Excellus BCBS

Healthcare Statistical Analyst I/II/III/IV (VBP)

Excellus BCBS · Full Time · 3 days ago

Excellus BCBS

🌎 United States 💵 $62400 - $142K per year ⭐ 5-10 yrs exp 💼 Healthcare

The analyst performs technical services to support health plan operations, including monitoring financial solvency, identifying trends, and developing predictive models. They also assist in the creation of benefit designs, claims experience analysis, and Value Based Payment program valuations.

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Utilization Management Reviewer (RN) - Multiple Positions!

Excellus BCBS · Full Time · 8 days ago

Excellus BCBS

🌎 United States 💵 $65346 - $117K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Utilization Management Reviewer coordinates and monitors behavioral and physical health services to ensure compliance with regulatory standards and medical policies. They perform clinical reviews to determine the appropriateness of services and collaborate with providers to ensure seamless care delivery.

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IT Platform Admin I/II/III/IV

Excellus BCBS · Full Time · 8 days ago

Excellus BCBS

🌎 United States 💵 $60410 - $157K per year ⭐ 5-10 yrs exp 💼 Others

The IT Platform Administrator acts as a liaison between business and technical teams to ensure the availability, performance, and security of enterprise software platforms. Responsibilities include monitoring systems, troubleshooting incidents, managing configurations, and performing audits to maintain compliance.

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Manager of Credentialing Operations

Excellus BCBS · Full Time · 14 days ago

Excellus BCBS

🌎 United States 💵 $71880 - $129K per year ⭐ 5-10 yrs exp 💼 Others

The Manager of Credentialing Operations oversees the end-to-end provider credentialing process, ensuring compliance with regulatory and accreditation standards. They lead the credentialing team, monitor performance metrics, and drive process improvements to enhance operational efficiency.

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Community Connections Representative I/II (Utica and Broome County Areas)

Excellus BCBS · Full Time · 16 days ago

Excellus BCBS

🌎 United States 💵 $19.22 - $33.03 per hour ⭐ 2-5 yrs exp 💼 Others

The role focuses on bridging the gap between health plan members and clinical operations through home visits and community outreach. Responsibilities include educating members on healthcare benefits, assisting with Marketplace insurance enrollment, and connecting individuals to social services to address social determinants of health.

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Business Systems Analyst

Excellus BCBS · Full Time · 19 days ago

Excellus BCBS

🌎 United States 💵 $60410 - $157K per year ⭐ 10+ yrs exp 💼 Others

The Business Systems Analyst collaborates with stakeholders to define IT system requirements and specifications for implementation. They serve as the primary interface between business and IT teams to deliver functional and non-functional requirements.

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Finance Solutions Consultant I/II/III

Excellus BCBS · Full Time · 19 days ago

Excellus BCBS

🌎 United States 💵 $71880 - $157K per year ⭐ 5-10 yrs exp 💼 Sales

The role involves the administration and configuration of Workday finance applications and data models to support financial transactions and reporting. The consultant collaborates cross-functionally to optimize business processes and ensure the quality and timeliness of financial analysis.

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Manager, Data Platforms Admin

Excellus BCBS · Full Time · 21 days ago

Excellus BCBS

🌎 United States 💵 $110K - $198K per year ⭐ 5-10 yrs exp 💼 Others

The Manager of Data Platform Administration leads the planning, design, and maintenance of data systems and applications. This role involves managing a team of professionals, overseeing the systems lifecycle, and ensuring adherence to corporate standards and regulatory mandates.

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IT Cloud Engineer Server Platform

Excellus BCBS · Full Time · 25 days ago

Excellus BCBS

🌎 United States 💵 $79068 - $198K per year ⭐ 5-10 yrs exp 💼 Software Development

Design and maintain distributed public and private cloud platforms to support business requirements and infrastructure deployment lifecycles. Lead the implementation of PaaS, SaaS, and on-premises solutions while ensuring security, resiliency, and cost optimization.

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Account Executive Pharmacy Solutions (Rochester Region)

Excellus BCBS · Full Time · 25 days ago

Excellus BCBS

🌎 United States 💵 $79068 - $142K per year ⭐ 5-10 yrs exp 💼 Sales

Responsible for sales, prospecting, and retention of medical and Rx groups while acting as a strategic advisor on benefit design and financial impacts. Provides subject matter expertise on pharmacy trends and clinical developments to clients, brokers, and internal sales teams.

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Case Manager, RN or Licensed Behavioral Health (Multiple Openings!)

Excellus BCBS · Full Time · a month ago

Excellus BCBS

🌎 United States 💵 $62400 - $117K per year ⭐ 5-10 yrs exp 💼 Healthcare

Conducts comprehensive case management activities to identify member needs, develop care plans, and coordinate health services. Collaborates with interdisciplinary teams and community resources to ensure cost-effective and optimal health outcomes for members.

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IT Platform Admin I/II/III/IV

Excellus BCBS · Full Time · a month ago

Excellus BCBS

🌎 United States 💵 $60410 - $157K per year ⭐ 5-10 yrs exp 💼 Others

The IT Platform Administrator ensures the availability and operation of enterprise applications through monitoring, troubleshooting, and maintenance. They act as a liaison between business and technical teams to optimize system functionality and maintain compliance.

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Customer Care Advocate IA - Utica/Albany areas

Excellus BCBS · Full Time · a month ago

Excellus BCBS

🌎 United States 💵 $18.22 - $23.89 per hour ⭐ 0-2 yrs exp 💼 Support

The Customer Care Advocate resolves member and provider inquiries regarding contract benefits, claim payments, and enrollment across various communication channels. They are responsible for documenting interactions and ensuring compliance with legislative requirements to enhance customer satisfaction.

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Reimbursement Analyst II/III

Excellus BCBS · Full Time · a month ago

Excellus BCBS

🌎 United States 💵 $62400 - $106K per year ⭐ 5-10 yrs exp 💼 Others

This role serves as the primary representative for physician, ancillary, and facility reimbursement analysis, focusing on contracting strategies and rate testing. The analyst monitors provider billing trends and develops common payment approaches to ensure cost and quality management goals are met.

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Director Digital Delivery

Excellus BCBS · Full Time · a month ago

Excellus BCBS

🌎 United States 💵 $137K - $248K per year ⭐ 10+ yrs exp 💼 Others

Lead the strategy and delivery of customer-facing digital platforms using an AI-first approach to improve member experiences and operational efficiency. Oversee cross-functional teams in product, engineering, and architecture while ensuring regulatory compliance within a healthcare environment.

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