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BlueCross BlueShield of South Carolina jobs
Summary We are currently hiring for a Senior Medical Reviewer to join BlueCross BlueShield of South Carolina. In this role as a Senior Medical Reviewer, you will act as Team Lead for specialty programs, medical review, u...
Summary The Managed Care Stop Loss Reinsurance Sales position with Summit Reinsurance is responsible for developing and growing relationships with brokers, health plans, managed care organizations, provider-sponsored hea...
Summary Leads corporate distribution systems, general agents, brokers, and other market support personnel. Responsible for planning, product development, marketing services, production and profitability for as few as two...
In this role, you will lead a high-visibility initiative focused on evolving the platforms our members rely on to access critical healthcare services. As both a technical lead and people leader, you’ll guide a team of en...
BCBST is hiring a Data Consultant to support Actuarial processes by producing routine and ad-hoc reports, as well as maintaining, modifying, and augmenting the underlying code of those reports. They will also work closel...
BlueCross BlueShield of Tennessee is seeking a Solution Architect I to enhance and accelerate application development while ensuring solutions align with established enterprise standards and reference architectures. This...
Job Responsibilities Initiate referrals to ensure appropriate coordination of care. Seek the advice of the Medical Director when appropriate, according to policy. Assists non-clinical staff in performance of administrati...
Summary Rates and designs benefits for largest and most complex groups. Serves as primary contact to stop loss vendors. Description Position Purpose: Rates and designs benefits for largest and most complex groups. Serve...
Summary Position Purpose: The Behavioral Health Medical Director provides medical leadership to specific health plan or LOB to include overseeing physician review, utilization review/quality assurance, directing case man...
Summary As a member of the senior management team, the Physical Medicine and Rehabilitation Medical Director provides administrative oversight to the medical staff, analyzes medical review utilization data, researches ne...
Summary Performs medical reviews using clinical/medical information provided by physicians/providers and established criteria/protocol sets or clinical guidelines. Documents decisions using indicated protocol sets or cli...
The BlueCard ITS Applications team is seeking an experienced Software Engineer! In this role, you will support critical BlueCard claims processing by maintaining and enhancing internal‑facing applications while helping m...
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