Blue Cross & Blue Shield of Rhode Island

Senior Contract Manager

Blue Cross & Blue Shield of Rhode Island · Full Time · 9 hours ago

Blue Cross & Blue Shield of Rhode Island

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

Negotiate and implement complex contracts with hospitals, physician groups, and healthcare vendors to achieve financial and business objectives. Serve as a technical expert providing mentorship to contract administrators and managing provider relationships to ensure compliance.

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Senior Benefits & Wellbeing Analyst

Blue Cross & Blue Shield of Rhode Island · Full Time · 19 hours ago

Blue Cross & Blue Shield of Rhode Island

🌎 United States 💵 $93600 - $140K per year ⭐ 5-10 yrs exp 💼 Others

Design, administer, and improve health, retirement, and wellbeing programs while ensuring seamless employee experience through Workday configuration. Maintain strict compliance with federal and state regulations and manage vendor relationships to align with organizational goals.

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Lead Total Cost of Care Implementation Manager

Blue Cross & Blue Shield of Rhode Island · Full Time · 19 hours ago

Blue Cross & Blue Shield of Rhode Island

🌎 United States 💵 $102K - $163K per year ⭐ 2-5 yrs exp 💼 Others

Manage the onboarding lifecycle of population health vendors, including eligibility, financial arrangements, and data exchanges. Serve as the Business Lead for the EPMO to ensure timely project completion and delivery per contractual terms.

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Lead Total Cost of Care Program Manager

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

Blue Cross & Blue Shield of Rhode Island

🌎 United States 💵 $102K - $163K per year ⭐ 5-10 yrs exp 💼 Product

Lead the planning and execution of Total Cost of Care (TCOC) initiatives to manage medical costs and improve member outcomes. Analyze medical cost drivers and synthesize complex data into actionable insights and executive-level narratives for leadership.

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Total Cost of Care Program Specialist

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 💼 Others

Provide operational and analytical support for Total Cost of Care (TCOC) initiatives to manage medical costs and improve member outcomes. This includes tracking milestones, creating executive presentations, and coordinating cross-functional stakeholders.

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Risk Adjustment Medical Coder

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

Perform medical record reviews and data validation for Medicare Advantage members to ensure accurate risk adjustment payments to CMS. Coordinate with physicians for chart reviews and provide recommendations on industry best practices for documentation.

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Managing Director of Strategy and Corporate Development

Blue Cross & Blue Shield of Rhode Island · Full Time · 9 days ago

Blue Cross & Blue Shield of Rhode Island

🌎 United States 💵 $196K - $313K per year ⭐ 10+ yrs exp 💼 Others

Lead the corporate strategy function to shape BCBSRI's strategic direction in partnership with the Executive Leadership Team. Translate vision into actionable priorities and lead high-impact initiatives including growth opportunities and strategic partnerships.

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Senior Payroll Systems Analyst

Blue Cross & Blue Shield of Rhode Island · Full Time · 13 days ago

Blue Cross & Blue Shield of Rhode Island

🌎 United States 💵 $93600 - $140K per year ⭐ 5-10 yrs exp 💼 Finance

Lead end-to-end bi-weekly payroll operations and provide expert support for Workday Payroll configuration, testing, and enhancements. Partner with vendors and cross-functional stakeholders to ensure compliant payroll processing and optimize system workflows.

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Medical Policy Analyst

Blue Cross & Blue Shield of Rhode Island · Full Time · 13 days ago

Blue Cross & Blue Shield of Rhode Island

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

Develop, evaluate, and research company medical and administrative policies while benchmarking them against industry standards. Coordinate quarterly code releases from the AMA and CMS and ensure internal and external documentation remains consistent with guidelines.

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Case Manager

Blue Cross & Blue Shield of Rhode Island · Full Time · a month 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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Lead Provider Payment Integrity Analyst

Blue Cross & Blue Shield of Rhode Island · Full Time · a month 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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