GuideWell Source

Account Executive

• Develop, coordinate and implement strategies and plans associated with all aspects of renewals for groups of 50-499, including Diversified Business, new sales and renewals.
• Accountable for coordination of marketing service efforts in a manner that facilitates the retention and effective administration activities of assigned accounts by assuring that Florida Blue delivers appropriate service to all group administrators, employees and agents.
• Maintain relationships with key contacts and provide a mutual understanding of the plans, policies and procedures to ensure group’s expectations are met.
• Manage and conduct the development, coordination and distribution of enrollment materials and enrollment educational sessions.
• Build strong partnerships with agents and individuals internal/external to the sales organization who support servicing, renewing and selling of our products.
• Develop and maintain strong partnerships with a specific assigned group of agents.
• Educate agents on Florida Blue sales processes, products, pricing, policies and procedures.
• Act as liaison or key point of contact between agent and Florida Blue.
• Build strong relationships with individuals within and outside the sales organization who support retention of our products.
• Manage the agent through the Florida Blue sales process to achieve retention goals through collateral material, proposal and rating, influencing RFP's, closing/acquisition, objection handling, and enrollment/implementation.
• Create commitment to Florida Blue by moving agent to higher levels (Gold and Blue Diamond).

Mid Market Account Executive – Renewal

Manager

• Engage Members telephonically or face to face at Florida Blue Retail Centers, hospitals, etc. with a focus on health coaching and member education.
• Facilitate access to care and resources to meet the member’s health care needs. Provide education and tools to promote self-management.
• Plan, implement, coordinate and monitor Case Management activities that may include acute and non-acute services, outpatient services and or community resources.
• Facilitate care for high risk members across the continuum of the health care experience, including care transitions, coordination of community and social service and coordinating with other value-based organizations, providers as needed.
• Close gaps in care
• Conduct Medication Reconciliation
• Collaborate with Member, Member’s Physicians, Plan Medical Directors, Managers, Local, Regional and Specialty team members as well as other functional areas to assist the member to meet their health care goals.
• Promote healthy lifestyles, assist in strengthening the patient-physician relationship, encourage behavior and lifestyle changes to realize a better quality of life, for individuals with identified chronic conditions, costly and/or catastrophic illnesses.
• Assist Members and their physicians to navigate through the health continuum, educate regarding benefits, identify candidates for Care Programs and provide information pertaining to the network and network access.
• Facilitate and document interdisciplinary care team meetings for at risk members as appropriate.

Registered Nurse – Case Manager

Product Manager

• Execute/support SLAs with internal business partners seeking product insight / direction.
• Delivers routine analysis to facilitate understanding of product performance, provide input to the competitiveness process, which includes proposing issue solutions, recommendations and the creation of cross – functional decision memos that require sign off from Product, Legal, Actuarial, Compliance, Service Care, Pharmacy and others at times.
• Responsible for supporting the transition of products from development to management and helps with issue resolution for all products post implementation launch
• Support Product Management analysis, enrollment and pricing trends to support, lead and manage product performance and life cycle management.
• Accountable for competitor trend reporting, analysis and cross functional coordination for timely effective market response decisions.
• Provide support, oversight and communication of market and segment needs
• Perform, support and collaborate with stakeholders on initiatives that support retention, enrollment, network and forecasting.
• Develops and maintains strong business relationships, and is skilled in leading, facilitating productive team meetings.
• Skilled in identifying stakeholders, and is effective in driving collaboration and clarity around key objectives and producing appropriate communication documents
• Develop, support and implement effective product management policies and procedures
• Work with cross-functional team to ensure technical, operational and sales dependencies are achieved within sales, financial and operational goals.
• Perform, support and collaborate with stakeholders on initiatives that support retention, enrollment, network and forecasting
• Lead/support communication/training plans in coordination with segment corporate strategy.
• Support vendor management as appropriate
• Support sales and other internal training on new products / products in the market as appropriate

Product Management Specialist III

Systems Engineer

• Provides functional and technical support/expertise during development, implementation, testing of complex projects
• Produces detailed functional requirements and/or user stories, including non-functional requirements
• Develops user acceptance criteria, test plans and test cases. Responsible for conducting functional/user testing (User Acceptance Testing) and accountable for user sign off of changes
• Monitors system implementation ensuring user satisfaction and be comfortable with being hands on in support of implemented solutions. – Operational readiness, Implementation/Warranty Support, Production support, Project analytics and reporting
• Responsible for facilitating business requirements gathering and determining technical impacts
• Reviews and clarifies user stories and user acceptance criteria with the stakeholders, and works with development lead/technical architect to layout technical design
• Assumes the role of product owner as necessary
• Develops system related documentation that includes flow charts, work flow tables, mapping documents, integration specifications and provides system training
• Develops a strong understanding of the business unit's function and effectively communicates technical issues and solutions in non-technical terms to the business unit
• Supports business architecture design (including Business Process), capability roadmap development and strategy development for the domain

IT Business Systems Analyst

Claims Specialist

• Day-to-day processing of claims for accounts:
• Responsible for processing of claims (medical, dental, vision, and mental health claims)
• Claims processing and adjudication.
• Claims research where applicable.
• Reviews and processes insurance to verify medical necessities and coverage under policy guidelines (clinical edit logic).
• Investigation and overpayment administration:
• Facilitate claims investigation, negotiate settlements, interpret medical records, respond to Department of Insurance complaints, and authorize payment to claimants and providers.
• Other responsibilities include resolving claims appeals, researching benefits, verifying correct plan loading.

Claims Examiner I

• Case Management process includes assessing the member’s health status and care coordination needs.
• Contact with patient, family, physicians, additional health care providers, and community resources.
• Identification of alternative treatment plans, which would have to be approved by all parties.
• Assessment of the clinical status and resultant sequela to coordinate the most appropriate service to meet the individual’s health care needs.
• Identification of services, resources, providers, and facilities that could best serve members in a timely and cost-effective manner.
• 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.
• 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.

RN Case Manager

Actuary

• Will be responsible for Medicare pricing and risk revenue analytics.
• Managing Actuaries typically manage one or more direct reports and are responsible for their team’s work, reviews, and development, as well as being responsible for producing their own work
• Managing Actuaries participate in the Actuarial Rotation program which provides the opportunity to rotate to a different team every 3-4 years.
• Support pricing, trend analytics, gross margin reporting, and financial reporting related to ACA, Medicare, Group, Reserves, Segment, and other teams
• Actuarial representation on cross-functional workgroups as an active participant

Managing Actuary – Medicare

Payroll

• Ensure Compliance and Regulatory Adherence: Stay current with payroll legislative changes and reporting regulations to ensure compliance with multiple tax reporting units, multi-state reporting requirements, and complex payroll processing cycles. Oversee quarter-end and year-end tax filings, including reconciliation and preparation for submission to tax agencies and employees.
• Payroll Subject Matter Expertise: Provide expert analysis and report on key financial/accounting matters, including recurring and ad hoc reports for leaders and areas within the organization.
• Interpret and administer HR policies related to payroll processing, ensuring compliance and accuracy.
• Consultation and Collaboration: Collaborate with various departments on complex pay practices and provide guidance on projects impacting payroll processing, employee compensation, or regulatory compliance.
• Financial Reporting and Reconciliations: Manage and reconcile high-volume and complex general ledger accounts, including payroll tax accounts, and prepare and maintain complex payroll-related account reconciliations.
• Journal Entries and Close Activities: Prepare and process complicated journal entries, and support month-end, quarter-end, and year-end close activities.
• Audit Support and Compliance: Collaborate with internal and external auditors, provide payroll documentation, reconcile and validate data, and support during audits.
• Process Improvement and Optimization: Identify opportunities for process improvement, implement changes to enhance efficiency and effectiveness.

Senior Payroll Accountant, CPP

Controller

• Lead the accounting function, financial reporting, internal controls, and compliance for GuideWell.
• Partner closely with executive leadership to provide accurate, timely, and actionable financial information.
• Direct all accounting operations, including general ledger, accounts payable, accounts receivable, payroll, fixed assets, and related functions.
• Oversee the monthly, quarterly, and annual close process to ensure financial statements are accurate, complete, and issued on time.
• Maintain documented accounting policies, procedures, and controls that support compliance and consistency.
• Coordinate external and regulatory audits and related documentation requests to ensure timely completion.
• Prepare reports and filings required by governmental, regulatory, and statutory agencies.
• Support system improvements and workflow enhancements across accounting operations.

Communications

• Develop and execute a proactive CEO communications strategy — including speeches, op-eds, thought leadership, stakeholder briefings, and social and digital presence — that builds Brian Pieninck's profile as a credible, visible leader in health care and business.
• Partner with the SVP and senior leaders across the enterprise to develop communications that reflect individual voice, advance the enterprise narrative, and strengthen credibility with internal and external audiences alike.
• Support the development of Board-facing communications materials in partnership with the SVP and executive leadership team.
• Own the internal and external narrative for Future Ready — ensuring that the scale, purpose, and human dimensions of GuideWell's transformation are communicated with clarity, consistency, and authenticity across every audience and channel.
• Lead a proactive media relations strategy that builds positive coverage of GuideWell, Florida Blue, and Triple-S — elevating stories about mission, community impact, innovation, and member outcomes while reducing the organization's reactive exposure.
• Serve as the communications lead for sensitive issues, policy developments, and reputational threats — developing response strategies, preparing spokespeople, and coordinating cross-functional response with speed and discipline.
• Maintain and continuously strengthen enterprise crisis communications capabilities — including playbooks, spokesperson training, scenario planning, and real-time response protocols — so the organization is never caught unprepared.
• Develop and steward the enterprise narrative architecture — ensuring GuideWell's story, purpose, and points of differentiation are expressed with consistency and conviction across all external audiences and channels.
• Lead enterprise social media strategy and digital reputation management, with clear integration into brand and marketing efforts across the CMX function.
• Lead internal communications strategy across GuideWell's workforce — building the content, channels, and cadences that keep employees informed, connected to the mission, and genuinely engaged — especially through periods of change.
• Serve as the strategic communications partner for enterprise-wide transformation — developing multi-channel strategies that translate complex organizational change into clear, human, meaningful employee experience, and that sustain momentum rather than just announce milestones.
• Partner with Human Resources and senior leadership to make GuideWell's values visible in how we communicate internally — reinforcing belonging, celebrating the people behind the mission, and ensuring culture is something employees experience, not just read about.
• Enable managers and leaders across the enterprise to communicate effectively — developing toolkits, talking points, and cascade frameworks that ensure consistent, credible communication from the C-suite to the front line.
• Own and evolve the master narrative that anchors communications across internal and external channels — ensuring the GuideWell enterprise story is coherent, differentiated, and grounded in mission rather than marketing language.
• Partner closely with the VP of Enterprise Marketing & Customer Acquisition and the Senior Director of Brand & Creative to align communications tone, language, and storytelling with brand strategy and the broader member and customer experience.
• Develop a thought leadership platform that positions GuideWell, Florida Blue, and Triple-S as credible, forward-thinking voices in health care — across media, conferences, and community engagement.
• Ensure community investment, partnerships, and social impact efforts are communicated in ways that are authentic and meaningfully connected to our mission — not an afterthought to our marketing.
• Develop and own the enterprise communications framework — establishing shared standards, narrative architecture, channel strategy, and measurement methodology that extend across GuideWell, Florida Blue, Triple-S, and GuideWell's portfolio of health solutions subsidiaries.
• Serve as enterprise communications standard-setter and strategic partner for subsidiary communications leaders — enabling consistency in voice, narrative, and reputation strategy while honoring the distinct market contexts of Florida, Puerto Rico, and GuideWell's other business lines.
• Partner with peers across the CMX Leadership Team — including the VP of Enterprise Marketing & Customer Acquisition, the VP of Enterprise Voice of Customer & Insights, and the VP of Customer Experience & Engagement — to ensure communications strategy is integrated with marketing, brand, and customer experience at every level.
• Lead and develop a high-performing communications team spanning strategic communications, reputation management, and enterprise storytelling — recruiting, retaining, and growing talent capable of operating at the highest levels of the discipline.
• Build AI-enabled communications capabilities — championing the responsible adoption of AI tools and data analytics to improve content quality, production speed, measurement, and audience targeting across all communications channels.
• Establish robust measurement — implementing a data-driven approach to communications effectiveness, including media analytics, employee sentiment tracking, executive visibility metrics, and enterprise reputation monitoring.
• Foster a culture of craft — maintaining high standards for writing, clarity, and strategic thinking across the team, while building an environment where creative ambition is encouraged and speed never comes at the expense of quality.

VP Enterprise Communications

Sales

• Engage with Medicare prospects and existing members to educate and guide them in the sales process.
• Develop and maintain long term relationships with an assigned base of existing Florida Blue members.
• Operate as a licensed telephonic sales agent, utilizing exceptional communication and interpersonal skills.
• Assist prospective and existing FB members to find a Florida Blue Medicare plan by conducting a Needs Analysis.
• Proactively educate current and prospective members on Medicare basics, enrollment requirements, and penalties.
• 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.
• Identify and overcome buying obstacles from new customers and existing members.
• Maintain regular contact with clients to drive retention.

Medicare Tele-Sales, Planning Agent

Account Manager

• Respond to client inquiries within 24 hours, acknowledging and building expectations for resolution.
• Delivering on commitments.
• Create and maintain a proactive communication strategy with clients, related distributors, business partners, and consultants adequate to identify and address problems and issues expeditiously.
• Build and maintain a strong understanding of product/service delivery systems and infrastructure adequate to identify and address problems and issues, including information requests, expeditiously.
• Evaluate client needs and lead cross functional teams to design, plan, configure, and implement products and services on a timely basis.
• Schedule and lead client/delivery team meetings; developing and communicating progress against client's plan management strategy; gathering required data, research, and supporting analysis, and handouts/documents to guide the discussion.
• Build and maintain effective feedback infrastructure to gather critical intelligence on client satisfaction from all sources related to the client's total product/service delivery system, including brokers, consultants, vendors, partners, stop loss carriers, etc., to ensure maximum opportunity to retain the business and related revenues.
• Build and maintain a strong business/working relationship with clients and distribution networks sufficient to maintain and increase revenues.
• Identify other opportunities and referrals.
• Develop and maintain familiarity with WebTPA reporting and analysis tools adequate to report plan performance metrics to brokers, consultants, and clients.
• Ensure delivery of fully executed client contracts including but not limited to ASA, Plan document, Compliance, Network, PBM, BAA, etc.
• Analyze and evaluate client's plan performance and seek out opportunities to upsell/cross sell WebTPA products and services, or revenue producing partner products and services, while improving the overall service experience to clients and their members.
• Develop and maintain a thorough understanding of clients objectives for their plan; discuss key performance indicators, analyze issues, and recommend/model changes necessary to achieve those objectives.
• Communicate and assure client compliance with federally and state mandated requirements.
• Review and assess clients benefit plans broadly considering key factors - industry, locations, required product/service mix and compliance factors

Cloud Engineer

• Define and maintain the enterprise cloud architecture roadmap aligned with business objectives and IT strategy.
• Lead the design of multi-cloud and hybrid cloud solutions across AWS, Microsoft Azure, and/or Google Cloud Platform (GCP).
• Establish architecture standards, patterns, reference architectures, and guardrails for cloud adoption across all business units.
• Conduct architecture reviews and provide technical guidance to project teams and engineering leads.
• Evaluate emerging cloud technologies and recommend adoption where strategically beneficial.
• Develop and enforce cloud governance frameworks, policies, and tagging/cost management standards.
• Ensure cloud environments comply with applicable regulations (e.g., SOC 2, ISO 27001, HIPAA, GDPR) and internal security policies.
• Partner with Information Security to integrate security-by-design principles into all cloud workloads.
• Maintain documentation of architecture decisions (ADRs), infrastructure diagrams, and runbooks.
• Oversee and guide enterprise cloud migration initiatives, including lift-and-shift, re-platforming, re-architecting, and retiring workloads.
• Lead modernization efforts including containerization (Kubernetes, Docker, etc.), microservices adoption, and serverless architectures.
• Collaborate with application teams to assess on-premises workloads for cloud readiness and develop migration plans.
• Drive cloud cost optimization strategies including right-sizing, reserved instances, and resource lifecycle management.
• Partner with Finance and IT leadership to develop cloud budgets, forecasts, and chargeback/showback models.
• Establish KPIs and dashboards to monitor cloud spend, performance, and operational health.
• Serve as a trusted advisor to the CTO, IT Sr. Leadership, and business stakeholders on cloud strategy and investment decisions.
• Mentor and coach cloud engineers and technical teams; contribute to building internal cloud competency.
• Lead cloud Center of Excellence (CoE) working groups and facilitate architectural governance councils.
• Collaborate with vendors, managed service providers, and external partners on cloud initiatives.

Enterprise Cloud Architect

QA Engineer

• Serve as a liaison between internal clients and functional departments;
• Identify risks, evaluate controls and prepare findings and recommendations.
• Ensure through audits that the organization’s programs are consistently administered in compliance with organizational policies and procedures.
• Monitor and evaluate the effectiveness of solutions, policies, practices and processes.
• Develop, implement, administer and revise policies, procedures and programs that meet business needs.
• Research, analyze, maintain, modify, validate and prepare data, information and content used in making business decisions.
• Produce, edit and distribute a variety of business documents such as reports, proposals, policies, procedures, etc.
• Create, present and/or facilitate meetings, webinars, training programs, etc.
• Participate on or lead large, complex departmental and/or divisional projects.
• Develop and build internal and external partnerships to improve communication, coordination, collaboration and effective working relationships within own department.

Utilization Management RN

• Ensure accuracy and compliance of payroll-related financial processes.
• Prepare and maintain payroll account reconciliations and resolve discrepancies.
• Support month-end, quarter-end, and year-end close activities.
• Provide support for internal and external audits and maintain compliance records.
• Identify opportunities for process improvements.
• Maintain accurate tax jurisdiction setup in payroll systems.