101 Job Openings at BCBSM Within 50 mi. of Detroit, MI (Page 2)

Displaying results 1 - 15 of 101
BCBSM

Risk Modeling-ERM Analyst

BCBSM - Detroit, MI
Macroeconomic, market and BCBSM specific business scenario development - This task will include working with contributors in finance, actuary, strategy, etc. to develop stress scenarios for input to Hyperion Strategic Finance (HSF) financial modeling tool in order to understand capital adequacy and prospective solvency needed for NAIC Own Risk Solvency Assessment (ORSA) regulatory filin...
Application Deadline: None
BCBSM

Case Manager RN/Bhvrl Hlth

BCBSM - Southfield, MI
Responsible for utilizing the nursing process in the development of treatment plans, with established goals, implementation, monitoring and evaluation of an assigned patient case loads in order to provide quality care appropriate to clinical needs. Review and analyze referrals from a variety of sources for acceptance into the program. Evaluate patient needs, identify and recommend c...
Application Deadline: None
BCBSM

Team Leader I - Group Administration

BCBSM - Detroit, MI
Responsible for planning, coordinating, and supervising all administrative, operative and employee functions within assigned area(s) to ensure an efficient and cost effective area in accordance with departmental and corporate standards and objectives. Supervise, coordinate, direct and monitor staff activities to ensure prompt, courteous and accurate response t...
Application Deadline: None
BCBSM

Manager of Govt. Programs Compliance Dept.

BCBSM - Detroit, MI
DEPARTMENTAL SUMMARY This manager will be responsible for leading 5 to 8 compliance monitoring staff members which conduct audit coordination responses with the Center for Medicare and Medicaid Service's audits over the company's Medicare Advantage and Part D Medicare drug programs. This department is also conducting monitoring reviews and advisory services for Medicaid and the Federal ...
Application Deadline: None
BCBSM

Accounts Receivable Manager - Blue Care Network - Southfield

BCBSM - Southfield, MI
Manages the daily activities of the Accounts Receivable staff including cash receipts, receivables, collections or disenrollment for non-payment for all individual and employer group business. Responsible for monitoring and reporting on collection of current Michigan claims tax and new National Health Care Reform (NHCR) taxes and fees that start in 2014. Responsible for monitoring delinquenc...
Application Deadline: None
BCBSM

Accountant (Part-time) BCN-Southfield

BCBSM - Southfield, MI
Part-time = 20 hours per week- Hours are 8:00 a.m. to 12:00 p.m. Monday through Friday - Note: Hours can change based on operational need. Responsible for recording accounting transactions in the general ledger and preparing financial statements, reports, reconciliations, presentations and analysis. Prepare journal entries, monthly/annual c...
Application Deadline: None
BCBSM

Advanced Application Developer

BCBSM - Southfield, MI
Provide application analysis, design, development, testing, deployment, documentation, and integration. Support business process, problem analysis and consultation. Process open defects or maintenance tickets and resolve technical issues. Ensure application and promotion package documentation is current and complete. Provide after hours on call support. Provide technical consultation and leader...
Application Deadline: None
BCBSM

Senior Benefit Communications Analyst

BCBSM - Detroit, MI
Under general supervision, develop and produce benefit information and client communications that are designed to attract, retain, inform and educate group customers and subscribers. Analyze components of product offerings to ensure compliance with coverage documents.Analyze group coverage documents and develop non-standard benefit specifications that amend ce...
Application Deadline: None
BCBSM

Wellness Team Leader II

BCBSM - Detroit, MI
Responsible for planning, coordinating and supervising assigned departments(s)/area(s) to ensure an efficient and cost effective area of responsibility in accordance with established corporate and departmental policies and procedures. Supervise and promote the professional development of assigned staff through selection, development, and exploration of more effective methods of...
Application Deadline: None
BCBSM

Pharmacy Technician

BCBSM - Detroit, MI
Support BCBSM providers (pharmacists and physicians) with Medicare Part D and Commercial pharmacy drug benefits analysis, drug coverage inquiries and prior authorizations. Answer telephones in an efficient and timely manner to lend appropriate assistance to providers Assists in maintaining pharmacy prior authorization criteria used in the adjudication of pharm...
Application Deadline: None
BCBSM

Sr Account Representative - SE 50-299 Retention

BCBSM - Detroit, MI
Responsible for retention activities for BCBSM and/orBCN customers generally with 50 to 99 contracts in a group within an assigned geographic area. Retention activities include planning, strategizing, benefit consulting and administration to increase membership as well as required resell activities. Responsibility may include enrolled and prospective customers. Develop specific ...
Application Deadline: None
BCBSM

Grievance & Appeals Team Lead

BCBSM - Detroit, MI
Responsible for planning, coordinating, using discretion/independent judgment, and supervising all administrative, operative and employee functions within Executive Services to ensure an efficient and cost effective unit in accordance with departmental and corporate standards and objectives. Lead team in the analysis, research and resolution of requests, complaints, appeals, an...
Application Deadline: None
BCBSM

Business Relationship Manager I

BCBSM - Detroit, MI
Business Relationship Manager Departmental Summary: Blue Cross Blue Shield of Michigan is currently seeking a Business Relationship Manager for our downtown / Jefferson facility. This individual will be responsible for the following: Departmental Preferences:
Application Deadline: None
BCBSM

Customer Service Representative II

BCBSM - Detroit, MI
Locations include: Detroit, Southfield andAnn Arbor Analyzes, evaluates, resolves and responds to customer/provider inquiries received via telephone, correspondence or in person involving a variety of claim/benefit issues under various product lines. Will direct the adjudication of claims/inquiries. Conducts internal and external research to ...
Application Deadline: None
BCBSM

Senior Health Care Analyst- Behavioral Health Vendor Management

BCBSM - Detroit, MI
Responsible for planning, organizing, directing, implementation, and leading department assignments. Position operates within broad objectives to ensure optimum utilization of manpower and budget. Research, compile and analyze appropriate and relevant data and make recommendations for operational improvements. Department Description:
Application Deadline: None
Displaying results 1 - 15 of 101