BlueCross BlueShield of Tennessee

Full-stack Engineer

• Design, develop, test, and deploy intelligence automation solutions using UiPath platform
• Collaborate with internal team and business stakeholders
• Participate in requirements sessions, resolve defects, enhance existing processes
• Provide production support to the processes developed
• Respond to system failures and performance events
• Devises or modifies application systems and procedures to optimize functional requirements
• Must be competent to work on most phases of application systems analysis
• Provide guidance to less-experienced programmers, conduct presentations to provide end users with knowledge

Associate Software Engineer II

Manager

• Supporting utilization management functions for more complex and non-routine cases as needed.
• Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs.
• Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits.
• Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation.
• Digital positions must have the ability to effectively communicate via digital channels and offer technical support.

Care Transition Case Manager

• Identifying educational topics, methods, and strategies to enhance compliance throughout the provider network.
• Implementing, supporting, and monitoring provider programs and enterprise initiatives
• Implementing processes and changes needed to maintain regulatory compliance, contract compliance or to improve quality.
• Handling escalated provider enrollment processing and problem resolution.
• Leading data reporting and analysis projects to monitor financial and service relations with providers.
• Consulting with providers on delivery, training and support related issues, identifying opportunities for enhancement and recommending solutions.
• Able to travel to provider offices or conduct virtual meetings as required.

Network Manager II

• Formulates and defines system scope and objectives through research and fact-finding to design, develop, modify, or integrate complex information systems
• Devises or modifies application systems and procedures to optimize functional requirements including capacity, operating time, response time, and form of desired results
• Designs, codes, tests, debugs, and documents programs, subroutines, and scripts
• Develops and implements program/system test plans
• Devises data verification methods and standard system procedures
• Responds to system failures and performance events by taking appropriate measures to reduce system downtime and eliminate recurrence of problems
• May conduct research on software and hardware products to justify recommendations and support management in budgeting and purchasing efforts
• Acts as expert technical resource to development staff in all phases of the development and implementation process

Senior Software Engineer

Data Analyst

• In this fully remote role, you’ll leverage SQL and analytical tools to support complex reporting, pricing, and rebate processes.
• Analyzing, defining requirements, developing, and validating complex reporting and/or data files necessary to meet business objectives.
• Utilizing business knowledge to perform in-depth analyses, proactively investigating abnormal results, writing descriptive summaries of gathered data, and optimizing delivery of end product.
• Proactively analyzing changes in business processes and updating reporting/file feeds accordingly.
• Researching and responding to questions and change requests from business partners; articulating reporting results and business impact.
• Peer review work product of junior and senior analysts and mentor junior analysts.
• Influence medication cost and utilization strategies through data-driven insights.

Pharmacy Data Analyst II

Consultant

• Design and deliver strategic development solutions that build capability, foster growth, and support business transformation
• Diagnose learning needs, create scalable programs, and partner with leaders to embed a culture of continuous improvement
• Develop course curricula, supporting materials and programs for learning initiatives
• Assist in determining learning needs and objectives for an organization's various employees
• Ensure delivery of learning courses and programs through suitable methodologies, such as individual coaching and classroom training
• Assist in evaluating employees' learning performance and related improvements

Organizational Learning Consultant

• The Behavioral Health Case Manager for Transitions of Care is dedicated to proactive engagement with members admitted to Acute Inpatient Psychiatric facilities.
• This role involves coordinating care to address immediate behavioral health needs and overcoming barriers to discharge from inpatient care.
• The goal is to reduce readmissions and adverse events through patient education, support, and connection to outpatient services.
• This hybrid position involves telephonic outreach and weekly visits to local Acute Inpatient Psychiatric facilities in the Murfreesboro area.
• The caseload is fluid, adapting to changes in facility admissions and referrals.
• Please note this role will require in person visits with members.
• In order to be considered, candidates must be willing to travel and will ideally be within 25 miles of Murfreesboro, Tennessee.
• Job Responsibilities: Supporting utilization management functions for more complex and non-routine cases as needed. Serving as a liaison between members, providers and internal/external customers in coordination of health care delivery and benefits programs. Overseeing highly complex cases identified through various mechanisms to ensure effective implementation of interventions, and to ensure efficient utilization of benefits. Performing the essential activities of case management: assessment: planning, implementation, coordinating, monitoring, outcomes and evaluation. Perform case management activities in community settings including face to face with members as required. Various immunizations and/or associated medical tests may be required for this position. Testing/Assessments will be required for Digital positions

Behavioral Health Case Manager

Analyst

• Work closely with stakeholders to understand business and evolve digital solutions for mobile app
• Support Customer Support, Sales Enablement, and Product Marketing in developing digital strategies, features, capabilities, and content
• Collaborate with cross-functional teams to propose digital strategy supporting business and product initiatives
• Oversee a backlog aligned with engineering capacity and digital solutions roadmap
• Lead Agile ceremonies (planning, refinement, demos, retrospectives) with technology teams
• Coordinate cross-functional teams to support product, program, outreach optimizations and delivery of regulatory/contractual assets
• Work with Engineering to ensure solutions delivered to specification, timely and cost-effective
• Contribute to shaping user-driven mobile app experiences and influence product direction

Senior Digital Analyst, Mobile App

Business Development Rep

• Monitoring and maintaining adherence and compliance to quality standards on an ongoing basis.
• Overseeing multiple application programming and analysis projects which include development, installation and maintenance of application programs.
• Maximizing staff contribution through professional growth and development, to increase teamwork and more effectively meet business needs.
• Analyzing applications to ensure that all systems that are developed, meeting business needs and specifications.

Manager, eBusiness Development

• Oversee multiple critical systems supporting all lines of business in their abilities to trigger and track member outreaches and document face to face interactions between our members and care coordinators.
• A strong, hands-on leader who can execute assigned development projects to scrum teams, develop employee leadership, engage effectively with business leadership and support the onboarding/offboarding of contractor resources as new projects roll in.
• If you're passionate about team leadership, system optimization, and making a meaningful organizational impact, this is the role for you.
• You’ll be great match for the role if you bring: Experience managing teams developing in .NET, SQL, HTML/Java Script and vue.js coding languages; Comfortability with managing and presenting roadmaps and team deliverables to business leadership; Strong understanding of leading teams working in an Agile / Scrum environment.
• Job Responsibilities: Monitoring and maintaining adherence and compliance to quality standards on an ongoing basis.
• Overseeing multiple application programming and analysis projects which include development, installation and maintenance of application programs.
• Maximizing staff contribution through professional growth and development, to increase teamwork and more effectively meet business needs.
• Analyzing applications to ensure that all systems that are developed, meeting business needs and specifications.

Manager, Clinical & Tracking Systems

Sr. Software Engineer

IT Support

• As the EIT Engineering Team Lead for the Encounter Management team, you will guide a talented group of developers who play a vital role in our organization’s Medicare and Medicaid operations.
• This team is responsible for ensuring accurate and timely reporting of claims data to federal and state agencies, maintaining compliance with regulatory requirements.
• We are seeking a leader who can oversee the daily operations of this essential business function, foster a collaborative and high-performing team environment, and drive future enhancements to our systems.
• The ideal candidate will demonstrate strong leadership, a commitment to operational excellence, and a passion for continuous improvement in support of our mission .
• This role requires on-call support and occasional after-hours system deployments to ensure the reliability of our critical business functions.
• Sponsorship is not available for this role.

EIT Engineering Team Lead

Risk

• Load medical records into BCBST coding system and link records to appropriate chart IDs.\n• Download medical records from Electronic Medical Record (EMR) systems remotely and in person.\n• Schedule appointments and assist with the medical record quality assurance process as necessary.\n• Perform or participate in special projects as directed by management\n• Travel to provider offices and assist in the acquisition of medical records.\n• Willing to travel locally on a regular basis with occasional overnight stays.\n• Various immunizations and/or associated medical tests may be required for this position.\n• This position will be dedicated to the Memphis, TN area.