Wellmark Blue Cross and Blue Shield

Analyst

• Provide clinical leadership and subject-matter expertise for complex medical policy content
• Ensure accurate implementation of medical policies and authorization requirements
• Research and analyze system and business issues
• Develop high-level requirements, test and implement solutions, and audit outcomes
• Mentor and train Coding Specialists and provide policy-related training to operational partners
• Maintain the claims processing system infrastructure to ensure compliance
• Collaborate with teams to resolve coding-related denials and questions

Health Services Coding Analyst, CPC Required

• Provide clinical leadership and subject-matter expertise to support the analysis, configuration, and administration of complex medical policy content within claims processing systems, including Plan General Exclusion (PGE) rules and FACETS table maintenance.
• Ensure the accurate implementation of medical policies, review criteria, and authorization requirements, while maintaining the integrity of system infrastructure and serving as a key liaison between business and technical teams.
• Research and analyze system and business issues, develop high-level requirements, test and implement solutions, and audit and document outcomes.
• Mentor and train Coding Specialists, and provide policy-related training and support to operational partners such as customer and provider services.

Full-stack Engineer

• Wellmark Inc. seeks a Sr Software Engineer – Dynamics CRM
• Design, develop, test, implement, maintain, and document highly complex Microsoft Dynamics 365 solutions
• Ensure completed activities meet project specifications, requirements and Wellmark standards
• Lead discussions with Technology and business units on solution design and implementation
• Collaborate with other areas of Technology to ensure solutions improve the user experience
• Work to resolve technical problems for on-premise, cloud native, and hybrid applications
• Serve as subject matter expert in the implementation of innovative, cost-effective business solutions for multiple applications.

Senior Software Engineer – Dynamics CRM

• Lead full stack development for the Digital Services team, performing detailed systems analysis and implementation of high performing software solutions that are efficient and cost effective, supporting Wellmark’s business and Technology applications
• Lead system development and guides the team in the design, development, code testing and debugging necessary to ensure successful completion or resolution of issues while focusing on utilization of emerging technologies
• Orchestrate cross-functional end-to-end execution across diverse platforms, all meticulously aligned with Wellmark's SDLC standards and the structured SAFe methodology in order to culminate the making of these advancements accessible and beneficial to all Information Product teams and foster a unified and elevated approach to development and delivery
• Work closely with UX/UI designers, product managers, Architects and DevOps engineers to create responsive, interactive, and high performing applications by delivering high quality code that ensures a seamless user experience across multiple devices
• Develop and optimize web pages for maximum speed, accessibility and scalability
• Develop and optimize backend architecture ensuring scalability, performance and security
• Write clean, maintainable and efficient code, adhering to best practices and Wellmark engineering standards
• Ensure mobile responsiveness of applications
• Ensure analysis of defects to find root cause and guide others in the identification of potential improvement opportunities
• Provide production support of applications including root cause analysis and break-fix resolution
• Use data and cost measures (AWS, infrastructure, labor, etc.) to influence timely decisions, build consensus, and take actions to successfully deliver project or production support objectives and support benefits realization
• Identify known issues, impacts to project or production outcomes if not resolved and escalate as necessary
• Contribute to a collaborative agile environment, including PI Planning, iteration planning, estimation, demos and retrospectives

Health Services Coding Analyst, CPC Required

Health Services Coding Analyst, CPC Required

Senior Software Engineer – Dynamics CRM

Senior Full Stack Digital Services Software Engineer