Buildings & Grounds Custodian Blue Cross and Blue Shield AssociationBuildings & Grounds CustodianCheyenne, WYDepending on the department and the position, eligible employees may be offered limited In-Office/WFH flexibility (for those positions that are offered limited WFH, there will be a required number of In-Office days per week/month depending on department). As a Building and Grounds Custodian with the BCBSWY Building and Grounds Team, you will play an essential role in ensuring best-in-class appearance of our facilities to members, employees, and members of the general public.
Client Success Specialist (Hybrid- DE, NJ, PA) Blue Cross and Blue Shield AssociationClient Success Specialist (Hybrid- DE, NJ, PA)NJRole Summary: The Client Success Specialist plays a critical support role in the implementation process, focusing on data collection, documentation, and quality assurance. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
UM Case Representative Blue Cross and Blue Shield AssociationUM Case RepresentativeCheyenne, WYAs a new member of the BCBSWY team, you will receive training on the various software applications and computer systems used in the performance of required duties, an opportunity to make a real impact on members' access to care, work from home opportunities, and an excellent company provided benefit package! Depending on the department and the position, eligible employees may be offered limited In-Office/WFH flexibility (for those positions that are offered limited WFH, there will be a required number of In-Office days per week/month depending on department).
Nurse Reviewer, RN Blue Cross and Blue Shield AssociationNurse Reviewer, RNCheyenne, WYDepending on the department and the position, eligible employees may be offered limited In-Office/WFH flexibility (for those positions that are offered limited WFH, there will be a required number of In-Office days per week/month depending on department). To succeed in this role, you will need to be able to apply critical thinking skills, work with a team of clinical and non-clinical staff, multi-task, and have flexibility in an ever-changing healthcare system.
Strategy Lead Consultant Blue Cross and Blue Shield AssociationStrategy Lead ConsultantChicago, IL$127,500–$182,400 / yearResponsibilities include scoping out projects, developing and managing teams, building relationships with key stakeholders, facilitating / delivering key findings and insights to senior leaders, and assuming full accountability on project outcomes. Execute corporate or internal strategy projects in their entirety or components through scoping of work, development of teams, and development/presentation of deliverables to meet desired outcomes set by senior leadership.
Provider Engagement Specialist I/II Blue Cross and Blue Shield AssociationProvider Engagement Specialist I/IICoeur d'Alene, ID$66,353–$92,894 / yearThe pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, internal equity, geography, business or organizational needs, and alignment with market data. Required Licenses/Certifications: Must hold: Certified Professional Coder Certification (CPC) or Clinical Certification/Clinical License (MA or above).
DSNP Care Manager Blue Cross and Blue Shield AssociationDSNP Care ManagerHopewell, NJ$63,000–$84,420 / yearThis compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. This field based position is accountable for the assessment and case management of Dual Special Needs members using established guidelines to ensure appropriate level of care as well as developing a member centric plan of care.
Client Success Specialist (Hybrid- DE, NJ, PA) Blue Cross and Blue Shield AssociationClient Success Specialist (Hybrid- DE, NJ, PA)PARole Summary: The Client Success Specialist plays a critical support role in the implementation process, focusing on data collection, documentation, and quality assurance. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.
Supervisor Operations (Call-center) [Hybrid- DE, PA, NJ] Blue Cross and Blue Shield AssociationSupervisor Operations (Call-center) [Hybrid- DE, PA, NJ]Philadelphia, PAWhile associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania. Responsible for ensuring that all departmental functions are completed promptly, thoroughly, professionally and accurately.
Data Science Associate Blue Cross and Blue Shield AssociationData Science AssociateDes Moines, IARequired: For consideration, you must meet one of the following educational/technical requirements: Bachelor's degree in quantitative discipline such as statistics, mathematics, finance, accounting, computer science, engineering, or economics. If you're passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!
RN I, PCA/MDC/DSNP (Field-Based - Atlantic County) Blue Cross and Blue Shield AssociationRN I, PCA/MDC/DSNP (Field-Based - Atlantic County)Hopewell, NJ$70,500–$94,395 / yearThis compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. Knowledge: Proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint) and Lotus Notes; prefers knowledge in the use of intranet and internet applications.
AI Engineer I Blue Cross and Blue Shield AssociationAI Engineer IMeridian, ID$78,064–$117,095 / yearThe pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data. They help build the system infrastructure that allows models to function reliably and solve real-world business problems The AI Engineering team supports the design, development, testing and deployment of AI-enabled applications, automation workflows and generative AI solutions.
Sr. Account Service Representative Blue Cross and Blue Shield AssociationSr. Account Service RepresentativeSioux Falls, SDCollaborate and serve as a subject matter expert for customers/agents products, services, processes and value proposition; including providing knowledge of issues such as union considerations, ancillary products and services, complex benefit designs, funding arrangements, IRS guidelines, and ERISA. Provide integral review of Summary Plan Descriptions (SPDs), Coverage Manuals, Summaries of Benefits and Coverage (SBCs), Group Implementation Guides, and other documents for the customer based on their specific needs and by market segment, including language changes as appropriate, prior to delivering to the customer/agent.
Case Manager, RN Blue Cross and Blue Shield AssociationCase Manager, RNWA$80,200–$125,600 / yearCreate a space where a case manager and member can collaborate, along with relevant caregivers and providers, to develop a member-centric case management plan that sets goals, addresses potential barriers, and leads to improved health outcomes. Provide interventions focused on removing barriers, promoting positive behavior change using motivational interviewing techniques, and stabilizing the members' natural support systems by ensuring that caregiver needs are identified and being met.
Quality Business Analyst Blue Cross and Blue Shield AssociationQuality Business AnalystPhiladelphia, PAThe Quality Business Analyst or blends subject matter expertise, a passion for process effectiveness and focused productivity in supporting business areas through successful outcomes in Quality Management. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
RN I Blue Cross and Blue Shield AssociationRN IHopewell, NJ$70,500–$94,395 / yearThis compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions, including but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. Knowledge: Prefers proficiency in the use of personal computers and supporting software in a Windows based environment, including MS Office products (Word, Excel, PowerPoint and Outlook) prefers knowledge in the use of intranet and internet applications.
Health Plan Pharmacist Blue Cross and Blue Shield AssociationHealth Plan PharmacistCheyenne, WYIn addition to the minimum requirements, we prefer candidates who possess Post-graduate PGY1 managed care pharmacy residency accredited by AMCP, ASHP; Masters of Healthcare Administration; Masters of Business Administration; work experience with health insurance payor; and/or work experience with a PBM. You will deal with long term strategies, high-level company initiatives, and day-to-day operations - overseeing functions including (but not limited to) Group benefits consultation, formulary management, drug cost evaluations, network management, and pharmacy operations.
Lead Software Engineer - Tech Incubation Team Blue Cross and Blue Shield AssociationLead Software Engineer - Tech Incubation TeamDes Moines, IAOperates as a builder and technical catalyst, rapidly experimenting, iterating, and shipping proof-of-value solutions that explore new capabilities (including agentic and AI-enabled development) and unlock future business outcomes. Proven ability to take ambiguous problems from concept to working solution-shaping hypotheses, building proof-of-value demos, and communicating learnings to stakeholders.
Provider Compliance & Policy Manager Blue Cross and Blue Shield AssociationProvider Compliance & Policy ManagerDes Moines, IAEstablish and maintain effective partnerships and perform in the role of liaison between Network Administration and internal stakeholders, including Legal and Compliance, to manage corporate and department project initiatives. Interpret state and federal regulations as well as Blue Cross Blue Shield Association (BCBSA) changes and provide impact to stakeholders regarding changes which may impact Provider Credentialing.
Actuarial Analyst II (Medicare Part D) Blue Cross and Blue Shield AssociationActuarial Analyst II (Medicare Part D)Philadelphia, PAKey Responsibilities: Design, build, and maintain Part D pricing models to project member-level drug utilization, cost sharing, plan liability, and CMS payments. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey, or Pennsylvania.