- Excellus BlueCross BlueShield (Rochester, NY)
- …Summary: The LTC Customer Service Representative resolves customer inquiries via telephone, mail, fax, and email concerning, but not limited to, policy benefits, ... claim payments, benefit reductions and billing. The LTC Customer Service Representative provides service for customers and business partners while responding in a professional, efficient, and timely manner to resolve issues and enhance customer satisfaction.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Based on the territory associated with this role, candidates must reside in Rochester, NY. Summary: This position is primarily responsible for the overall management ... of strategic and national accounts. This includes but is not limited to acting as a strategic advisor to support clients in the decision making process relative to benefit design, financial impacts, member experience, and industry trends. This role will focus… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …The Medical Director participates in the broad array of activities of the Medical Services area including, but not limited to, Medical and Pharmacy Utilization ... Management, quality management, member care management, and medical policy processes, and support for our various lines of business. The incumbent also provides input into the development of policies, programs and strategic objectives that cover Medical… more
- BlueCross BlueShield of North Carolina (NC)
- …As a Principal Actuary - ACA Pricing at our healthcare organization, you'll play a pivotal role in shaping the future of care delivery through data-driven insights ... and innovative actuarial strategies. You'll lead complex analyses that directly impact our pricing models, care management programs, and insurance product development-ensuring we deliver high-quality, cost-effective care to the communities we serve. You'll be… more
- BlueCross BlueShield of North Carolina (NC)
- …IT is different here. Our work as technology specialists pushes the boundaries of what's possible in health care. You will build solutions that make a real difference ... in people's lives. Driven by the importance of their work, our team members innovate to elevate. We're encouraged to be curious, collaborate, and turn ideas into solutions that can make health care better for all. In your role as, Senior Data Scientist will… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …Job Description Based on the territory associated with this role, candidates must reside in our Western NY service area (consisting of Allegany, Cattaraugus, ... Chautauqua, Erie, Genesee, Niagara, Orleans and Wyoming counties) Summary: This role ensures prompt, accurate, and efficient service for all inquiries from brokers, consultants, members, and group administrators across all product lines. The Account Service… more
- BlueCross BlueShield of North Carolina (NC)
- …IT is different here. Our work as technology specialists pushes the boundaries of what's possible in health care. You will build solutions that make a real difference ... in people's lives. Driven by the importance of their work, our team members innovate to elevate. We're encouraged to be curious, collaborate, and turn ideas into solutions that can make health care better for all. In this role you will manage an AI and Machine… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Summary: Conducts case management program activities in accordance with departmental, corporate, NYS Department of Health (DOH), Centers for Medicaid & Medicare ... Services (CMS), Federal Employee Program (FEP) and National Committee for Quality Assurance (NCQA) accreditation standards, as appropriate to the member's case assignment. Uses a systematic approach to identify members meeting program criteria; assessing for… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …This position is onsite/in-person at our Court St. office in Rochester, NY. Shift: Monday - Friday 9AM - 5:30PM Summary: Under general supervision of department ... management, the Production Floor Operations Specialist may support one or more areas of Production Operations. Assignments are determined based on need; shifts may include day, evening and/or overnight hours, with some including weekend coverage. NOTE:… more
- Excellus BlueCross BlueShield (Dewitt, NY)
- …Summary: The Customer Care Field Relations Specialist acts as the Face of the Organization by providing in-person support for customers, providers, representatives, ... and leadership on-site at business and partnership locations. Field Relations specialist additionally functions as an external business liaison and develops relationships with key partner groups to drive new business. Essential Accountabilities: Level I +… more
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