BlueCross BlueShield of Tennessee

Accountant

BlueCross BlueShield of Tennessee · Full Time · 17 hours ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 0-2 yrs exp 💼 Finance

The role involves maintaining financial records according to GAAP and performing balance sheet and P&L reconciliations. The accountant will also create financial performance reports and utilize automated tools for consolidated financial reporting.

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Correspondent

BlueCross BlueShield of Tennessee · Full Time · 17 hours ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 0-2 yrs exp 💼 Others

Responsible for preparing and responding to member and provider correspondence regarding insurance products, claims, and accounts. The role involves modifying templates, collaborating with internal teams, and providing backup support to Customer Service.

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Coverage Review Pharmacist

BlueCross BlueShield of Tennessee · Full Time · 17 hours ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Perform prospective and retrospective coverage reviews and appeals for medications in accordance with state and federal regulations. Serve as a clinical resource to ensure accurate, evidence-based coverage determinations and maintain compliant denial rationales.

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Sr. Information Security Governance, Risk and Compliance Analyst

BlueCross BlueShield of Tennessee · Full Time · 19 hours ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Software Development

Lead information security governance, risk, and compliance initiatives, including SOC 2 audit support and the development of NIST System Security Plans. Manage enterprise and third-party risk assessments while overseeing security policies and vulnerability remediation.

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EIT Engineering Team Lead

BlueCross BlueShield of Tennessee · Full Time · 21 hours ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Others

Lead a team of engineers in designing, building, and scaling enterprise authentication and federation solutions. Manage day-to-day operations, staff development, and technical direction to ensure secure and resilient identity services.

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Sr. Software Engineer

BlueCross BlueShield of Tennessee · Full Time · a day ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Software Development

The Senior Software Engineer will design, support, and enhance systems for processing accumulator data. This role involves modernizing integration processes and ensuring systems meet operational and business expectations.

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Senior Cyber Threat Hunter-1

BlueCross BlueShield of Tennessee · Full Time · 2 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Sales

Identify, analyze, and mitigate cyber threats and vulnerabilities using penetration testing tools and defensive measures. Provide technical expertise to protect the organization's networks, systems, and data from sophisticated attacks.

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Senior AI Engineer

BlueCross BlueShield of Tennessee · Full Time · 5 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Software Development

Lead the design, development, and productionalization of sophisticated AI and automation solutions for healthcare payer use cases. Architect scalable systems using Python and GCP Vertex AI while mentoring junior engineers and partnering with business stakeholders.

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Solutions Architect

BlueCross BlueShield of Tennessee · Full Time · 5 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Software Development

Design secure, scalable blueprints and frameworks for automation platforms and AI-driven workflows. Collaborate with technical teams and stakeholders to align solution designs with enterprise architecture and business strategies.

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Manager Data Governance

BlueCross BlueShield of Tennessee · Full Time · 5 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Others

Lead the enterprise data governance program by developing policies, standards, and a federated stewardship network. Partner with cross-functional stakeholders to ensure data assets are classified and protected in alignment with healthcare regulatory requirements.

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Quality Incentive Consultant (Tennessee Based)

BlueCross BlueShield of Tennessee · Full Time · 5 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Others

The consultant drives quality and cost improvement by translating TennCare priorities into actionable initiatives to enhance HEDIS outcomes and care delivery. They partner with provider groups and clinical teams to design sustainable improvement strategies and resolve data issues.

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Nurse Case Manager (Madison County, Gibson County, Dyer County, Obion County, or Weakley County )

BlueCross BlueShield of Tennessee · Full Time · 7 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

The Nurse Case Manager assesses members’ current status and facilitates coordination of long-term services and supports. They collaborate with members, caregivers, and providers to develop integrated plans of care based on health needs.

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Clinical Quality Research Analyst

BlueCross BlueShield of Tennessee · Full Time · 8 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Perform quality and compliance audits to identify improvement opportunities and ensure audit readiness for organizations like URAC and NCQA. Collaborate with cross-functional teams to design solutions for healthcare service gaps and educate stakeholders on quality standards.

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Software Engineer - Integrations

BlueCross BlueShield of Tennessee · Full Time · 11 days ago

BlueCross BlueShield of Tennessee

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

Build and support enterprise APIs to connect critical applications across the organization. Manage the full API lifecycle, including design, delivery, and production support through incident response and deployments.

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Principal AI Workflow Engineer

BlueCross BlueShield of Tennessee · Full Time · 22 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Software Development

Lead the design and implementation of enterprise-wide AI workflows to modernize clinical operations and improve member healthcare journeys. Act as a strategic advisor to executive leadership to identify automation opportunities and establish governance standards.

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Provider Data Consultant

BlueCross BlueShield of Tennessee · Full Time · 2 months ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Others

Support technical solutions for managing provider networks by designing and enhancing reporting, data integrations, and tools. Drive efficiency through automation and AI-enabled solutions to improve provider credentialing and data quality.

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Manager eBusiness Development

BlueCross BlueShield of Tennessee · Full Time · 9 months ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 10+ yrs exp 💼 Others

Lead the design, development, and delivery of enterprise-grade applications while ensuring compliance with quality standards. Manage vendors and contracts, and mentor developers to inspire high performance and teamwork.

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