Most Recent BCBSM Job Listings (Page 2)

Displaying results 1 - 15 of 114
BCBSM

Pharmacy Auditor

BCBSM - Detroit, MI
Responsibility 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. Review of medical records. Perform clinical reviews with knowledge of body systems, ...
Application Deadline: None
BCBSM

Sr Analyst - External Sales Distribution

BCBSM - Detroit, MI
This position will be an integral part of the unit's mission to strategically engage processes, systems, communication and training to leverage initiatives within the Sales division for growth and retention of group health memberships. The position will independently work within a collaborative team environment to identify, monitor, and analyze information and engage related activiti...
Application Deadline: None
BCBSM

Case Manager RN/Bhvrl Hlth

BCBSM - Detroit, 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

IT Manager I

BCBSM - Detroit, MI
Summary Blue Cross Blue Shield of Michigan is currently seeking an IT Manager to support their Medicare Advantage IT division. The IT Manager will be accountable for the following responsibilities: Departmental Required Skills/Experience Create a team environment of accountability and commitment to r...
Application Deadline: None
BCBSM

Supervisor

BCBSM - Southfield, MI
Plan, coordinate, and supervise all administrative, operational and employee functions within assigned corporate functional area (e.g. Customer Service, Member Service, Claims, Membership and Billing, Enrollment, Training) to achieve unit/department goals, increase operational efficiencies and reduce cost. Supervise, coordinate, direct and monitor staff activities to ensure pro...
Application Deadline: None
BCBSM

Communications Project Manager - Commercial Business

BCBSM - Detroit, MI
Position is responsible for managing communications for the Commercial Business division. Manage direction and development of communication materials related to the division and office of the Executive VP, including: employee engagement and messaging, talking points, speeches, newsletters, and more. Develop strategies for speaking engagements involving the Executive VP and ensure proper...
Application Deadline: None
BCBSM

Customer Support Specialist II

BCBSM - New Hudson, MI
SUMMARY Blue Cross Blue Shield of Michigan is currently seeking a Customer Support Specialist II for our Lyon Meadows / New Hudson facility. This individual will be responsible for Internal and/or External Customer service and relationship management for technology solutions. The candidate will be responsible for Internet Claim Tool enrollment and maintenance a...
Application Deadline: None
BCBSM

IT Team Lead II

BCBSM - Detroit, MI
Summary: Blue Cross Blue Shield of Michigan is currently seeking an IT Team Lead II for their downtown Detroit / Jefferson facility. Excellent oral, written and presentation skills are a must and this individual also must be comfortable interacting with all levels of leadership. This IT Team Lead II will be responsible for the following: ...
Application Deadline: None
BCBSM

Sr Analyst- Enterprise Risk Adjustment

BCBSM - Detroit, MI
Leadership responsibility to coordinate the development and implementation of programs and strategies to improve service to our customers. Department Summary: This position within the Enterprise Risk Adjustment Department will be responsible for ensuring the accuracy and integrity of all data submitted to the government in support of Risk Adjus...
Application Deadline: None
BCBSM

Vice President National Health Reform

BCBSM - Detroit, MI
Lead and oversee analytic assessment of the impact of environmental and regulatory changes on market dynamics, competitive profiles and insurer business operation and financing. Translate analysis into strategic and tactical requirements for the enterprise and each business segment in order to respond to the relevant environmental and regulatory changes. Provide consultative support and subject...
Application Deadline: None
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
Displaying results 1 - 15 of 114