Director incepture solutions delivery jobs at Blue Cross And Blue Shield Of Florida, Inc.

Description Salary Grade: MIB Job duties include but are not limited to the following: Achieve staffing results consistent with strategies and plans: - Calls on prospects for filling positions; establish positive relationships with current and prospective candidates - Represents Incepture to external audiences and key candidates; serve as a key candidate contact at multiple levels - Conducts recru...
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Description Job duties include but are not limited to the following: *Manage the PCS department including the issue management area, transaction management, clinical product development, PCS business compliance, and EDI product management area *Lead execution of complex compliance projects (e.g., 5010 ICD-10, administrative simplification) and prepare for future state. Utilize strong program manag...
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Description E33 The Business Process Management Continuous Improvement leader is intended to drive the initiation and successful implementation of Continuous Improvement and Customer Experience in support of Corporate Strategic Objectives. Ensures all business processes meet or exceed customer expectations, quality standards and appropriate efficiency levels through the combined application of lea...
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Description Job duties include but are not limited to the following: Initiate, plan, organize, and coordinate the execution of transformational projects and capabilities in support of Network, Care Management, Quality, Pharmacy, PCS, Network Operations, Medicare, Network Financial Analytics, and other Delivery System business leads. Job Duties include but are not limited to the following: 1) Follo...
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Description Job duties include, but are not limited to the following: Analyzes existing and emerging medical trends of a group population resulting in specific clinical recommendations Integrates clinical and financial analysis to develop and refine metrics and reporting to assist in determining the drivers of healthcare costs for client accounts Data interpretation, customized strategy with recom...
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Description Managers (MGRs) are primarily responsible for communicating, planning, directing and providing leadership to a work unit that provides day-to-day, tactical execution of operational implementation of plan. Managers provide direction to project / functional resources within and outside their reporting structure, gather, support and develop the resources needed to execute the plan, and ch...
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Description The Senior Director, Service Strategy & Readiness will lead and facilitate efforts to manage, align and integrate the company’s service strategy, along with its enabling capabilities, with our strategic market imperatives as well as the strategies of all other functional areas. This leader will be accountable to ensures that the customer experience is represented and prioritized approp...
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Description Job duties include but are not limited to the following: *Manage and assist in the development of the contracting and network development strategy within targeted pricing, renewal rates, payment models and infrastructure changes *Manage team of Network Managers and Provider Solutions Advisors in multiple regional offices to accomplish department and company goals *Negotiate and/or advi...
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Description The Sr. Dir, Facility Audits is responsible for the strategic leadership, program direction and oversight of the Facility Audit Department. This department provides Facility audit capabilities to meet regulatory, fiduciary and customer requirements and expectations through consistent statewide audit programs. This position serves as a significant conduit between Florida Blue and its pr...
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Description The Sr. Dir, Facility Audits is responsible for the strategic leadership, program direction and oversight of the Facility Audit Department. This department provides Facility audit capabilities to meet regulatory, fiduciary and customer requirements and expectations through consistent statewide audit programs. This position serves as a significant conduit between Florida Blue and its pr...
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Description Job duties include but are not limited to the following: Administer the UM training and quality auditing programs within Delivery System’s Care Management for all lines of business in order to improve provider satisfaction, medical cost management, and administrative performance *Develop standardized training and materials for consistent statewide processes *Manage and direct the Educa...
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Description Job duties include but are not limited to the following: The work of a Specialist IIIb is guided by practices, procedures, precedents or well-defined policy and/or supervisory review. Incumbents determine their own priorities and may deviate from established procedures and practices as long as the end results meet standards of acceptability. Representative duties include, but are not l...
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Description Roles in Health Data Analytics research, extract, model, manipulate, compile, analyze, evaluate and validate financial, clinical and network statistical data using advanced statistical, risk and financial analytical skills in order to identify and quantify impacts to medical cost trends. Job duties include but are not limited to the following: Incumbents assist more experienced analyst...
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Description Job duties include but are not limited to the following: - Identify's and quantifies key medical cost impacts within network and clinical operations areas - Analyzes historical provider trends and experience to support the company’s move to alternative payment methodologies. - Provides ROI/ potential savings estimates analysis of Medical Cost savings initiatives/proposals - Performs da...
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Description Job duties include but are not limited to the following: -Roles in Health Data Analytics research, extract, model, manipulate, compile, analyze, evaluate and validate financial, clinical and network statistical data using advanced statistical, risk and financial analytical skills in order to identify and quantify impacts to medical cost trends - Incumbents assist more experienced analy...
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Description Job duties include but are not limited to the following: -Roles in Health Data Analytics research, extract, model, manipulate, compile, analyze, evaluate and validate financial, clinical and network statistical data using advanced statistical, risk and financial analytical skills in order to identify and quantify impacts to medical cost trends - Incumbents assist more experienced analy...
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Description Job duties include but are not limited to the following: The Consultant Ia (Sr. Project Manager) is subject to practices and procedures covered by functional precedents and policies and/or managerial direction. Incumbents are given the degree of independence needed to achieve results, provided that their activities are consistent with approved operating plans and objectives, as well as...
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Description Job duties include but are not limited to the following: - Maintain an in depth understanding of all the BCBSF Health Product line including all supporting capabilities, services, care programs and retail capabilities to effectively develop new products. - Maintain cross functional business partner relationships to identify opportunities for improvements to the product development proc...
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Description *REPOST - PREVIOUS APPLICANTS CAN APPLY* Job duties include but are not limited to the following: • Identifies, investigates and evaluates moderate to complex potential fraud, waste or abuse, including pre-pay and/or post-pay medical claim reviews to determine valid cases for appropriate action; documents findings, and prepares case referrals, letters, etc. if applicable for the FEP li...
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Description Job duties include but are not limited to the following: Works with in-house clients and graphic designers to develop concepts, ad campaigns and sales materials for print, broadcast, direct mail and other forms of promotion for our clients Writes ads that help to build awareness of client product benefits and stimulate sales Strives for excellence in concept/copy, helping organization ...
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Description *REPOST PREVIOUS APPLICANTS REMAIN UNDER CONSIDERATION AND NEED NOT REAPPLY* Job duties include but are not limited to the following: *Research, analyze, plan, recommend and implement solutions to solve problems and address issues *Liaison to Network Development; identify, develop and maintain SOP automated process *Facilitate updates to workflow and coordination of Job Aids for all of...
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Description Job duties include but are not limited to the following: •Work with Sales Leadership to develop individual sales and retention tactics for profitable growth. •Primary job responsibilities are to sell health and ancillary insurance products to Florida individual consumers as follows: •Support both inbound form and outbound calls to Consumer prospects through market driven and Florida Bl...
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Description Job duties include, but are not limited to the following: Major responsibilities: The Proposal Manager will be responsible for executing the strategic centralization of all sourcing and bidding activities within Florida Blue. This position is responsible for the overall management of specific proposal efforts for new business opportunities and/or competitive renewals of current contrac...
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Description Job duties include but are not limited to the following: - Lead the strategy for the member website user experience, includes development and implementation of eTools, technologies, and enhancements - Research, analyze, interpret member and stakeholder feedback and apply it to making sound business decisions for the website strategy. - Serve as e-tool technical and business process SME...
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Description Job duties include but are not limited to the following: - Design and develop training according to the ADDIE model (Analyze, Design, Develop, Implement, and Evaluate). - Thorough knowledge and understanding of the adult learning theory and the Instructional Systems Design process. - Understanding of Rapid Instructional Design / Rapid Prototyping methodology. - Analyze learning needs a...
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