Florida Blue

Sr. Manager Health Business Analytics, Medicare Risk Adjustment - Remote

Florida Blue · Full Time · 8 hours ago

Florida Blue

🌎 United States 💵 $119K - $194K per year ⭐ 10+ yrs exp 💼 Software Development

Lead the strategy, design, and execution of Medicare Risk Adjustment programs to optimize revenue accuracy and regulatory compliance. Manage a team of analysts to provide predictive modeling and evidence-based insights for executive leadership.

APPLY

Florida Blue, Service Advocate III, State Group Contact/Claims, Jacksonville Remote

Florida Blue · Full Time · 2 days ago

Florida Blue

🌎 United States 💵 $18 - $27 per hour ⭐ 0-2 yrs exp 💼 Legal

The Service Advocate III resolves member and provider inquiries regarding health insurance benefits and claims. They utilize company tools to educate customers on self-service options and ensure timely resolution of service-related issues.

APPLY

Senior Payroll Accountant, CPP - Remote

Florida Blue · Full Time · 5 days ago

Florida Blue

🌎 United States 💵 $84500 - $137K per year ⭐ 5-10 yrs exp 💼 Finance

The Senior Payroll Accountant ensures compliance with payroll regulations and manages complex general ledger accounts and tax filings. They provide expert analysis on payroll matters, support audit activities, and mentor team members.

APPLY

FEP Pharmacy Technician CPhT, Remote Jacksonville

Florida Blue · Full Time · 6 days ago

Florida Blue

🌎 United States 💵 $21 - $35 per hour ⭐ 2-5 yrs exp 💼 Healthcare

Conduct telephonic outreach to members to close HEDIS care gaps and educate patients on appropriate medication use. Analyze clinical and claims data to identify quality improvement opportunities and collaborate with MTM Pharmacists to optimize pharmaceutical care.

APPLY

Enterprise Cloud Architect

Florida Blue · Full Time · a month ago

Florida Blue

🌎 United States 💵 $141K - $230K per year ⭐ 10+ yrs exp 💼 Software Development

The Enterprise Cloud Architect designs, governs, and evolves the organization's multi-cloud and hybrid infrastructure strategy. They lead large-scale cloud migrations, modernization initiatives, and establish architectural standards while collaborating with cross-functional teams.

APPLY

VP Enterprise Architecture

Florida Blue · Full Time · 2 months ago

Florida Blue

🌎 United States ⭐ 10+ yrs exp 💼 Others

The VP of Enterprise Architecture will define the technology vision, strategy, and roadmap while establishing the Architecture Office to ensure alignment with business and clinical outcomes. This role involves leading architecture governance, overseeing cloud and data strategies, and serving as a strategic advisor to executive leadership.

APPLY

VP Customer Experience (CX) & Engagement

Florida Blue · Full Time · 2 months ago

Florida Blue

🌎 United States ⭐ 10+ yrs exp 💼 Support

This executive role is responsible for transforming how GuideWell, Florida Blue, and Triple-S engage with stakeholders by leading the design of health-centric member experiences and developing enterprise-wide CX strategy, governance, and capability. Key duties include leading end-to-end journey design across channels, championing AI for personalization, and establishing a unified CRM and communications strategy.

APPLY

VP AI Engineering

Florida Blue · Full Time · 2 months ago

Florida Blue

🌎 United States ⭐ 10+ yrs exp 💼 Software Development

This executive role involves owning the architecture, development, and operation of platforms powering AI-driven innovation across the health plan enterprise, focusing on transforming operations from predictive models to automation in areas like claims and care management. Key duties include executing the multi-year technical roadmap, serving as the senior engineering authority for AI, and ensuring production-grade AI systems are scalable, compliant, and clinically sound.

APPLY

Sr Internal Auditor I

Florida Blue · · 3 months ago

Florida Blue

🌎 United States 💵 $71200 - $115K per year ⭐ 5-10 yrs exp 💼 Finance

Lead audit engagements from planning to execution, identifying observations and providing recommendations to stakeholders. Collaborate with audit management and business stakeholders to implement changes and ensure compliance with policies and procedures.

APPLY

Medical Director Care Management

Florida Blue · Full Time · 4 months ago

Florida Blue

🌎 United States 💵 $224K - $364K per year ⭐ 5-10 yrs exp 💼 Healthcare

The Medical Director will conduct various utilization management reviews, including pre-service, post-service, concurrent review, and appeals, while discussing cases with physician providers. Key duties involve applying health plan criteria to render timely medical necessity decisions and collaborating with Case Managers for physician assistance.

medical hiring organization

APPLY