Operations AI Analyst Q-1

BCBST is hiring an Operations AI Analyst.

We’re looking for a detail-driven operations professional with a strong focus on member experience who is eager to work hands-on with AI and support accurate, compliant, and AI-powered member interactions. The ideal candidate will bring healthcare experience, including knowledge of Medicare and Medicaid, along with experience supporting or optimizing AI-enabled user experiences. Experience with Star Ratings programs and initiatives is also preferred.

In this role, you’ll provide day-to-day operational oversight of our member-facing virtual assistant, partnering closely with the Senior Operations AI Analyst and technical teams. You’ll monitor performance, validate outcomes for accuracy, quality, and compliance, document operational requirements, and execute testing and validation to ensure AI releases are safe, stable, and scalable.

Success in this role means proactively identifying opportunities for improvement, delivering consistent and compliant member interactions, establishing standardized and repeatable operational processes, and helping build a scalable, enterprise-ready virtual assistant that enhances the member experience and supports organizational goals, including quality and Star Ratings outcomes.

Ready to take the next step? If driving measurable improvements in AI-powered member experiences motivates you, and you have experience navigating healthcare operations, Medicare and Medicaid programs, AI-enabled solutions, and Star Ratings initiatives, apply today.

Note:

• This is a remote role with occasional travel to BCBST headquarters.
• Sponsorship is not available for this role.
• We foster a culture where innovation is encouraged. That includes using AI-enabled tools responsibly to support everyday work, guided by proven workflows, templates, and policies. As roles become more advanced, we expect employees to leverage AI more broadly to transform how we serve members.

Job Responsibilities

•  Execute daily operations of AI-enabled member service processes across multiple channels
• Monitor performance and review interaction outcomes for accuracy, quality, and compliance
•  Analyze escalations and exceptions to surface trends, risks, and improvement opportunities
• Document business and functional requirements: workflows, procedures, user stories, acceptance criteria, and test scenarios
• Lead user acceptance and regression testing to validate operational readiness
• Maintain issue and defect logs; coordinate resolution with cross-functional partners
• Produce clear operational documentation, standard work, and runbooks
• Partner with Operations, Quality, IT, Analytics, and vendor teams on continuous improvement

 Job Qualifications

Education

• Bachelor’s degree or equivalent work experience require
• Equivalent experience is defined as four years of professional work experience in a corporate environment

Experience

• 3 to 4 years in service operations, operations analysis, quality, reporting, business analysis, or contact center environments
• Proven ability to translate operational processes into clear, structured documentation
• Experience supporting testing activities and validating operational readiness
• Comfortable working in cross-functional, fast-moving, operations-focused teams

Skills / Certifications

• Strong analytical and problem-solving skills
•  Ability to translate operational workflows into clear, structured documentation
• Proficiency with Microsoft Office tools including CoPilot
• Ability to manage multiple priorities with minimal supervision in a collaborative environment

Number of Openings Available

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Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.