BlueCross BlueShield of Tennessee

Financial Planning and Analysis

• Lead and support key financial projects, driving initiatives from concept through execution
• Serve as the owner of reporting processes, delivering accurate, timely, and insightful financial data
• Act as a subject matter expert and trusted partner, collaborating across Finance and enterprise teams
• Identify and implement process improvements, including leveraging AI-enabled solutions to enhance efficiency and effectiveness
• Manage the distribution of tasks to junior staff as appropriate
• Providing generic financial planning, investment, forecasting and/or budgeting and control functions for the organization
• Managing the organization's tax filing and governmental reporting activities
• Performing finance, investment and/or accounting functions for the organization, including record keeping and reporting

Senior Financial Analyst

Full-stack Engineer

• 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.
• May serve one or more project team roles, such as project lead, business systems analyst, or technical lead, for small to medium efforts or manage phases of medium to large efforts.
• Maintains technical skill set for software languages, databases, platforms, operating systems, utilities and networks needed to support work assignments.
• Responds to system failures and performance events by taking appropriate measures to reduce system downtime and eliminate recurrence of problems.
• Regularly provides guidance and training to less-experienced analysts/programmers.

Software Engineer

QA Engineer

• Understanding of entire project with the ability to prepare testing strategy and/or test plans, and perform testing as assigned including end-to-end validation by coordinating with multiple teams
• Understand and gather project requirements from the customer, both internal and external, creating and reviewing testing specification artifacts
• Review requirements and identify gaps/missing information and estimate small to medium projects using any one or more estimation techniques
• Derive scenarios for testing, design test cases using test design techniques, document test data requirements, identify and create test data, perform testing utilizing different testing techniques, and report results
• Hands-on experience of functional automation tools and/or performance automation tools
• Promotes and recommends improvements to the quality assurance standards
• Leads collaboration with stakeholders or product team to communicate test delivery artifacts, results and metrics

SQA Analyst III

Product Manager

• Lead agile teams in the ongoing management and advancement of digital products, channels, and programs
• Develop innovative, industry-leading solutions that uniquely serve BlueCross and its customers
• Lead digital initiatives and cross-functional teams by driving strategy, tactics, and delivery timelines
• Identify, research and scope key business opportunities in support of the future-state vision for digital solutions across products, programs, and campaigns
• Build strong partnerships across teams in delivering excellent service
• Work with key stakeholders throughout the organization to establish priorities, gain buy-in, and align resources appropriately

Digital Product Manager

Executive Assistant

• Drive executive effectiveness by developing high-quality reports and polished correspondence
• Manage sensitive communications with officers and executive members of external organizations
• Create impactful visual presentations for senior leadership
• Prioritize complex calendars and manage high-volume communications
• Coordinate meetings and sales-related travel
• Process expense reports and support distribution activities
• Serve as project manager for special initiatives and maintain confidential information
• Leverage working knowledge of Microsoft tools and electronic signature platforms to streamline operations

Risk

• Monitor PMO processes, procedures, and outputs for compliance with quality and governance standards, escalating deviations or concerns as identified
• Collect, analyze, and report data related to quality and compliance performance
• Support the design, refinement, and implementation of quality assurance protocols and governance frameworks through documentation and testing activities
• Identify process gaps, inconsistencies, or risks and support corrective actions
• Assist with internal and external audit preparation and follow-up activities
• Identify opportunities to apply automation or AI-assisted analysis to support monitoring and reporting, consistent with established governance standards

PMO Quality and Governance Coordinator

• Design, develop, test, and deploy intelligence automation solutions using UiPath platform
• Collaborate with internal team and business stakeholders
• Participate in requirements sessions
• Resolve defects and enhance existing processes
• Provide production support to the processes developed
• Formulates and defines system scope and objectives through research to design, develop, modify, or integrate moderately complex information systems
• Devise or modify application systems and procedures to optimize functional requirements
• Responds to system failures and performance events
• Provides services to multiple project teams or management staff

Associate Software Engineer II

Analyst

• Implement business strategies aimed at improving processes, ensuring they are completed on time and within scope.
• Lead investigations into service disruptions or inefficiencies, applying structured problem-solving to recommend practical solutions.
• Collaborate across teams to identify and implement workflow enhancements that improve efficiency and accuracy.
• Coordinate with internal teams (e.g., clinical, IT, finance, vendor management) to support pharmacy-related initiatives and program interdependencies.
• Maintain a working knowledge of pharmacy regulations and ensure data and processes align with compliance standards.
• Share knowledge within team learning sessions and onboarding activities.
• Manage various workstreams in strategic projects, ensuring alignment with pharmacy business objectives and stakeholder expectations.

Pharmacy Analyst II

• Supporting finance, investment and/or accounting needs wherever called for within the organization.
• Developing financial modeling, reports and presentations for management.
• Filing tax forms and other government reports required of the organization.
• Performing generic financial planning, investment, forecasting and/or budgeting as needed by a given business unit.
• Identifying trends and developments in competitive environments and presenting findings to senior management.

Financial Analyst

Artificial Intelligence

• Own operational oversight, quality standards, and escalation management for AI-enabled member service processes
• Lead complex issue triage, root cause analysis, and corrective action planning
• Define and maintain operational validation standards, sampling approaches, and quality measures
• Lead requirements definition, prioritization, and validation for enhancements and releases
• Drive user acceptance testing, operational readiness reviews, and post-release validation
• Define, monitor, and communicate key performance indicators and operational insights to leadership
• Serve as the primary operational liaison across Operations, Quality, IT, Analytics, and vendor partners
• Mentor analysts and establish repeatable standards, documentation practices, and best practice

Senior Operations AI Analyst

Technical Recruiter

• Serve as a strategic partner to hiring managers by educating, advising, and counseling on recruiting strategies, labor market conditions, and best practices aligned to organizational goals.
• Lead full-life cycle recruiting for professional and hard-to-fill positions, including intake, sourcing, interviewing, selection, and offer processes.
• Develop and execute internal and external sourcing strategies to attract qualified and diverse candidate pools.
• Apply advanced recruiting techniques and methodologies to identify and engage candidates with complex skill requirements.
• Manage relationships with third-party recruiting vendors and oversee related contracts and deliverables.
• Conduct and coordinate interviews, facilitate selection decisions, and extend and negotiate employment offers.

Senior Technical Recruiter

Manager

• Conduct comprehensive clinical reviews of medical service requests using established criteria
• Support utilization management activities such as pre‑certifications, appeals, and retrospective reviews
• Apply sound clinical judgment and contractual guidelines to promote appropriate care
• Collaborate with the Medical Director on escalated cases
• Facilitate care coordination through referrals
• Support administrative review processes to ensure compliance with clinical standards and policies
• Initiate referrals to ensure appropriate coordination of care
• Seek the advice of the Medical Director when appropriate, according to policy.
• Assist non-clinical staff in performance of administrative reviews
• Perform comprehensive provider and member appeals, denial interpretation for letters, retrospective claim review, special review requests, and UM pre-certifications and appeals.

Clinical Review Manager

Solutions Engineer

• Create strategic roadmaps, framework templates/models, and solution blueprints in area of specialty.
• Establish value of implemented roadmaps and create reference architectures which are searchable and usable by teams and systems.
• Collaborate with technical teams and management to devise architecture strategy, roadmaps for alignment with other architecture domains and architectural runways for backlogs and planning.
• Collaborate with business and IS stakeholders, architects, and management, to ensure business architecture and Applications Solutions processes are aligned with business strategy and IS standards.
• Create appropriate documentation, training, and transformation patterns within domain.

Solutions Architect

Operations

• Establishes the enterprise operational strategy, performance framework, and governance model for customer-oriented commercial operations to meet organizational goals.
• Provides executive oversight to leaders responsible for day-to-day execution, ensuring consistent performance management, accountability, and results across operations.
• Sets enterprise performance standards and outcome-based goals aligned with operational, financial, service, and experience targets.
• Coaches, mentors, and develops leadership teams to achieve sustained operational performance and talent readiness.
• Ensures standardized procedures, policies, and controls are designed, implemented, and executed consistently across operational areas.
• Oversees development and implementation of procedures to deliver effective service to internal and external customers while ensuring regulatory and contractual compliance.
• Provides executive-level feedback on operational outcomes, efficiencies, and risks across commercial operations.
• Sponsors and governs large-scale process improvement and transformation initiatives to ensure adoption and realization of business benefits.
• Leads the embedding of AI, automation, and advanced analytics into operational workflows, decision-making, and service delivery models.
• Partners with Technology, Data, Compliance, and Risk leaders to ensure AI use is scalable, compliant, and aligned to business objectives.

Managing Director – Commercial Operations

• Execute daily operations of AI-enabled member service processes across multiple channels
• Monitor performance and review interaction outcomes for accuracy, quality, and compliance
• Analyze escalations and exceptions to surface trends, risks, and improvement opportunities
• Document business and functional requirements: workflows, procedures, user stories, acceptance criteria, and test scenarios
• Lead user acceptance and regression testing to validate operational readiness
• Maintain issue and defect logs; coordinate resolution with cross-functional partners
• Produce clear operational documentation, standard work, and runbooks
• Partner with Operations, Quality, IT, Analytics, and vendor teams on continuous improvement