, and excels at setting architectural standards, overseeing a distributed delivery team, and ensuring high-quality outcomes from vendor partners. This role focuses on designing, governing, and guiding the implementation of new data capabilities, data models, identity resolution, and integration patterns. What you will do: Lead enterprise data architecture and modeling: Define the architectural vision, standards, and conceptual/logical/physical models that unify data across clinical, claims, provider, demographic, and engagement domains. Provide technical leadership and drive vendor delivery teams: Guide external engineering teams in implementing pipelines, transformations, and models aligned with architectural standards. Conduct design reviews, enforce best practices, and ensure quality, performance, and cost efficiency in Snowflake. Translate business needs into scalable architectures: Partner with stakeholders across IT, analytics, clinical, and operations to convert requirements into actionable roadmaps and technical designs. Champion modern cloud data engineering patterns: Promote Snowflake-native and cloud-native design patterns including semi-structured/unstructured data handling, streaming ingestion, and cost/performance optimization. Strengthen governance & data quality: Collaborate with governance and security teams to define metadata standards, lineage practices, PHI protection, and stewardship models. What you need to succeed: Bachelor's degree in Computer Science, Information Science, or related field, or equivalent experience. 10 or more years of experience in data architecture, data engineering, or related disciplines. 10 or more years of experience designing logical and physical data models for complex, cross-domain environments (relational, dimensional, and/or canonical). 8 or more years influencing enterprise-level technical architecture decisions. Experience with modern ELT/ELT development patterns, data orchestration methodologies, and cloud-native architecture best practices. Technical Hands-on, advanced expertise with Snowflake as a cloud data platform, including advanced features (Snowpipe, Streams & Tasks, performance optimization, and governance capabilities). Experience with modern ELT tools such as Matillion, dbt, or similar. Strong experience with modern storage paradigms - NoSQL, data lakes, unstructured content management. Strong experience with modern integration patterns - APIs, FHIR, event streaming, real-time data flows. Advanced knowledge of industry-leading BI tools (such as Power BI) Strong experience with layered/lakehouse architectures (e.g., raw/bronze, conformed/silver, curated/gold). Strong background in designing canonical models, conformed dimensions, and large-scale data integration patterns. Business Experience in healthcare or health insurance industry, especially with claims, clinical, provider, and member data. Strong business acumen, including the ability to understand operational, clinical, and analytical workflows. Demonstrated ability to lead and manage day‑to‑day work of vendor or offshore engineering teams. Strong leadership and communication skills with the ability to influence stakeholders, mentor technical teams, and drive clarity in complex data environments. Creativity and innovation in developing modern data solutions. The extras: Master's degree in Information Systems, Engineering, Computer Science, or related field. Experience with healthcare administrative systems (e.g., Facets) is a plus. Experience with HL7 / FHIR / healthcare interoperability standards Experience building or governing data products Experience with data governance and cost optimization in cloud ecosystems Location: BCBSRI is headquartered in downtown Providence, conveniently located near the train station and bus terminal. We actively support associate well-being and work/life balance and offer the following schedules, based on role: In-office: onsite 5 days per week Hybrid: onsite 2-4 days per week Remote: onsite 0-1 days per week. Permitted to reside in the following states, pending approval from the Human Resources Department: Arizona, Connecticut, Florida, Georgia, Louisiana, Massachusetts, North Carolina, Oklahoma, Rhode Island, South Carolina, Texas, Virginia Our culture of belonging at Blue Cross & Blue Shield of Rhode Island (BCBSRI) is at the core of all we do, and it strengthens our ability to meet the challenges of today's healthcare industry. BCBSRI is an equal opportunity employer. The law requires an employer to post notices describing the Federal laws. Please visit ************************************************************** to view the "Know Your Rights" poster.

Recognized by Newsweek in 2024 and 2025 as one of America's Greatest Workplaces for Diversity Make Lives Better Including Your Own. If you want to work in an environment where you can become your best possible self, join us! You'll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness. Full suite of health insurance, life insurance and retirement plans are available and vary by employment status. Part and Full Time Benefits Eligibility * Medical, Dental, Vision insurance * 401(k) * Associate assistance program * Employee discounts * Referral program * Early access to earned wages for hourly associates (outside of CA) * Optional voluntary benefits including ID theft protection and pet insurance Full Time Only Benefits Eligibility * Paid Time Off * Paid holidays * Company provided life insurance * Adoption benefit * Disability (short and long term) * Flexible Spending Accounts * Health Savings Account * Optional life and dependent life insurance * Optional voluntary benefits including accident, critical illness and hospital indemnity Insurance, and legal plan * Tuition reimbursement Base pay in range will be determined by applicant's skills and experience. Role is also eligible for team based bonus opportunities. Temporary associates are not benefits eligible but may participate in the company's 401(k) program. Veterans, transitioning active duty military personnel, and military spouses are encouraged to apply. To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year. The application window is anticipated to close within 30 days of the date of the posting. * Manages the day-to-day healthcare operations of the community to ensure resident's healthcare needs are met. * Ensures residents are treated with respect and dignity and ensures quality care as resident's healthcare needs change. * Ensures consistent quality resident care and service delivery throughout all shifts; this may require assuming the role and responsibilities of a Caregiver or Med Tech/Aide in order to meet the residents' needs and staffing requirements. * Assists in the supervision of community-based licensed nursing staff, medication technicians/CMA's, and Caregivers and provides training and education to Caregivers on an ongoing basis to include classroom in-services and situation-specific training. In addition, they will also manage the associates schedules. * Oversees and manages the continuity and consistency of medication training, pharmacy management and medication supervision and/or administration in the community. Conducts periodic Care Associate medication skills inventory checks, and periodic medication audits per Brookdale Guidelines. * Shares on call duties as required. * Education as required to obtain state nursing license (LPN/LVN or RN) and a minimum of 1-2 years relevant experience. * LPN or LVN license. Brookdale is an equal opportunity employer and a drug-free workplace.