Ready to help us transform healthcare. Bring your true colors to blue. The Senior Claims Testing Analyst is responsible for reviewing business requirements. developing, and executing comprehensive test plans, analysis of reporting, performing claims quality. review, mentoring associates and ensuring department goals are met in a high-quality manner within. established time frames. Key Accountabilities. Define, develop, and implement test plans an...
Ready to help us transform healthcare. Bring your true colors to blue. The Role. The Clinical Care Manger is responsible for facilitating care for members and families of members who may have rising health risks or complex healthcare needs, to promote optimal health. This position is self-directed and works independently and collaboratively to facilitate care based on the principles of care management. Facilitation is focused on assessing needs, ...
Ready to help us transform healthcare. Bring your true colors to blue. What We Need. The Senior Project Manager, Scrum Master will be responsible for supporting complex projects/products and programs using pre-existing knowledge, skills, templates, and expertise in various organizational and implementation methodologies. They will support all phases of the project/product lifecycle using project/product management practices. This position is resp...
Ready to help us transform healthcare. Bring your true colors to blue. What We Need. An energetic Release Train Engineer to drive performance across multiple Scrum teams on complex initiatives that impact multiple business areas. Focused on bringing new and innovative solutions to fruition across the entire product lifecycle. This role will also play a key role in driving the next level of agile transformation for the Value Stream. Ideal candidat...
Ready to help us transform healthcare. Bring your true colors to blue. What We Need. At BCBSMA, we are seeking an experienced Lead Full Stack Engineer to join our dynamic support team, where your expertise will be pivotal in ensuring the seamless operation and support of our cutting-edge portfolio of healthcare software solutions. This role represents a strategic succession plan for the outgoing Support Leader, presenting a clear path for career ...
Ready to help us transform healthcare. Bring your true colors to blue. What We Need. The Senior Audit Specialist role will review paid claims for coding accuracy in accordance to claims processing guidelines, BCBSMA Medical and Payment Policies. contract interpretations and established audit protocols. The role involves detailed claims analysis of complex issues including but not limited to. understanding the specifics of new and existing claim s...
Ready to help us transform healthcare. Bring your true colors to blue. The Role. The Clinical Care Manger is responsible for facilitating care for members and families of members who may have rising health risks or complex healthcare needs, to promote optimal health. This position is self-directed and works independently and collaboratively to facilitate care based on the principles of care management. Facilitation is focused on assessing needs, ...
Ready to help us transform healthcare. Bring your true colors to blue. The Role The Clinical Care Manager is responsible for facilitating care for members and families of members who may have rising health risks or complex healthcare needs, to promote optimal health. This position is self-directed and works independently and collaboratively to facilitate care based on the principles of care management. Facilitation is focused on assessing needs, ...
Ready to help us transform healthcare. Bring your true colors to blue. The Role The Clinical Care Manager-LPN is responsible for facilitating care for members and families of members who may have rising health risks or complex healthcare needs, to promote optimal health. Under the direction of an RN , the LPN CM works collaboratively with the entire Clinical Care management team to facilitate care based on the principles of care management. The C...
Ready to help us transform healthcare. Bring your true colors to blue. What We Need. The Medicare Advantage Network Performance Manager, as a member of a cross-functional team, is responsible for engaging and collaborating with provider organizations to effectively manage our value-based Medicare Advantage contracts, advance our mutual goals of delivering high quality and affordable care for our members, and promote profitable membership growth. ...
Ready to help us transform healthcare. Bring your true colors to blue. What We Need. BCBSMA has been a national leader in implementing value-based payment models like the Alternative Quality Contract and most recently announced our intent to collaborate with providers to develop incentives to reduce racial inequities in care. The Senior Contract Manager works closely with the Director of Network Contracting to successfully execute these innovativ...
Ready to help us transform healthcare. Bring your true colors to blue. What We Need. At BCBSMA, we have a unique opportunity to work within the Integration and Interoperability Team as a Senior Full Stack Engineer. You will set guardrails, patterns and framework for other IIT & federated API development teams to follow as well as provide needed governance and audit to make sure it is followed. You will work with stakeholders, engineers, and subje...
