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Medical Review Specialist (RN)
This position is accountable for performing medical review to ensure correct dispositions according to all contracts, related endorsements, government regulations and BCBSNE medical policies.
Compliance Analyst
This position serves as the principal and initial point of contact for all formal consumer complaints filed against BCBSNE through the Nebraska Department of Insurance, CMS, or other regulatory/oversight bodies. This position routinely collaborates with departments throughout BCBSNE at a variety of levels (management and non-management). Comprehensive knowledge of health insurance regulations and regulatory practices, excellent analytical abilities and investigative skills, the ability to understand and verify company processes and procedures, and the ability to articulate and communicate BCBSNE’s position are critical success factors for the Compliance Analyst. This position will also support other Compliance and Ethics work efforts to include, but not limited to compliance monitoring and special projects.
Account Management Analyst
Performs a wide variety of support for assigned department’s leadership. Serves as a primary point of contact to both internal and external constituents. Assists in the coordination of general office functions, including coordination, supervision, and completion of projects for the department.
Network Engineer II
As a member of an Agile team you will be focused on analyzing, operating, engineering and architecting technology solutions. You will also be expected to support your team in Agile ceremonies and processes such as story writing, standups, release planning, sprint planning etc. This highly empowered environment will grant you have great freedom to achieve while also demanding a high level of responsibility.
Enterprise Product Owner II
The Enterprise Product Owner uses operational experience and strategic planning expertise to guide initiatives to maximize the business value delivered by the team. The Enterprise Product Owner possesses an in-depth knowledge of the vision, goals and desired objectives of the initiatives and acts as the first authority for decisions regarding business value and functionality for all the work done by the team. The Enterprise Product Owner works to establish the vision, set prioritization, eliminate obstacles, maximize the ROI and is the voice of the stakeholders and sponsors. The Enterprise Product Owner is a leader in the team's leadership triangle; a servant leader, effective communicator and accountable to the team.
Security Analyst II
The Security Analyst’s role is to lead and support the secure operations of the BCBSNE network and data components. This includes securing and optimizing all network and data while ensuring minimal system downtime. The candidate will also diagnose, resolve, and document security incidents and audits in a timely and accurate fashion, and provide end user training and support where required.
Junior Accountant Cash
Responsible for daily cash functions not limited to wire transfers, posting ASC, miscellaneous cash deposits (backup), positive pay check clearing, daily check releases for printing and their corresponding entries and preparation of the daily cash sheet. Prepare bank reconciliations on a monthly basis and A/S schedule E’s quarterly along with annual processing of unclaimed property. Coordination of the Audit PBC related to external auditors, NE DOI etc. Annual review of the AM Best Galley.
.net Software Developer I/II
Under general direction, responsible for participating as a technical resource in design development, coding, testing, and debugging new software or enhancements to existing software. Able to work with other technical staff to understand problems with software and to develop specifications to resolve them. A developer works directly with the business and other IS Teams to ensure that technical solutions are put in place to serve these communication objectives, and that these solutions are aligned with established strategic goals and policies.
Senior FWA Research & Investigation Analyst
The position will lead research and audits focused on the prevention of fraud, waste, and abuse (FWA) by recommending benefit, contract, or system edit changes, when appropriate. The Sr. FWA Research & Investigations Analyst will also act as a subject matter expert (SME) in identifying and communicating health care policy best practices and provide policy consultation to other investigators, when appropriate. The position requires a highly motivated person who has skills to participate in a team accountable for the detection, triage, and investigation of medical, dental, and pharmacy claims suspected of FWA in the Commercial, Medicare, and Federal Employee Programs (FEP). Investigations may involve medical providers, insured members, and employees.
Sales & Implementation Manager- HATCX
If you are looking for a challenge and a career you can grow with than HATCX is looking for you! We are a small, fun, and winning team who believes we can make a difference in the way people use and think about healthcare.
Medical Director
This position is a physician leader who provides leadership in utilization, prior authorization and case management for BlueCross BlueShield of Nebraska. The individual is responsible for enhancing relationships with providers and facilities, make utilization and prior authorization determinations, assist in case management and be a project manager for medical management programs..
Supervisor Tax and Accounting
Coordinates the preparation of the BCBSNE federal and state tax returns. Prepares the monthly, quarterly, and annual federal tax provisions (current and deferred) for the financial reports. Completes quarterly federal tax estimates and makes applicable payments. Prepares the tax footnote disclosures for the year end annual statement and audit report to be filed with the Nebraska DOI. Performs research, documents, and implements applicable tax, regulatory and related matters. Prepares and assists with preparation of quarterly and annual regulatory and other reports. Leads and provides oversight of Fixed Assets accounting including determination of capital assets based on company’s policies and assignment of appropriate book and tax depreciation schedule. Prepares accounting and other financial analysis for other financial matters as directed. Provides coaching, education and guidance to interns within the department, as applicable.