Jobs in Analyst

Engagement Description – Service Operations is in need of a dedicated compliance liaison to support monitoring compliance with Center for Medicaid and Medicare Services (CMS), Patient Protection and Affordable Care Act (PPACA), National Committee for Quality Assurance (NCQA) accreditation, Health Information Trust Alliance (HITRUST), state mandates, Member Touchpoint Measures (MTM), regulations, and for ensuring that…

Responsible for assisting and supporting the Group Operational Readiness team in the project coordination, establishment, and delivery of programs including but not limited to 2022 and 2023 ASC Contracting. Top 3 Required Skills/Experience – The most important must-have skills. Include: • Advanced Microsoft Skills in Word and Sharepoint, along with intermediate skills in Excel and…

Plan, develop, test and implement IT system solutions that improve business efficiency and productivity as well as support business strategies and goals. Identify and communicate business needs and translate business requirements into technical system and functional specifications. Support one or more moderately to highly complex business processes/systems for multiple business units. Project team member for…

Engagement Description – The Data Analyst III is responsible for comprehensive data mining, management, and manipulation techniques to report on Medicare Advantage (MA) , assisting and offering assistance in organizing and facilitating strategic program creation and execution , with minimal direction from Principal BI Analyst, Supervisor, or leadership. This role assists in researching and compiling…

Engagement Description – IT Testing Office (ITTO) is looking for a Software Quality Consultant with experience in establishing and maturing our Testing Center of Excellence (CoE) models. This role requires interactions with Quality Stakeholders across the organization and with Senior Leadership. The ideal candidate should have experience with change management in large organizations and stakeholder…

Serve as a liaison between the business areas and the IT organization to provide technical solutions required for the achievement of business goals. Collect, analyze, develop, document, and communicate business requirement. Support several moderately complex business processes within one or more business functions. Bachelor’s degree in related field preferred. Three (3) year of relevant technical…

Intermediate Controls Specialist provides support for all plant floor related automation control based systems supported by the IT organization. Responsibilities include but not limited to: • Support includes the implementation of system changes, support of daily plant activities relating to these systems, and system management including the implementation of IT standards and incident management. •…

Engagement Description – IT Testing Office (ITTO) is looking for a Software Quality Consultant with experience in establishing and maturing our Testing Center of Excellence (CoE) models. This role requires interactions with Quality Stakeholders across the organization and with Senior Leadership. The ideal candidate should have experience with change management in large organizations and stakeholder…

The General COTS Application Functional Developer Senior will be responsible for project management, analysis and documentation of business needs, strategy and methods development, and application development. Responsibilities include but not limited to: • Responsible for creating project plans, schedule and project timeline • Conduct workshops between global project teams and drive team to acceptable solution…

Engagement Description – The Senior Analyst is an analytical role responsible to coordinate the development and implementation of programs and strategies to improve service to our customers. This position applies project leadership skills for the delivery of accurate and timely regulated member communications through coordination with internal and external business partners Top 3 Required Skills/Experience…

Support providers (pharmacists and physicians) with Commercial pharmacy/ specialty drug benefits analysis, drug coverage inquiries and prior authorization ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Answer telephones in an efficient and timely manner to lend appropriate assistance to providers Triage prior authorization requests under the supervision of a Clinical Pharmacist.…

Role-Responsibilities: Project management experience with Excellent Communication skills. Experience delivering initiatives in a technology environment including estimation, budget and delivery the solutions. Knowledge of project management tools and methodologies with solid Attention to Detail. Maintain the broadest range and depth of knowledge in their respective area of expertise within the IT organization. Stay abreast of…

Engagement Description – IT Testing Office (ITTO) is looking for a Software Quality Consultant with experience in establishing and maturing our Testing Center of Excellence (CoE) models. This role requires interactions with Quality Stakeholders across the organization and with Senior Leadership. The ideal candidate should have experience with change management in large organizations and stakeholder…

This position shall perform cross-functional collaboration with the other members of the information security team, EIT division, and the business to manage the identification, mitigation, resolution and acceptance/deferral of information security risks to the BCBSM organization. In addition, provide guidance on mandatory and recommended security and IAM controls to ensure they are appropriately implemented. Collaborate…

Perform technology functions to include but not limited to business and systems analysis, application development and process improvement. Serve as a liaison between the business area and the IT organization as needed. Identify, document and communicate system and process changes necessary to improve system and operational performance measures. Possess an in-depth knowledge of line of…

: Responsible for assisting and supporting management in the evaluation, recommendation, establishment, implementation and analysis of new and improved production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality. Assist and support in the planning, coordinating, developing and implementing of approved projects which are Divisional and/or Corporate…

Member Engagement analytics team seeks analytics consultant to support member-facing engagement campaigns such as email, print, SMS, and social media campaigns. The consultant will be responsible for developing and rolling out an approach that evaluates performance within each campaign as well as cross campaign. The Analytics Consultant will work closely with Marketing Strategists and Data…

Other Skills: 4 Key required skills: • Extensive claims and benefits experience is required (NPS). • Extensive Analysis and Design experience including process flow development in Visio. • Healthcare industry experience is required. • Ability to handle multiple projects concurrently. • Reminder: When submitting candidates please include a response to the questions listed below. •…

SUMMARY: Support providers (pharmacists and physicians) with Medicare Part D drug coverage inquiries, Grievances, and prior authorizations. RESPONSIBILITIES/TASKS: Answer telephones in an efficient and timely manner to lend appropriate assistance to providers. Process prior authorization requests under the supervision of a Clinical Pharmacist. Apply pharmacy prior authorization criteria used in the adjudication of pharmacy PA…

We are looking for an experienced Business Analyst Scrummaster to oversee scrum team/s. The candidate should have good interpersonal and problem-solving skills and a firm grasp of agile practices and the ability to effectively manage and mentor development teams. They will serve as a liaison between the business areas and the IT organization to provide…

Support providers (pharmacists and physicians) with Commercial pharmacy/ specialty drug benefits analysis, drug coverage inquiries and prior authorization ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Answer telephones in an efficient and timely manner to lend appropriate assistance to providers Triage prior authorization requests under the supervision of a Clinical Pharmacist.…

Engagement Description – The qualified candidate will be able to research government regulations for the Medicare Advantage program. The candidate will apply their research to be able to perform an accurate marketing review assessment for required materials; i.e., (Evidence of Coverage, Annual Notice of Change, Summary of Benefits, etc.). Will also be able to interpret…