GuideWell Source

Manager

• Developing and managing an ongoing digital communications strategy for internal audiences.
• Accountable for implementing and evaluating multiple complex initiatives, capabilities, and functions.
• Acts as a strategic digital communications consultant to Chief Communications Officer and senior leaders.
• Establishes deep partnerships with key internal stakeholders across the business and IT organizations.
• Responsible for gaining alignment and driving change within assigned functions.
• Leads cross function initiatives and is relied upon to anticipate and mitigate cross functional issues.
• Ensures a world-class and forward-leaning user experience, thoughtfully integrating proprietary and partnered solutions.

Senior Digital & Technology Communication Manager

Auditor

• Execute audit procedures as outlined by Leadership including perform and document findings of quality accuracy reviews/quality audits of coding and documentation completed by Companies Internal Risk Adjustment Coders/Auditors to ensure consistency and accuracy of ICD-10 coding and industry standards.
• Advise Companies Internal Coders/Auditors on proper code selection, documentation guidelines as well as assist with training and education.
• Research and communicate ICD-10, Coding Clinics, and other industry standard guidance, when appropriate, for facilitating quality review findings and education.
• Perform and document findings of quality accuracy reviews/quality audits of coding and documentation completed by External Vendors, Partners and/or Provider Groups to ensure consistency and accuracy of ICD-10 coding.
• Communicate with external Vendors, Partners and/or Provider Groups to share out audit results and educational materials.
• Escalates trends in quality accuracy reviews/quality audits findings to Leadership and provide suggested corrective actions
• Assists Leadership and resources to support audit scope, deadlines, and objectives.
• Assist Leadership with improvements to the quality accuracy reviews/quality audits process, identifying risks, evaluating controls, and preparing documentation.
• Assists in developing, maintaining, and updating departmental procedures, workflows, and other work tools/job aides.

Senior Medical Quality Auditor – Risk Adjustment

Events

• Assist with the identification and maintenance of assets for events. Load, ship and track inventory going out and coming back from events.
• Accountable for management of asset inventory platform ensuring items are properly checked out and returned upon completion as well as keeping inventory quantities updated.
• Responsible for quality inspection of information entered into Warehouse Inventory Webstores.
• Communicate and coordinate with team based on daily/weekly needs of deliveries and pick-ups.
• Provide direct oversight and coordination of processing and fulfilment associated with inventory and asset services.
• Work with internal departments to ensure creation and shipment of all the necessary marketing materials for the Events.
• Accountable for tracking and reconciling shipment and asset charge backs to correct cost center.
• Maintain warehouse in an organized fashion.
• Maintain the integrity of all assets. Monitor conditions and notify asset owner when items are damaged, need to be cleaned or replaced.
• Ensure company vehicles are up to date on registration & insurance and work with Risk Management on updating any policies as needed.
• Manage and maintain vehicle and statewide asset calendar to ensure no scheduling conflicts.
• Ensure all display assets shipped out for event use is returned back to inventory.
• Manage inventory request, processing and fulfilment within 3-5 business days.
• Manage Inventory Webstore for 5 locations and 10+ different client assets.
• Manage inventory request email inbox.
• Operate forklift when needed for shipments.
• Accountable for production of Field Marketing large scale and high-profile activations in their entirety.
• Support Staffing Specialist with the recruitment and on-site training of brand ambassadors.
• Support Field & Experiential Project Manager on event production from event conception to reconciliation.
• Accountable for event inventory tracking, load in and out at 100%, event production set up and smooth execution.
• Coordinate all logistics for load-in and load-out of events.
• Ensure all event assets and supplies are in place and functioning properly prior to event going live.
• Perform walkthrough with Event Lead prior to start of event to ensure everything is accounted for.
• Communicate with Field Marketing Team to confirm space requirements for each event and offer recommendations for layout and assets that can be utilized.
• Troubleshoot any production issues that arise onsite.
• Assist with preparing post-event reports and sharing with necessary stakeholders.
• Support Experiential Marketing Project Manager and Field Marketing Team with production of large scale events and activations from inception to execution to ensure 100% project completion and success.
• Work with event lead to ensure all logistics are planned and scheduled in a timely manner.
• Manage and report all expenses to ensure to stay within event budget.
• Creative design and development of event layout, using production knowledge and best practices to ensure most efficient layout.

Event Production Specialist

Medical Director

• Overall case guidance and consulting to ensure that fraud, waste, and abuse efforts are performed with the highest and most current clinical standards
• Apply health plan review hierarchy to member contracts, medical policy, clinical guidelines and other approved resources to render timely decisions on services provided to members
• Perform reviews and participate in peer-to-peer discussions of inpatient DRG Clinical Validation audits and appeals
• Serves as a resource for information and consultation on the issues related to utilization management and clinical services
• Approval and direction of consultant reviews. Participation in and support of overpayment recoveries
• Support as needed to internal and external agencies in conjunction with these reviews such as but not limited to the Special Investigations Unit
• Review of services suspected of being performed for purposes not medically necessary. Appropriate documentation of decisions and follow-up
• Comply with all state, federal, and regulatory requirements
• Other duties as necessary to ensure progression and completion of reviews
• Participate on projects and committees as necessary

Medical Director – Payment Integrity Officer

Bilingual

• Case Management process includes assessing the member’s health status and care coordination needs. Can include inpatient review and discharge planning, as well as possible outpatient management.
• Contact with patient, family, physicians, additional health care providers, and community resources. Contact with provider business offices and with the employer/client may also be required.
• Identification of alternative treatment plans, which would have to be approved by all parties. These alternative care plans will be based on quality care within cost containment guidelines, allowing available claims dollars to be used in the most judicious manner possible.
• Assessment of the clinical status and resultant sequela to coordinate the most appropriate service to meet the individual’s health care needs. The Case Manager will then monitor the health status and the impact of the treatment plan for each client. The Case Manager will be responsible for altering the care plan as deemed appropriate by the dynamic, ever-changing client needs.
• Identification of services, resources, providers, and facilities that could best serve members in a timely and cost-effective manner, to promote optimum value for the client and reimbursement source.
• Development and implementation of Case Management goals, both short and long term, with documented care plans.
• Utilize technology/resources to evaluate the cost-effectiveness of the elected treatment plan, pre-implementation and post-implementation. This outcome measurement will be used in determining the effective results and in establishing future patient-centered care plans.
• Accurate and timely reporting as deemed appropriate by each client member.
• Medical record review to determine medical necessity of requested services.
• Interpreting individual health plans and authorizing/coordinating care in accordance with plan provisions.

Bilingual RN Case Manager

Consultant

• Support Lever Owners in designing and implementing strategic initiatives, ensuring alignment with TCOC framework and governance guardrails.
• Collaborate with Lever Owners to identify and mitigate cross-lever dependencies and risks, and track progress against financial targets.
• Develop and maintain initiative documentation and validation standards, promoting consistency and excellence across levers.
• Understands the strategic direction of business unit and the organization. Communicates the business units strategic plan to internal departments and external stakeholders for influencing decision making, selling concepts and providing advice and counsel that impacts business objectives. Develops communications and presentations for aligning cross-functional teams and ensuring effective execution.
• Develops tactical plans and translates to project plans and leads projects from problem definition to planning and execution.
• May lead, coach and develop a small staff.
• Synthesizes collected data/information and advises management on options, risks, cost versus benefits and impacts on business processes, systems, employees, etc. May oversee reporting, monitoring and evaluation activities.
• Provides consultative support to organization management within context of overall strategic objectives and broad policy; typically supports senior management.

Business Support Consultant – Total Cost of Care

Project Manager

• Identify additional ideation sources, including Lean, Kaizen, and operational insights, to inform TCOC initiatives.
• Facilitate quarterly enterprise ideation sessions to surface data-driven opportunities for total cost of care (TCOC) initiatives.
• Support the development of TCOC initiatives, ensuring alignment with TCOC framework and governance guardrails.
• Serve as a liaison between internal clients and functional departments; help clients achieve their objectives by serving as a resource in the interpretation, application and compliance with internal and external laws, regulations, policies, procedures, standards and practices.
• Identify risks, evaluate controls and prepare findings and recommendations. Implement compliance programs to prevent illegal, unethical or improper business practices.
• Ensure through audits that the organization’s programs are consistently administered in compliance with organizational policies and procedures, contractual obligations, rulings, laws and government regulations.
• Monitor and evaluate the effectiveness of solutions, policies, practices and processes to ensure continuous improvement, good client relations and adherence to business requirements. Recommend improvements to achieve and deliver high quality, value-added services.
• Develop, implement, administer and revise policies, procedures and programs that meet business needs; assist and/or lead program development and enhancements.
• Research, analyze, maintain, modify, validate and prepare data, information and content used in making business decisions. Present findings and articulate results.
• Produce, edit and distribute a variety of business documents such as reports, proposals, policies, procedures, audit results, issue papers, marketing materials, newsletters, brochures, etc.
• Create, present and/or facilitate meetings, webinars, conference calls, training programs, education sessions, certifications, etc. for a variety of internal and external audiences.
• Represent assigned function at external hearings, mediations, audits, meetings, etc.
• Participate on or lead large, complex departmental and/or divisional projects. Plan, organize, monitor and control projects to ensure the effective use of resources and adherence to project management standards and reporting requirements.
• Develop and build internal and external partnerships to improve communication, coordination, collaboration and effective working relationships within own department, across the Company and outside of the Company.
• Mentor and coach less experienced coworkers on the technical and interpersonal skills needed for effective job performance.

Project Management Specialist – Total Cost of Care

Sales

• Engage with Medicare prospects and existing members to educate and guide them in the sales process by assisting them in selecting and enrolling in a suitable Medicare and ancillary plan.
• Develop and maintain long term relationships with an assigned base of existing Florida Blue members aging into Medicare, ensuring their healthcare needs are met.
• Operate as a licensed telephonic sales agent, utilizing exceptional communication and interpersonal skills to drive sales growth and retention.
• Assist prospective and existing FB members to find a Florida Blue Medicare plan by conducting a Needs Analysis and pitching an appropriate plan that will meet their healthcare needs including ancillary products and ultimately enrolling them telephonically.
• Proactively educate current and prospective members aging into Medicare-on-Medicare basics, enrollment requirements, and penalties, with the goal of recommending a FB Medicare plan and assisting with the enrollment process.
• Understand commercial plans for those aging in to ensure appropriate plan selection.
• Retain membership after enrollment through a series of welcome calls educating the members on their new plans.
• Support marketing campaigns via inbound and outbound telephonic sales calls.
• Exceed New Sales quota, retention rates, telephonic service levels, and quality expectations.
• Respond to sales inquiries from prospective and existing members regarding product offers and annual product changes.
• Manage the customer lifecycle, including acquisition, welcome, engagement, retention and re-sale.
• Maintain regular contact with clients, for follow up buying decision and drive retention.
• Identify and overcome buying obstacles from new customers and existing members.
• Deliver best in class sales experience ensuring ongoing satisfaction and customer retention.

Planning Advisor – Medicare Tele-sales

Customer Support

• Lead the design of experiences that reflect the reality that most member interactions are connected to health — getting care, managing a condition, navigating a care transition, or working toward better well-being.
• Partner with clinical, medical management, and population health teams to design engagement strategies for members managing chronic conditions or complex care needs — ensuring that the experience of being supported feels proactive, personal, and connected.
• Develop experience models that move members from passive coverage-holders to active participants in their own health — leveraging data, behavioral science, and community connection to drive meaningful engagement.
• Identify and redesign the friction points that occur when members move between care settings, coverage changes, or life stages — moments where disengagement is most likely and the cost of failure is highest.
• Lead the human-centered design of end-to-end member, customer, and provider journeys across digital and non-digital channels — prioritizing the highest-impact moments across the full arc of a member’s health and coverage experience.
• Partner with Product, Technology, Operations, and Clinical teams to translate journey insights into concrete improvements in processes, platforms, and policies.
• Design specific interventions for critical milestones — enrollment, first use of benefits, a significant diagnosis, care completion, renewal — to reduce friction and increase both loyalty and health engagement.
• Champion the application of AI and automation to reduce friction and surface timely, relevant health support — while ensuring that human connection remains accessible and high-quality for members who need it most.
• Lead the overarching strategy for CRM and outbound communications throughout the member relationship — spanning service moments, care milestones, condition management touchpoints, and well-being programming.
• Develop communication cadences that anticipate member needs — particularly at key health and coverage moments — moving beyond reactive service to proactive relationship building that supports better health decisions.
• Build a high-performing CX function from the ground up: recruit, develop, and retain top-tier talent across journey design, CRM, health engagement, and CX program management.
• Develop enterprise CX training programs and competency models that embed member-centric, health-outcome-oriented thinking across business units, call centers, and clinical teams.
• Establish a CX center of excellence that serves as an internal resource, thought partner, and standard-setter across the GuideWell enterprise.

VP Customer Experience – Engagement

AI Engineer

• In collaboration with the office of the CEO and VP Of AI Factory, execute on the multi-year technical roadmap for AI engineering, aligned with the company's strategic goals across care delivery, cost management, and member experience.
• Serve as the senior engineering voice for AI at the executive level, partnering with VP Of AI Factory, influencing platform investment, architecture direction, and build-vs-buy decisions across the enterprise.
• Partner with the CTO, Chief Data Officer, VP Of AI Factory and clinical leadership to ensure AI engineering capabilities support the full AI lifecycle from research and experimentation to scalable production deployment.
• Architect and operate a cloud-native, enterprise-grade AI platform that supports model training, evaluation, versioning, deployment, and monitoring at scale.
• Establish and enforce MLOps best practices including CI/CD pipelines for model development, automated testing, model registry management, and drift detection.
• Drive infrastructure strategy across compute, orchestration (e.g., Kubernetes, Airflow), and data pipelines to optimize cost, performance, and regulatory compliance.
• Lead engineering teams responsible for developing, fine-tuning, and deploying machine learning models and LLM-powered solutions into production healthcare environments.
• Oversee integration of AI models with core health plan systems including claims platforms, EHRs, care management tools, and member-facing applications ensuring high availability, low latency, and auditability.
• Champion rigorous model evaluation, A/B testing, and continuous improvement frameworks appropriate for high-stakes healthcare use cases.
• Recruit, develop, and retain a world-class team of AI engineers, ML engineers, and data scientist with deep healthcare domain exposure.
• Build an engineering culture rooted in technical ownership, clinical accountability, psychological safety, and continuous learning.
• Define career frameworks, leveling guides, and growth paths for the AI engineering organization.
• Establish and enforce AI engineering standards covering responsible AI, bias detection, model explainability, and clinical safety in alignment with HIPAA, CMS regulations, and applicable state requirements.
• Ensure all AI systems and infrastructure meet the company's security, data privacy, and compliance standards, protecting sensitive member and clinical data.
• Partner with Office of CEO, Legal, Compliance, Security, and Risk teams to identify, assess, and mitigate technical and ethical risks associated with AI deployments, including third-party and vendor AI solutions.
• Develop and maintain AI governance policies and audit frameworks to support regulatory reporting and internal oversight.
• Collaborate with Office of CEO, clinical, operational, and business stakeholders to translate complex engineering capabilities into clear, actionable AI solutions.
• Communicate AI engineering strategy, platform performance, and risk posture to executive leadership and board-level stakeholders with clarity and confidence.
• Work closely with vendor and technology partners to evaluate and integrate external AI capabilities into the enterprise platform.
• Define and own engineering KPIs including model performance, system reliability (SLOs/SLAs), deployment velocity, infrastructure cost efficiency, and clinical outcome metrics.
• Provide regular executive reporting on AI engineering progress, translating technical performance into measurable business and clinical impact.
• Lead cost optimization efforts across AI infrastructure without compromising platform capability or compliance posture.

VP AI Engineering

Account Manager

• Design and develop a comprehensive PEO program, including services, pricing, and operational infrastructure.
• Collaborate with cross-functional teams, including sales, marketing, and operations, to ensure alignment and successful launch.
• Own sales and account management for PEO groups, driving revenue growth and customer acquisition.
• Develop and execute sales strategies to penetrate existing markets and expand into new ones.
• Build and maintain strong relationships with key customers, partners, and stakeholders.
• Identify opportunities for growth and expansion into additional executive-level account management for other group segments.
• Develop and execute strategies to drive growth, increase revenue, and enhance customer value.
• Build, lead, and develop a high-performing sales and account management team.
• Foster a culture of excellence, innovation, and customer-centricity.
• Develop and maintain strategic partnerships with key stakeholders, including brokers, agents, and industry partners.
• Collaborate with internal stakeholders to ensure alignment and effective execution.

VP, PEO Sales & Account Management

Vice President

• Lead the annual strategic planning process, developing near-term focuses and a 3–5 year enterprise strategic plan in partnership with the CEO and ELT
• Define the company's "where to play / how to win" choices, identifying key markets, customers, and competitive advantages
• Develop and maintain a portfolio strategy and long-range growth thesis, partnering with Finance to align strategic ambition with financial guardrails and capital allocation priorities
• Conduct scenario planning, structural risk assessments, and competitor analysis to inform strategic decisions
• Prepare Board-level strategy materials and strategic narrative, ensuring clear communication of the company's vision and goals
• Accountable for both shaping strategy and tracking execution, value realization, and sustained enterprise impact.
• Establish and govern a consistent strategic planning framework across business units, ensuring alignment with enterprise priorities and financial expectations
• Support strategic planning and business orientation to drive near-term performance results and long-term growth
• Guide and pressure-test 2–3-year Business Unit (BU) strategies, identifying cross-BU growth opportunities and synergies
• Ensure BU plans align to enterprise priorities and financial expectations, surfacing structural and capability gaps as needed
• Define and execute the enterprise innovation thesis, aligned to the company's strategic vision and goals
• Oversee the innovation portfolio, including core, adjacent, and disruptive initiatives, and establish governance and stage-gate discipline
• Align innovation investments with the capital allocation framework, ensuring strategic alignment and commercial viability
• Build and maintain an external partnership ecosystem to support innovation efforts, as needed
• A successful innovation approach will include measurable business, operating model, and growth outcomes
• Continuously assess the competitiveness and scalability of the company's operating model, identifying areas for improvement and optimization
• Partner with the transformation team to identify structural risks and future-state requirements, anticipating organizational friction and proposing design solutions
• Drive organizational transformation and operating model evolution, ensuring alignment with the strategic plan and innovation agenda

VP, Enterprise Strategy & Innovation

Director

• Provide strategic counsel to the executive leader on key business initiatives, enterprise priorities, and performance objectives
• Translate enterprise objectives into integrated functional strategies and tactics and measurable execution plan
• Anticipate strategic risks and opportunities; provide actionable recommendations
• Represent the executive leader in key enterprise forums and decision-making settings
• Lead the annual strategic and business planning process for the functional area, ensuring alignment with enterprise objectives
• Oversee development, execution, and monitoring of short- and long-term strategic initiatives tied to financial and operational outcomes
• Drive accountability for goal achievement, performance metrics, and continuous improvement
• Ensure enterprise reporting alignment, including executive dashboards, monthly and quarterly operating reviews, and materials for executive leadership team, CEO, and board of directors
• Direct, monitor, and contribute to highly complex strategic projects involving multifaceted, cross-functional teams
• Serve as executive liaison to resolve issues and ensure successful implementation of company initiatives
• Lead or champion cross-functional teams supporting planning, development, and execution of key initiatives
• Identify and mitigate risks that could impact financial performance, operational stability, or organizational reputation
• Strong analysis, parsing large amounts of data in either excel or data analytics tools and present fact-based options to the Executive Leadership Team member
• Communicate executive decisions clearly and monitor downstream execution
• Plan and execute leadership forums, town halls, and strategic summits
• Prepare and oversee executive presentations for internal and external audiences
• Foster a culture of innovation, inclusivity, accountability, and engagement aligned with enterprise values
• Support talent development efforts in partnership with HR to build leadership pipeline and organizational capability
• Ensure effective communication of performance measures and business outcomes
• Facilitate leadership meetings and develop executive-level content as needed

Senior Director – Office of the CEO

Digital Marketing

• Own the organization and prioritization of incoming requests for the digital marketing team and implement those requests or assign them to other team members as needed.
• Manage webpage creation, maintenance and optimization within the enterprise content management system
• Partner with segment owners and other internal stakeholders to execute brand and product marketing content on digital channels to drive awareness, positioning and engagement efforts
• Manage the use of core marketing technology platforms such as Invoca for call tracking as well as author and validate redirects and campaign URLs for marketing attribution
• Monitor and analyze performance using platforms such as Google Analytics and Google Search Console; provide insights to internal stakeholders and identify opportunities and areas for improvement using dashboards and reports created in Looker Studio
• Assist other digital marketing team members with digital marketing tasks and projects as needed
• Research and identify technical fixes and opportunities that will drive improved website performance; partner with IT to ensure improvements are implemented correctly
• Stay up-to-date on ever-changing trends within digital marketing and develop strategies aligned to these trends where relevant
• Ensure partners, stakeholders and requestors have a strong understanding of the digital marketing team’s processes and requirements and follow them, providing all necessary assets for each submitted request
• Ensure consistency of content, design, imagery, and visual components across GuideWell brand websites

Assistant Digital Marketing Manager

• Develop and maintain strong partnerships with assigned accounts and their business partners as well as other key influencers, per Account Management plan
• Achieve an understanding of client’s organization and business processes, both formal and informal
• Educate accounts on BCBSF , and other plans when appropriate sales process, products, policies and procedures, assistance in effective implementation and ongoing execution
• Communicate state and federal legislation impacts. Assist the accounts with implementing procedures for the legislative plans
• Act as liaison or key point of contact between account, business partner, TPA’s, reinsurers, BCBSF and other BCBS plans manage the coordination of reinsurance and other cross company services when appropriate
• Develop and maintain relationships to meet the client’s expectations and requirements. These relationships are with both management and staff positions with a multitude of internal stakeholders
• Build strong partnerships with individuals within and outside the sales organization who support servicing and selling of our products
• Provide leadership to various work teams assigned to enrollment functions, Non-Standard Benefit design and administration, and complex issue resolution in order to ensure the effective administration and service to assigned accounts
• Manage and conduct the development, coordination and distribution of enrollment materials, enrollment/education meetings, administrative requirements
• Through the Alliance platform, work with and coordinate with other Blue Partners during the account management and service processes.
• Represent BCBSF in competitive (multiple insurers offered) enrollment situations and influence selection of BCBSF as the employee’s insurance choice
• Develop and implement account tactical plans based on needs analysis and continually update strategy as situation changes
• Coordinate account management to support the BCBSF conservation processes including periodic onsite account meetings with decision makers and other key individuals, as well as employees in multiple locations throughout the country.
• Manage resolution of complex account and business issues in collaboration with sales an d sales support staff
• Monitor account management to provide value added impact for renewal decision making
• Coordinate group specific analytical tools, e.g., reports, health care assessments, member surveys for the purpose of interpretation and presentation of suggested strategies for wellness initiatives and overall cost savings
• Coordinate the complete internal implementation/renewal process for specific assigned inventory
• Facilitate and coordinate multiple projects and tasks with external community partners and internal organizational partners to promote and enhance health and wellness programs in order to increase the quality of life of our customers, thereby assisting with regional and sales goals by adding value to our customer benefits and exceeding customer expectations
• Utilize influence, conflict resolution and problem solving skills with internal key stakeholders to innovate, enhance, and implement processes and systems capabilities in order to met the unique needs of the accounts
• Develop and manage Account Management plan, in partnership with Account Manager towards the profitable renewal and conservation of assigned accounts.
• Manage own personal and professional development
• Identify and implement opportunities for improvement with company process and procedures
• Identify opportunities to mentor and coach others to achieve results
• Manage time, territory, costs and administrative requirements by effectively planning and carrying out plans to ensure that support activities are achieved at reasonable cost
• Comply with state and regulatory requirements and corporate policies and procedures