Blue Cross & Blue Shield of Rhode Island

Star Rating Business Analyst

Blue Cross & Blue Shield of Rhode Island · Full Time · 7 days ago

Blue Cross & Blue Shield of Rhode Island

🌎 United States 💵 $65600 - $98400 per year ⭐ 2-5 yrs exp 💼 Software Development

The role focuses on advanced analytics and reporting to improve Medicare Advantage Star Ratings performance. It involves translating complex healthcare data into actionable insights to inform strategy and track progress across clinical and operational measures.

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Case Manager

Blue Cross & Blue Shield of Rhode Island · Full Time · 7 days ago

Blue Cross & Blue Shield of Rhode Island

🌎 United States 💵 $73600 - $110K per year ⭐ 2-5 yrs exp 💼 Healthcare

Manage members through evidence-based care and health assessments to identify risks and implement appropriate interventions. Coordinate services between members, providers, and community organizations to improve well-being and moderate claims costs.

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Case Manager - Social Worker

Blue Cross & Blue Shield of Rhode Island · Full Time · 8 days ago

Blue Cross & Blue Shield of Rhode Island

🌎 United States 💵 $73600 - $110K per year ⭐ 2-5 yrs exp 💼 Healthcare

Serve as an expert in community-based resources to help beneficiaries access services and achieve wellness goals. Conduct psychosocial assessments, develop individualized care plans, and coordinate with multidisciplinary teams and physicians.

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Lead Provider Payment Integrity Analyst

Blue Cross & Blue Shield of Rhode Island · Full Time · 12 days ago

Blue Cross & Blue Shield of Rhode Island

🌎 United States 💵 $92700 - $139K per year ⭐ 5-10 yrs exp 💼 Others

Conduct complex analysis of claim payments to identify overpayment recovery opportunities and cost avoidance. Develop solutions for payment integrity issues and ensure compliance with state, federal, and provider contract guidelines.

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Senior Business Analyst

Blue Cross & Blue Shield of Rhode Island · Full Time · 12 days ago

Blue Cross & Blue Shield of Rhode Island

🌎 United States 💵 $83200 - $124K per year ⭐ 5-10 yrs exp 💼 Software Development

Partner with strategic leaders to develop business solutions for complex enterprise initiatives and manage the full requirements lifecycle. Lead and mentor other business analysts while ensuring business needs are accurately translated into technical specifications.

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