Excellus BCBS

Job Description: SummaryThe Supervisor Risk Adjustment Quality Assurance and Auditing is responsible for oversight of the daily operations of the Risk Adjustment Quality Assurance Auditor team. This role ensures the accuracy compliance and quality of the risk adjustment coding and doc

Job Description: SummaryThe Supervisor Risk Adjustment Quality Assurance and Auditing is responsible for oversight of the daily operations of the Risk Adjustment Quality Assurance Auditor team. This role ensures the accuracy compliance and quality of the risk adjustment coding and doc

Job Description: This position is responsible for delivering multiple concurrent and sometimes accelerated Pharmacy Innovation projects and programs with quality to plan and budget and in support of department addition conducts operational process analysis process improvement identif

Job Description: This position is responsible for delivering multiple concurrent and sometimes accelerated Pharmacy Innovation projects and programs with quality to plan and budget and in support of department addition conducts operational process analysis process improvement identif

Job Description: Due to business needs and the responsibilities associated with this role were exclusively seeking candidates who reside in Albany/Capital Region. Summary:This role is responsible for the implementation of communications and public relations programs in the assigned re

Job Description: Due to business needs and the responsibilities associated with this role were exclusively seeking candidates who reside in Albany/Capital Region. Summary:This role is responsible for the implementation of communications and public relations programs in the assigned re

Job Description: Summary:The Manager of Data Platform Administration plans directs and evaluates the work of Data Platform Administration team in the planning design development and maintenance of new and existing applications and data systems. This position communicates with users to

Job Description: Summary:The Manager of Data Platform Administration plans directs and evaluates the work of Data Platform Administration team in the planning design development and maintenance of new and existing applications and data systems. This position communicates with users to

Job Description: Summary:This role provides the vision strategy functionality and technology solutions for creating and maintaining network platforms for both public and private cloud infrastructure-based solutions. This entails the design and use of flexible platforms that deliver fe

Job Description: Summary:This role provides the vision strategy functionality and technology solutions for creating and maintaining network platforms for both public and private cloud infrastructure-based solutions. This entails the design and use of flexible platforms that deliver fe

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:Under the general direction of the Assigned Management this position is responsible for supporting Medicare line of business strategy and execution. assuring that all Medicare products and programs are administered according to approved benefit design regulato

Job Description: Summary:Under the general direction of the Assigned Management this position is responsible for supporting Medicare line of business strategy and execution. assuring that all Medicare products and programs are administered according to approved benefit design regulato

Job Description: Summary:Under the guidance of Corporate Director of EPMO this position is responsible for execution of strategic projects while overseeing multiple Project Managers (PMs) and Project Coordinators. The Director balances strategic vision with day to day execution and le

Job Description: Summary:Under the guidance of Corporate Director of EPMO this position is responsible for execution of strategic projects while overseeing multiple Project Managers (PMs) and Project Coordinators. The Director balances strategic vision with day to day execution and le

Job Description: Summary:The Medical Record Retrieval Specialist I/II is responsible for the retrieval of medical records from various healthcare facilities.Essential Accountabilities:Level IAccurately and efficiently retrieves medical records via remote EMR access fax and/or on-site

Job Description: Summary:The Medical Record Retrieval Specialist I/II is responsible for the retrieval of medical records from various healthcare facilities.Essential Accountabilities:Level IAccurately and efficiently retrieves medical records via remote EMR access fax and/or on-site

Job Description: Summary:Under general supervision of department management the Production Print 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 weeke

Job Description: Summary:Under general supervision of department management the Production Print 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 weeke

Job Description: Summary:The Enterprise Regulatory Compliance Program Administrator evaluates new and evolving federal and state regulatory guidance and assesses their impact on enterprise-wide business processes products and operational strategies. This role partners closely with fun

Job Description: Summary:The Enterprise Regulatory Compliance Program Administrator evaluates new and evolving federal and state regulatory guidance and assesses their impact on enterprise-wide business processes products and operational strategies. This role partners closely with fun

Job Description: Summary:The Legal Operations Specialist supports the Office of General Counsel (OGC) by administering department programs technology platforms data analytics and reporting outside counsel and vendor management processes and other department initiatives. Working closel

Job Description: Summary:The Legal Operations Specialist supports the Office of General Counsel (OGC) by administering department programs technology platforms data analytics and reporting outside counsel and vendor management processes and other department initiatives. Working closel

Job Description: Summary:The Director Actuarial Services is responsible for supervision of staff in the routine operation of the Actuarial Services departments. This position leads healthcare cost trend and medical cost analysis and financial forecasting and budgeting process for the

Job Description: Summary:The Director Actuarial Services is responsible for supervision of staff in the routine operation of the Actuarial Services departments. This position leads healthcare cost trend and medical cost analysis and financial forecasting and budgeting process for the

Job Description: Summary:The Advocacy Clinical Review Coordinator investigates member and provider appeals grievances and complaints across all lines of business. Using clinical nursing and medical expertise they will review medical necessity requests determine appropriateness of care

Job Description: Summary:The Advocacy Clinical Review Coordinator investigates member and provider appeals grievances and complaints across all lines of business. Using clinical nursing and medical expertise they will review medical necessity requests determine appropriateness of care

Job Description: Summary:Under the direction of the Assigned Management upon successful completion of all phases of training and in accordance with established HIPAA regulations the Enrollment Specialist performs enrollment core processing and servicing in accordance with the Health P

Job Description: Summary:Under the direction of the Assigned Management upon successful completion of all phases of training and in accordance with established HIPAA regulations the Enrollment Specialist performs enrollment core processing and servicing in accordance with the Health P

Job Description: Summary:The Enrollment Resolution Examiner is responsible for resolving complex enrollment and billing reconciliation issues between the Health Plan and external customers including but not limited to State and Federal Government Agencies under the general direction o

Job Description: Summary:The Enrollment Resolution Examiner is responsible for resolving complex enrollment and billing reconciliation issues between the Health Plan and external customers including but not limited to State and Federal Government Agencies under the general direction o

Job Description: This position is onsite/in-person at our Court St. office in Rochester NY.Schedule: Monday - Friday 2PM - 10:30PM*New hires will temporarily orient on days to start.Summary:Under general supervision of department management the Production Print Specialist may support

Job Description: This position is onsite/in-person at our Court St. office in Rochester NY.Schedule: Monday - Friday 2PM - 10:30PM*New hires will temporarily orient on days to start.Summary:Under general supervision of department management the Production Print Specialist may support

Job Description: Summary:The position is responsible for collaborating with leaders across a 2000 person organization to support strategy around how to drive organizational effectiveness through collaboration sharing best practices ensuring effective change management productivity and

Job Description: Summary:The position is responsible for collaborating with leaders across a 2000 person organization to support strategy around how to drive organizational effectiveness through collaboration sharing best practices ensuring effective change management productivity and

Job Description: Summary:The Claims Examiner resolves a wide variety of claims transactions that may include but not limited to entry adjudication or adjusting simple or complex claims in accordance with Member Touchpoint Measures (MTM) Inter-Plan Scorecard FEP Performance Incentive P

Job Description: Summary:The Claims Examiner resolves a wide variety of claims transactions that may include but not limited to entry adjudication or adjusting simple or complex claims in accordance with Member Touchpoint Measures (MTM) Inter-Plan Scorecard FEP Performance Incentive P

Job Description: This position is onsite/in-person at our Court St. office in Rochester NY.Schedule: Monday - Friday 10:30AM - 7PM Summary:Under general supervision of department management the Production Mail Operator may support one or more areas of Production Operations. Assignment

Job Description: This position is onsite/in-person at our Court St. office in Rochester NY.Schedule: Monday - Friday 10:30AM - 7PM Summary:Under general supervision of department management the Production Mail Operator may support one or more areas of Production Operations. Assignment