Jobs at Blue Cross And Blue Shield Of Florida, Inc.

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 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: The role of the Loss Control Representative will be to evaluate the hazards/risks/exposures and subsequent controls of facilities and operations of policyholders and accounts; make recommendations for the purpose of assisting with controlling hazards; provide consultation and education to policyholders and accounts on employee sa...
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Description Job duties include but are not limited to the following:  Serve as a point of contact for member to assist in navigating them through the continuum, educate regarding benefits, identify candidates for Care Programs and provide information pertaining to the network and network access.  Facilitate access to resources to meet member’s needs  Promote healthy lifestyles, assist in streng...
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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 *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: 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: Major responsibilities: Performs check run claim audit post-payment for provider/hospital systems with low-mid complex contractsUtilizes standard audit processes to ensure claims paid accurately whether overpaid or underpaid for all lines of business Ensures claims are paid according to member’s benefits, provider contractual ar...
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Description Job duties include but are not limited to the following: - Researches, analyzes, validates, and prepares data for use in monitoring and reporting, strategy support, and special projects - Peer review Job Requirements: - Bachelor’s degree or equivalent work experience - 3+ years related work experience - Proficiency with Excel, Word, and PowerPoint - Use of computer-based tools — must b...
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Description Job duties include but are not limited to the following: - Manage team of licensed insurance agents in the BlueDirect multi-cultural contact center (telesales, chat, email, social media) environment to sell both individual and small group health insurance plans - Provide sales coaching and motivation in order to exceed sales goals - Collaborate with internal business partners to optimi...
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Description Job duties include but are not limited to the following: - Manage team of licensed insurance agents in the BlueDirect multi-cultural contact center (telesales, chat, email, social media) environment to sell both individual and small group health insurance plans - Provide sales coaching and motivation in order to exceed sales goals - Collaborate with internal business partners to optimi...
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Description Job Duties • Provide customer service by answering complex benefit questions, researching and resolving issues, inquiries and exceptions and ensuring customers understand the Company’s products and services (this position is in a call-center environment and will entail working on the phones up to 8 hours/day) • Educate members on their products as well as assisting with cost effective ...
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Description Job duties include but are not limited to the following: - Provide general administrative support to Vice President(s) and staff - Coordinate conferences and meetings, maintain calendars and prepare materials such as presentations, spreadsheets, reports and agendas - Receive, screen and handle telephone calls, incoming mail/email, publications and other correspondence, much of which is...
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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: • Serve as a point of contact for member to assist in navigating them through the continuum, educate regarding benefits, identify candidates for Care Programs and provide information pertaining to the network and network access. • Evaluate hospitalized members for benefit determination, medical necessity and appropriate level 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: 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 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 BCBSFL Developers (DEVs) are responsible for the detail design documentation, development, evaluation and system performance testing, unit testing and maintenance of internally developed and externally purchased applications created for BCBSF business partners. Job duties include but are not limited to the following: Develops business relationships and integrates activities with other ...
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Description BCBSFL Developers (DEVs) are responsible for the detail design documentation, development, evaluation and system performance testing, unit testing and maintenance of internally developed and externally purchased applications created for BCBSF business partners. Job duties include but are not limited to the following: Develops business relationships and integrates activities with other ...
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Description Major Job Responsibilities: Translate Business Strategy into an Actionable Business Plan: Responsible for creating the business plan to carry out divisional goals and strategy. Influence/provides input to Senior Leadership regarding the feasibility of business vision and goals. Conducts risk assessments and devises actionable steps to mitigate risks. Works with Service Organization Lea...
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Description Job duties include but are not limited to the following: - Perform activities related to forecasting, compiling, allocating, monitoring, and analyzing a multi-million dollar budget and associated costs, cost drivers, and controls - Provide monthly reporting of administrative expenses to leadership including detailed variance analysis reporting, detailed spending reports and position da...
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