Excellus BCBS

Job Description: Summary:This position supports the Utilization Management (UM) workflows by providing administrative support and customer service. This position acts as a resource for both internal and external customers through completing timely and accurate inbound and/or outbound

Job Description: Summary:This position supports the Utilization Management (UM) workflows by providing administrative support and customer service. This position acts as a resource for both internal and external customers through completing timely and accurate inbound and/or outbound

Job Description: Summary:This role supports the Team Leader B2B Marketing and Marketing Managers in creating editing and implementing marketing tactics for promotion of product and service launches go-to-market campaigns and customer initiatives for the Excellus BlueCross BlueShield a

Job Description: Summary:This role supports the Team Leader B2B Marketing and Marketing Managers in creating editing and implementing marketing tactics for promotion of product and service launches go-to-market campaigns and customer initiatives for the Excellus BlueCross BlueShield a

Job Description: Summary:Under general supervision of the Assigned Management this position is responsible and accountable for the management of pharmacy finance analytics reporting and pricing strategy to support the attainment of corporate growth and margin targets for the Pharmacy

Job Description: Summary:Under general supervision of the Assigned Management this position is responsible and accountable for the management of pharmacy finance analytics reporting and pricing strategy to support the attainment of corporate growth and margin targets for the Pharmacy

Job Description: Summary:The Manager of Accounting & Financial Reporting is responsible for designing implementing and maintaining appropriate policies and procedures to ensure accurate and timely monthly quarterly and annual financial reporting which is compliant with GAAP Statutory

Job Description: Summary:The Manager of Accounting & Financial Reporting is responsible for designing implementing and maintaining appropriate policies and procedures to ensure accurate and timely monthly quarterly and annual financial reporting which is compliant with GAAP Statutory

Job Description: Summary:The IT Platform Administrator acts as a liaison between the business and technical resources by ensuring the availability and successful operation of applications for users. This individual will demonstrate a high-level of responsibility and consistency by tim

Job Description: Summary:The IT Platform Administrator acts as a liaison between the business and technical resources by ensuring the availability and successful operation of applications for users. This individual will demonstrate a high-level of responsibility and consistency by tim

Job Description: Summary:The Software Engineer is responsible for working on projects that are currently being visualized or developed by our organization. This role will be involved with the Software Development Life Cycle methodology and framework directing software system validatio

Job Description: Summary:The Software Engineer is responsible for working on projects that are currently being visualized or developed by our organization. This role will be involved with the Software Development Life Cycle methodology and framework directing software system validatio

Job Description: Summary:This position supervises coordinates and is accountable for the daily work of employees who provide case management and clinical related services. The Supervisor facilitates day-to-day operations of the department such as customer requests coordination of depa

Job Description: Summary:This position supervises coordinates and is accountable for the daily work of employees who provide case management and clinical related services. The Supervisor facilitates day-to-day operations of the department such as customer requests coordination of depa

Job Description: Summary:Under the general direction of the Assigned Management and in accordance with sound and ethical procedures objectives and controls a Network Services Analyst analyzes and evaluates the composition and characteristics of Health Plan provider networks. This posi

Job Description: Summary:Under the general direction of the Assigned Management and in accordance with sound and ethical procedures objectives and controls a Network Services Analyst analyzes and evaluates the composition and characteristics of Health Plan provider networks. This posi

Job Description: NOTE: Based on business needs and geographic territory associated with this opening we are exclusively seeking candidates who reside in Rochester NY. Summary:The Account Sales Consultant is responsible for prospecting new sales while providing service solutions for ex

Job Description: NOTE: Based on business needs and geographic territory associated with this opening we are exclusively seeking candidates who reside in Rochester NY. Summary:The Account Sales Consultant is responsible for prospecting new sales while providing service solutions for ex

Job Description: NOTE: This position is aligned to support IT Vendor Management for our Analytics Data Technology & Digital (ADT&D) division. Summary:This role is accountable for strategically managing vendor portfolios and vendor relationships for assigned internal business organizat

Job Description: NOTE: This position is aligned to support IT Vendor Management for our Analytics Data Technology & Digital (ADT&D) division. Summary:This role is accountable for strategically managing vendor portfolios and vendor relationships for assigned internal business organizat

Job Description: Summary:This position assists the Health Plan in establishing a presence in the community through home visits and community outreach bridging the gap between members and the Clinical Operations Department. Community Connections Representatives educate members about ac

Job Description: Summary:This position assists the Health Plan in establishing a presence in the community through home visits and community outreach bridging the gap between members and the Clinical Operations Department. Community Connections Representatives educate members about ac

Job Description: Summary:This Team Leader provides oversight of a team that provides financial projections and actuarial analyses for complex projects or assignments or staff performing the design and implementation of data structures utilizing SAS software. Initiates organizes and an

Job Description: Summary:This Team Leader provides oversight of a team that provides financial projections and actuarial analyses for complex projects or assignments or staff performing the design and implementation of data structures utilizing SAS software. Initiates organizes and an

Job Description: Summary:The Database Administrator will provide enterprise-wide administration and production support for corporate databases. This position will be responsible for installing testing configuring monitoring performance tuning security and developing evaluation plans e

Job Description: Summary:The Database Administrator will provide enterprise-wide administration and production support for corporate databases. This position will be responsible for installing testing configuring monitoring performance tuning security and developing evaluation plans e

Job Description: Summary:The Digital Content Manager supports the Health Plans digital strategic initiatives by developing a digital content roadmap managing a centralized digital editorial calendar to provide content visibility to key stakeholders and creating digital content style g

Job Description: Summary:The Digital Content Manager supports the Health Plans digital strategic initiatives by developing a digital content roadmap managing a centralized digital editorial calendar to provide content visibility to key stakeholders and creating digital content style g

Job Description: Summary:As a professional within the network contracting and administration team the incumbent will contribute to the development and maintenance of provider networks. This position is accountable for performing provider and network analysis evaluating provider reimbu

Job Description: Summary:As a professional within the network contracting and administration team the incumbent will contribute to the development and maintenance of provider networks. This position is accountable for performing provider and network analysis evaluating provider reimbu

Job Description: Summary:The Provider Program Quality & Integration Consultant facilitates the development and effective implementation of quality and incentive programs and contracts. This work directly impacts the Excellus clinical provider network and member populations. As an indi

Job Description: Summary:The Provider Program Quality & Integration Consultant facilitates the development and effective implementation of quality and incentive programs and contracts. This work directly impacts the Excellus clinical provider network and member populations. As an indi

Job Description: Summary:The position is primarily responsible for the overall relationship and management of the Provider-Vendor agreement account. This position is responsible for the building and maintaining of favorable relationships with these entities; coordinating internal reso

Job Description: Summary:The position is primarily responsible for the overall relationship and management of the Provider-Vendor agreement account. This position is responsible for the building and maintaining of favorable relationships with these entities; coordinating internal reso

Job Description: Summary:The Community Investments and Partnerships (CIP) Regional Lead is responsible for developing recommending executing and overseeing regional CIP strategy with matrix accountability to regional executive leadership. This individual leads the collaborative select

Job Description: Summary:The Community Investments and Partnerships (CIP) Regional Lead is responsible for developing recommending executing and overseeing regional CIP strategy with matrix accountability to regional executive leadership. This individual leads the collaborative select

Job Description: Summary:This position is responsible for the accurate and thorough claim and clinical investigation of potential claim payment integrity issues involving all lines of business. This position investigates and remediates claim overpayments creating data and reporting an

Job Description: Summary:This position is responsible for the accurate and thorough claim and clinical investigation of potential claim payment integrity issues involving all lines of business. This position investigates and remediates claim overpayments creating data and reporting an

Job Description: 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

Job Description: 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