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Identifies and proactively develops policy recommendations that further the BCBS mission and drive solutions to better support the over 115 million Americans BCBS Plans cover. Identifies and analyzes proposed regulatory and legislative initiatives at the federal and state level which present significant implications to BCBS Plans' members and clients. Identifies policy que
Posted 1 day ago
Job Description Summary The Dir Lab Precision Medicine within the GPO will lead mid and large projects/contracts to help develop strategic contracting opportunities to improve the economic and financial competitive positions of the Blue System. Provides senior management of business operations and project implementation of multiple national scale Lab/Precision medicine agr
Posted 1 day ago
The Senior Data Engineer will be a key resource at Synergie, supporting IT and Analytics in developing creative and innovative solutions to support business and analytic outcomes. In this exciting role on a small team, you will have a big impact by working closely with both IT and business to create new technical systems, data models and processes that support "Lowering Me
Posted 1 day ago
This position enacts, monitors, and operationalizes multiple components of the FEP Medicare Prescription Drug Program. Act as liaison with third party compliance help line vendor; investigate potential compliance issues. Develop internal training programs to ensure compliance with regulatory requirements. Support Medicare Compliance Officer by maintaining current CMS polic
Posted 1 day ago
Job Description Summary The Sr. Consultant, Events is responsible for management of conferences and events at Blue Cross Blue Shield Association including but not limited to timelines, finances, stakeholders, contracts, and event technology for internal, external, hybrid, and virtual meetings. The role will collaborate with internal stakeholders in addition to managing the
Posted 2 days ago
Job Description Summary Partners with stakeholders, business analysts, systems analysts and team members to understand business requirements and correlate potential technology solutions that drive the analysis and design of quality technical solutions. These solutions must be aligned with business and IT strategies and comply with the organization's architectural standards
Posted 2 days ago
Job Description Summary Responsible for the design, development and implementation of advanced technology systems and data standards to meet the needs of business. Partners with customers to understand business requirements to create the technical functional specifications. Acts as an internal data consultant to advise and influence business and technical partners. This ro
Posted 3 days ago
Synergie Medication Collective is a new medication contracting organization founded by a group of Blue Cross and Blue Shield affiliated companies to serve both Blues and select independent health plans. Synergie is focused on improving affordability and access to costly medical benefit drugs ones that are injected or infused by a health care professional in a clinical sett
Posted 6 days ago
Executes measures for the prevention, identification and investigation of fraud, waste, and abuse (FWA) perpetrated against the Federal Employee Program (FEP). Ensures that Blue Cross Blue Shield (BCBS) Plans and Pharmacy Benefit Managers (PBMs) meet reporting requirements as mandated by the Carrier Letter and FEP Special Investigations Unit (FEP SIU) Standards Manual. Pro
Posted 6 days ago
The Executive Director supports strategic and operational leadership of the BCBSA Clinical Team, including support of the creation of the clinical operations strategy and delivery of value added resources and tools. This role provides clinical expertise and population health thought leadership in support of delivering more affordable and quality care for all members. In ad
Posted 8 days ago
Provides oversight and management of all drug utilization and spend across both the Pharmacy and Medical drug benefit. Provides operational oversight and management of the FEP Employer Group Waiver Plan program and Medicare Part D business. Works with contracted PBM's, executives, and operational staff on ongoing contract administration and maintenance. Leads the dire
Posted 8 days ago
Job Description Summary The Director, Systemwide Cybersecurity and Compliance will manage key aspects of implementing our Systemwide Cyber Strategy and governance across 33 Plans and several Non Plan Entities that represent the Blue Cross Blue Shield System. The Director will also provide thought leadership and support to Management in their work with Systemwide CISOs and
Posted 10 days ago
Job Description Summary The Senior Consultant, Customer Experience, is responsible for contributing to the Brand Strategy team and Corporate Affairs more broadly with various projects related to membership retention and growth to support the health of the Blue Cross Blue Shield Brand. Responsibilities include managing both internal and external initiatives and partnering w
Posted 10 days ago
Job Description Summary Responsible for the design, development and implementation of advanced technology systems and data standards to meet the needs of business. Partners with customers to understand business requirements to create the technical functional specifications. Acts as an internal data consultant to advise and influence business and technical partners. This ro
Posted 10 days ago
The Senior Consultant Internal Audit plans and leads audits of BCBSA operational, financial, governance, risk management and compliance processes. Audits are performed across all business units to identify risks and evaluate internal controls according to BCBSA and professional standards. Specific areas of focus include control design, operation and efficiency, policy comp
Posted 10 days ago
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