Blue Cross and Blue Shield of Nebraska

Project Manager

• Lead the development, interpretation, maintenance, and ongoing evaluation of medical policies using evidence-based clinical literature, national guidelines, regulatory requirements, and coding updates
• Analyze emerging technologies, new procedures, pharmaceuticals, and clinical treatments to determine policy implications and organizational impact
• Serve as the clinical authority for complex medical policy interpretation and implementation
• Recommend policy revisions that improve consistency, quality, compliance, and operational efficiency
• Lead evaluation and implementation of ICD-10, CPT, HCPCS, NCCI, CMS, and other industry coding updates impacting claims adjudication
• Provide strategic oversight for coding edits and clinical business rules within HealthRules and other claims administration systems
• Partner with Configuration and IT teams to translate clinical requirements into system functionality
• Identify opportunities to improve automation, reduce manual intervention, and strengthen payment accuracy
• Lead enterprise-wide initiatives involving medical policy, payment integrity, claims modernization, and regulatory compliance
• Provide expert consultation to executive leadership and business partners regarding complex clinical policy issues
• Serve as the clinical liaison across operational, technical, and vendor teams during implementation of strategic initiatives
• Evaluate business impacts and recommend solutions that balance clinical appropriateness, member experience, provider relationships, and operational effectiveness
• Direct clinical validation, user acceptance testing, and end-to-end testing activities for policy and configuration changes
• Ensure policy implementations are accurate, compliant, and operationally effective prior to production deployment
• Monitor implementation outcomes and identify opportunities for continuous improvement
• Mentor analysts and other team members on medical policy interpretation, coding methodologies, and clinical best practices
• Build collaborative partnerships across internal departments and external vendors

Medical Policy & Special Project Clinical Analyst – RN

Security Engineer

• Design and implement secure Azure configurations, guardrails, and reference architectures across identity, network, compute, and data
• Build and enforce policy-as-code and secure-by-default deployment patterns using Azure Policy and infrastructure-as-code
• Own and mature Cloud Security Posture Management (CSPM) , including risk prioritization, remediation, and baseline alignment
• Implement, tune, operate , and optimize cloud security tooling and core security platforms, including Microsoft Defender , WAF, Microsoft Sentinel, Entra ID, CyberArk, CrowdStrike, and related capabilities
• Define and enforce security guardrails for AI usage and secure adoption of AI platforms
• Identify , assess, and mitigate cloud and AI security risks, including misconfigurations, access risks, and emerging threats
• Partner with platform and application security teams to integrate security into CI/CD pipelines and enable secure AI-assisted development practices
• Build automation to improve remediation, monitoring, and compliance reporting at scale
• Partner with engineering teams to translate security strategy into practical, implemented solutions
• Mentor junior engineers and provide technical leadership while serving as a senior escalation point for complex issues

Senior Cloud Security Engineer

Analyst

• Assist in the maintenance of medical policy related to coding changes and analysis
• Provide ongoing technical support and configuration in the claims system
• Assist the Health Policy Research lead with Medical Policy research and development
• Coordinate and ensure completion of quality assurance and user testing of coding change configurations
• Collaborate with internal HealthRules configuration teams and share best practices for claims processing
• Identify system problems and open tickets in HE to resolve issues as needed

Medical Policy, Special Project Clinical Analyst, RN

Full-stack Engineer

• Deliver high‑quality, extremely delightful digital solutions: Build and maintain modern front‑end applications and shared experience components that support web, mobile, and marketing‑driven digital initiatives.
• Own digital solutions end‑to‑end: Take responsibility for digital capabilities from design handoff through development, release, monitoring, and ongoing support, ensuring reliability and continuous improvement.
• Develop reusable and scalable front‑end architecture: Design and implement micro frontends, shared UI components, and experience modules that can be leveraged across multiple digital products and initiatives.
• Apply data‑driven decision making: Use analytics, experimentation, and user testing to evaluate performance, inform improvements, and validate experience and personalization strategies.
• Innovate with AI: Leverage advanced AI-powered tools to accelerate design, development, and personalization.
• Partner to bring experiences to life: Collaborate with digital marketing, customer experience, product, architecture, and backend teams to implement cohesive digital solutions aligned to business and member needs.
• Integrate with enterprise platforms and services: Connect front‑end solutions with APIs, data, analytics, and experience platforms that support personalization, measurement, and omnichannel delivery.
• On-Call Rotation: Approx every 12-14 weeks for a 2-week period.

Senior Engineer – Mobile Development

Business Analyst

• Assist with researching market trends, competitors, and customer insights; summarize findings for team members and stakeholders
• Support technical and business teams by gathering, organizing, and maintaining strategic and customer-related data
• Help prepare KPI reports, dashboards, and data visualizations for marketing, product, customer experience, and sales teams
• Contribute to presentations and reporting materials for leadership and stakeholders
• Assist in maintaining accurate and reliable data used for product planning and strategic initiatives
• Support survey administration, data collection, and basic analysis for research and measurement projects
• Assist with gathering information and preparing materials related to business cases and strategic evaluations, including financial projections
• Support ad-hoc requests and other duties as assigned

Associate Strategy Insights Analyst

Medical Director

• Provide clinical leadership for utilization management programs
• Set UM strategy aligned with organizational goals
• Serve as senior clinical advisor to executive leadership on utilization trends
• Oversee the medical policy team
• Lead the Medical Policy and Utilization Management Governance Committees
• Oversee complex and high-risk utilization review cases
• Conduct clinical reviews and peer-to-peer reviews
• Ensure consistent, evidence-based application of clinical guidelines
• Provide clinical expertise to teams conducting coding and payment integrity
• Act as senior clinical UM liaison to network providers
• Build and maintain strong physician relationships
• Lead development and implementation of UM interventions
• Review utilization data for improvement opportunities
• Ensure UM programs meet regulatory requirements
• Conduct and support training of medical directors and UM staff

Senior Medical Director

Customer Support

• Handle incoming phone calls and be the primary customer interface for inquiries.
• Inform and educate customers and serve as member advocate.
• Use established best practices, attend ongoing training and utilize resources to navigate insurance.
• Research customer information utilizing appropriate systems to effectively respond to and resolve issues.
• Comply with State and Federal regulations and stay current on policies to support customers.