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Rate System Administrator
This role is a technical coordination role that is responsible for acting as the point of contact for new product quotes and rating changes. Critical thinking and focus on verifying that the four steps of rate communication (Plan Identification, Census Construction, Rating, and Correspondence) are effective and pass necessary testing, while aligning with expectations. In the event gaps exist in these systems, the role would be expected to step in and develop work around solutions. Goals of this role will be to implement, maintain, and test a new premium repository and API process, partner with IT teams to outline, create, and test necessary data outputs and census datasets, and to utilize a knowledge base of actuarial rate development processes and underwriting work streams to innovate new data collection methods that best serve the team, company, and members. This is a technical role with a high need for critical thinking.
Medical Policy and Special Project Clinical Analyst
This position is responsible for assisting in the maintenance of medical policy related to coding changes and analysis, providing ongoing technical support and configuration in the claims system. In addition to maintenance of Medical Policy, this position will assist the team lead with Medical Policy research and development. This position is responsible for assisting the team lead with day to day responsibilities for special projects related to medical claims processing, including special project assignments. Additional responsibilities include identifying and implementing coding edits in the HealthRules claims processing system, in collaboration with the internal HealthRules configuration teams and sharing of best practices for claims processing.
Manager, Information Services
We are adding to our IS Manager team! The IS Manager I is a professional who embraces the “art of the possible” and leads by empowering the team. The IS manager is responsible for talent development, leading community of practice teams and ensuring quality delivery of technical solutions that bring value to the enterprise.
Agile Project Manager II
This position will lead medium to large complex Agile stable teams/projects independently or with coaching as needed. Both Servant Leadership and facilitation skills as required leading the team and resolving impediments. This position will be focused on learning and applying Agile techniques and principles while seeking and applying input from their assigned coach/mentor. This position maybe asked to be involved in IS Leadership strategic initiatives.
Employee Experience Consultant
This position guides Talent Experience (HR) and the organization to create an environment that allows talent to thrive and enables the organization to achieve its vision of leading the way in supporting patient-focused care.
Nurse Case Manager (Care Transitions)
This position works collaboratively with health care providers to ensure that members receive high quality, medically necessary care in a timely fashion in a setting that maximizes benefit coverage and health outcomes. The incumbent educates members to understand innovative benefit structures that promote transparency and affordability and empowers consumers to make informed decisions regarding their healthcare options, coverage, and financial risk. The incumbent assists members to navigate the complex health care settings and ensures they get the support they need throughout the episode of care to optimize health status.
Financial Data Analyst
This position is responsible for extracting, preparing, analyzing and interpreting data to provide insight to the Finance Unit and Finance Leadership. Collaborate with Data Stake holders, Business areas, and IT in developing extracts and reports to assure that all areas are in alignment of the data and its use. Participate in new projects to coordinate data requirements for the financial operational reporting unit.
Health Data Analyst I
This position will serve on a highly collaborative Business Analytics team delivering health data analytics and informatics for groups, providers, members, leadership and the Board. As a member of an agile team, you will receive guidance from senior analysts in understanding and interpreting the business impacts of the data and assist in extracting, preparing, analyzing and interpreting data to provide insight for decision support to external and internal stakeholders. Our cross-functional, highly empowered environment will grant you the freedom to achieve while also demanding a high level of responsibility.
Finance Data Analyst- ABM
This position is responsible for extracting, preparing, analyzing and interpreting data to provide insight to the Finance Unit and Finance Leadership. Collaborate with Data Stake holders, Business areas, and IT in developing extracts and reports to assure that all areas are in alignment of the data and its use. Create and Maintain reporting of ABM data and results. Participate in new projects to coordinate data requirements to support the ABM process.
IAM Analyst II / III
Responsible for administering identity and security access for user and functional accounts within the Active Directory and CoreLink infrastructures. This includes administering Users, Groups and Shares in the environment and requires NTFS and role-based rights knowledge. This includes work related to the identification, classification, and following BCBSNE user access policy and administration. This position provides controls and validation services to ensure the effectiveness of information security, and user provisioning measures. The IAM Analyst II also manages, monitors, and supports infrastructure and applications associated with authentication and authorization technologies. An IAM Analyst may have an opportunity to participate on projects when new technologies are introduced.
Business Process Analyst Programmer I/II
Directly responsible for research, development and testing implementation of enhanced system applications to provide more efficient processes and streamlined workflow. Predict and/or research results, prepare analysis and provide recommendations for process and workflow improvements based on trending and efficiencies identified in Benefit Services’ activities. Responsible for complete system testing to ensure system applications do not adversely affect other areas. Prepare reports for management regarding status of project(s). Accountable for enhanced system application training, documentation, and curriculum creation and dissemination.