BlueCross BlueShield of Tennessee

Senior Technical Recruiter

BlueCross BlueShield of Tennessee · Full Time · 8 hours ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 2-5 yrs exp 💼 Recruitment

Lead full-cycle recruitment for professional and technical roles, serving as a strategic advisor to hiring managers. Develop sourcing strategies and manage third-party vendor relationships to attract diverse talent pools.

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Clinical Review Manager

BlueCross BlueShield of Tennessee · Full Time · 9 hours ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Conduct comprehensive clinical reviews of medical service requests and support utilization management activities including pre-certifications and appeals. Collaborate with the Medical Director on escalated cases and ensure compliance with clinical standards and contractual guidelines.

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Clinical Review Manager

BlueCross BlueShield of Tennessee · Full Time · 9 hours ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Conducts comprehensive clinical reviews of medical service requests and supports utilization management activities including pre-certifications and appeals. Collaborates with the Medical Director and providers to ensure care coordination and compliance with clinical standards.

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RN Case Manager (Federal Employees Program)

BlueCross BlueShield of Tennessee · Full Time · 10 hours ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Healthcare

Manage complex acute and chronic health cases by coordinating care between members, providers, and internal stakeholders. Perform essential case management activities including assessment, planning, implementation, and outcome evaluation.

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Sr. Data Engineer

BlueCross BlueShield of Tennessee · Full Time · 13 hours ago

BlueCross BlueShield of Tennessee

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

Lead a collaborative data engineering team to build and maintain production-grade data pipelines for regulatory reporting such as HEDIS and CMS. Design automated pipelines in a cloud environment to enable governed datasets and AI-driven self-service analytics for business partners.

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Principal AI Workflow Engineer

BlueCross BlueShield of Tennessee · Full Time · 13 hours 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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Senior AI Workflow Engineers

BlueCross BlueShield of Tennessee · Full Time · 14 hours ago

BlueCross BlueShield of Tennessee

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

Design, build, and operationalize AI-enabled workflows to improve efficiency and scalability across various business divisions. Partner with security and legal teams to ensure compliance with healthcare regulations like HIPAA while leading AI adoption and training.

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Clinical Team Expert

BlueCross BlueShield of Tennessee · Full Time · a day ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 2-5 yrs exp 💼 Healthcare

Serve as a clinical and operational leader for Women's and Children's Health programs, providing mentorship and workflow expertise to the team. Act as a liaison between members and providers while performing quality audits to ensure department performance goals are met.

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Sr. Software Engineer - Integration

BlueCross BlueShield of Tennessee · Full Time · a day ago

BlueCross BlueShield of Tennessee

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

Design, build, and operate web services to power AI-driven digital experiences. This includes formulating system scope, coding, testing, and responding to system failures to minimize downtime.

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Customer Service Trainee

BlueCross BlueShield of Tennessee · Full Time · 2 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 0-2 yrs exp 💼 Support

Handle customer inquiries via telephone, chat, email, and Teams to provide timely and accurate resolutions. Document all communications clearly and educate callers to ensure first-contact resolution.

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eBusiness Product Analyst

BlueCross BlueShield of Tennessee · Full Time · 2 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 2-5 yrs exp 💼 Product

Serve as a Product Owner for EDI front-end electronic transactions, focusing on healthcare claims adjudication. Act as a liaison between business stakeholders and EIT to translate business needs into system criteria and drive process improvements through data insights.

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Customer Service Trainee

BlueCross BlueShield of Tennessee · Full Time · 2 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 0-2 yrs exp 💼 Support

Provide support to Medicare and Medicaid members by resolving billing issues, finding providers, and obtaining prescriptions. Handle inquiries via phone, chat, email, and Teams while accurately documenting all communications.

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Corporate Pharmacy Director

BlueCross BlueShield of Tennessee · Full Time · 4 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 10+ yrs exp 💼 Healthcare

Develop and execute strategic pharmacy benefit options and serve as the subject matter expert for drug solutions. Collaborate with cross-functional teams and communicate clinical and economic value to clients and stakeholders.

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Software Engineer - Integrations

BlueCross BlueShield of Tennessee · Full Time · 5 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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Intern - Digital Experience

BlueCross BlueShield of Tennessee · Full Time · 6 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 0-2 yrs exp 💼 Others

Support outreach campaigns through strategy, development, QA, and reporting to ensure content accuracy and clean data. Contribute to improving team processes and digital engagement while maintaining a member-focused perspective.

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SQA Analyst II

BlueCross BlueShield of Tennessee · Full Time · 7 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 2-5 yrs exp 💼 Others

The role involves developing test plans, executing functional and automation scripts, and validating API endpoints to ensure seamless communication across platforms. The analyst will also review technical design documents and create E2E integration test scenarios to verify impacted systems.

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Dual Special Needs Plan VP, BlueCare

BlueCross BlueShield of Tennessee · Full Time · 7 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 10+ yrs exp 💼 Others

The VP will own the full Profit & Loss for the BlueCare Plus D-SNP business and set the strategic direction for market positioning and operational efficiency. This includes overseeing bid development, ensuring regulatory compliance with CMS and TennCare, and leading high-performing teams to improve member outcomes.

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EIT Engineering Team Lead

BlueCross BlueShield of Tennessee · Full Time · 11 days ago

BlueCross BlueShield of Tennessee

🌎 United States ⭐ 5-10 yrs exp 💼 Others

Lead a high-visibility initiative to modernize member portals and services while managing the day-to-day operations of an engineering team. This includes overseeing solution design, mentoring engineers, and partnering with cross-functional stakeholders to ensure system reliability.

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Provider Data Consultant

BlueCross BlueShield of Tennessee · Full Time · a month 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 · 8 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.

architecture project-management leadership history compliance

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