Blue Cross Blue Shield of Arizona

Payroll Analyst - Remote in AZ

Blue Cross Blue Shield of Arizona · Full Time · 3 hours ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Finance

The role focuses on payroll accuracy, reconciliation, and accounting integrity within Workday, including managing journal entries and general ledger activity. It also involves leading system testing for HRIS releases and implementing AI-enabled tools for operational efficiency.

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Medical Appeals and Grievance (MAG) Specialist II - Remote

Blue Cross Blue Shield of Arizona · Full Time · 4 days ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The specialist is responsible for managing medical appeals and grievances to ensure member satisfaction and regulatory compliance. This involves reviewing cases and coordinating with internal teams to resolve healthcare insurance disputes.

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Health Services Technician (Justice Technician) - Remote AZ

Blue Cross Blue Shield of Arizona · Full Time · 6 days ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Responsible for researching and triaging records to ensure accurate and timely processing of requests according to regulations. The role involves handling high-volume customer inquiries via phone and written communication while maintaining strict confidentiality.

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Justice Administrator - Remote AZ

Blue Cross Blue Shield of Arizona · Full Time · 6 days ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Software Development

Oversee the coordination and delivery of health plan services for justice-involved members and manage program staff. Develop relationships with community-based organizations and providers to support successful re-entry and re-integration.

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Sr Prescription Benefit Prior Authorization Technician Specialty

Blue Cross Blue Shield of Arizona · Full Time · 7 days ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 10+ yrs exp 💼 Others

Responsible for processing medication prior authorization requests and providing internal and external support for accurate claim processing. The role involves handling intake, approvals, denials, and responding to inquiries regarding benefit clarifications.

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High-Cost Claimant Review Unit Nurse Auditor

Blue Cross Blue Shield of Arizona · Full Time · 8 days ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 5-10 yrs exp 💼 Finance

Responsible for assessing member utilization and predicting future spend to improve member outcomes and optimize resource use. Collaborates with multi-disciplinary teams to identify community resources and lead process improvement initiatives for high-cost claimants.

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Business Intelligence Developer-Medicaid - Level I (Remote AZ)

Blue Cross Blue Shield of Arizona · Full Time · 11 days ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Software Development

Design, create, and maintain sustainable reporting solutions and analytical insights to drive data-driven decision making for the Medicaid segment. Partner with business leaders to provide high-quality reporting on financial and clinical outcomes, network performance, and claims processing.

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Health Plan Pharmacist - Remote

Blue Cross Blue Shield of Arizona · Full Time · 13 days ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Responsible for maintaining Medicare and Medicaid formularies and providing clinical and economic data for decision-making. Acts as a pharmacy resource for providers and members while ensuring CMS quality and compliance activities are met.

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Payment Integrity Operations Analyst - Remote AZ

Blue Cross Blue Shield of Arizona · Full Time · 13 days ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 5-10 yrs exp 💼 Others

Support payment accuracy and operational effectiveness across the healthcare claims lifecycle from intake through recovery. Partner with cross-functional teams to identify payment risks, analyze workflows, and drive sustainable improvements to reduce provider abrasion.

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Member Liaison Coordinator - Remote in AZ

Blue Cross Blue Shield of Arizona · Full Time · 14 days ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Others

The role focuses on advocating for members and veterans by removing barriers to service delivery and building partnerships with community organizations. It involves managing veteran-specific initiatives and analyzing demographic data to improve population health outcomes.

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Health Manager - RN or RD required - REMOTE - AZ

Blue Cross Blue Shield of Arizona · Full Time · 14 days ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Support members in managing chronic health conditions through assessment, planning, and the implementation of self-management strategies. Coordinate care among providers and members while maintaining accurate records and meeting performance goals.

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Initial Clinical Reviewer - Remote - AZ

Blue Cross Blue Shield of Arizona · Full Time · 19 days ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Responsible for researching and resolving customer inquiries regarding health insurance benefits and medical necessity. The role involves analyzing medical records and coordinating with internal and external providers to ensure compliance and accuracy.

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Integrated Care Manager - Remote

Blue Cross Blue Shield of Arizona · Full Time · a month ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Responsible for promoting continuity of care by assessing, planning, and coordinating care options for members to ensure quality and cost-effective outcomes. This includes analyzing medical records, collaborating with providers, and handling a high volume of health insurance customer inquiries.

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Health Manager - Remote in Arizona

Blue Cross Blue Shield of Arizona · Full Time · 2 months ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Support members in managing chronic health conditions through assessment, planning, and the implementation of self-management strategies. Coordinate care among providers and families while maintaining accurate records and meeting department performance goals.

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Prior Authorization Nurse - Remote - AZ

Blue Cross Blue Shield of Arizona · Full Time · 2 months ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The nurse ensures the accuracy and timeliness of prior authorization requests by utilizing evidence-based standards for Medicaid and Medicare members. They also manage the Notice of Action process and coordinate care across departments to ensure quality outcomes.

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Medical Appeals and Grievance (MAG) Specialist II - Remote

Blue Cross Blue Shield of Arizona · Full Time · 2 months ago

Blue Cross Blue Shield of Arizona

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

The specialist is responsible for researching, resolving, and responding to member and provider appeals, grievances, and corrected claims. They must maintain clinical accuracy and adhere to regulatory timelines while coordinating with internal and external stakeholders.

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