This position is an extended member of the departments leadership team and is responsible for the supervision and the execution of assigned audits and strategic initiatives. These responsibilities include ensuring the appropriateness of the scope, quality and execution of testing and reporting, and the identification as well as tracking of issues to closure. Responsibilit

This position is responsible for managing, monitoring, supporting, and participating in the development/enhancements of distributive system management platforms. Job Description Resolve issues through level 3 in server, operating systems or other software under the control of the Distributed Systems management team Provide guidance to junior infrastructure analysts and fo

Responsible for all workforce functions including budgeting, capacity planning, forecasting, scheduling and real time monitoring. Own and manage creation of leveryday tactical workload forecasting while continuously improving forecasting accuracy taking into consideration new hire classes, meetings, coaching product releases and key disruptions. Provide strategic insight

The Manager of Clinical Analytics is a managerial position requiring excellent leadership, communication, and data analytics technical skills. The position is a key team member collaborating in a multi disciplinary business environment with colleagues across the enterprise to support clinical performance analytics, development, and reporting that deliver actionable clinic

The Medical Economics Consultant provides support and consultation to the Medical Economics team through analyzing key business issues related to cost, utilization and revenue for all products at Horizon BCBS. This role will be responsible for the design and development of reports to monitor product performance and identify the root causes of medical cost trends. Responsi

This role is responsible for working collaboratively with members of the Quality & Health Equity Team and HNS to implement, monitor and evaluate Horizon clinical opportunities to develop enterprise and community health initiatives. These initiatives will be aimed at addressing Health Disparities and advancing awareness and education about social determinants of health to

This position provides Rating & Underwriting services and support to the Sales team and is responsible for the production of rates for the 51+ markets. This position will support Rating & Underwriting services for Stop Loss products. Develops and issues proposal rates for group size 51+ and experience rated proposals. Develops and issues experience rated renewals for grou

This position will perform care management duties specifically targeting high risk members within Medicare Advantage/Commercial risk adjusted populations to enhance the deployment of risk adjustment tactics. This position will work closely with the Care Management and Risk Adjustment Management (RAM) teams, including the RAM Manager & RAM Business Analysts to assess the h

The ASO Accountant I is responsible for the preparation, analysis, and completion of Minimum Premium and Self Insured invoices. This also includes compiling claims and traditional bills on a daily, weekly and monthly basis. The role is responsible for managing high dollar accounts and high priority Groups. Job Responsibilities Maintain accurate accounting sub ledgers for

This field based position is responsible for performing assessments for PCA and MDC services using established guidelines and assessments to ensure appropriate level of care and services are authorized. Responsibilities Assesses patient's clinical need against established guidelines and/or standards to ensure that the services provided are medically appropriate to members

he Director of Technology Strategy, Architecture & Governance at Horizon BCBS, will play a key role in shaping the technology direction of our organization. This is a strategic leadership position combines technical expertise and innovative problem solving skills and considered as a thought leader within the organization on Technology strategy & architecture. This positio

This field based position is accountable for the assessment and case management of members to ensure facilitation of health care services. Responsibilities Assist with implementation and facilitation of services to members in the program. Collaborates with member/family, physician and all members of the healthcare team, internal and external to this organization. Coordina