ABCBS_External_Careers

Arkansas Blue Cross is consistently ranked as one of the best places to work in Central Arkansas. Why? We Love our Employees At Arkansas Blue Cross, we care about the health, wellness, and education of our employees. We offer many great incentives such as: Tuition reimbursement. Club Blue, a free, onsite gym to encourage exercise. Green Leaf Grill and Green Leaf Grill Express, onsite restaurants in Little Rock that promote healthy eating. Incentives for wellness education and exercise We Love our Culture The average tenure is 10 years with hundreds of employees having been here 15 years or longer. Our inclusive culture brings employees together to connect while celebrating our differences. We Love our Community Our employees often volunteer within their communities, at charity events, walks and runs, schools and nonprofits. When disasters strike, our employees help wherever they are needed. It’s just another way we show that Blue cares.

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🔥 LPN Clinical Research Coordinator

Posted 1 day ago

📍 United States of America

🧭 Regular

🔧 Requirements

High school diploma or equivalent required.
Licensed Practical Nurse (LPN) with current active state license in the state(s) where job duties are performed required.
Minimum four (4) years' clinical nursing experience, to include a broad background in various facets of nursing.
Knowledge of HCPCS/CPT/Revenue codes and general coding principles.
Knowledge of claims processing rules/logic.
Knowledge of Health Plan operations, regulatory agencies and State/Federal regulations related to health care.
Minimum two (2) years' utilization review, medical policy, and/or case management experience required.
Previous experience in appeals and/or grievances process preferred.
Excellent Oral & Written Communication
Detail-Oriented
Strong analytical, critical thinking, organizational and time management skills
Proficiency using basic computer skills in Microsoft Office such as Word, Excel, Outlook, and PowerPoint, including the ability to navigate multiple systems and keyboarding.
Ability to make sound judgments and decisions based on facts and guidelines.
Ability to build collaborative relationships.
Ability to work independently with little supervision.
Ability to interpret complex documentation.

💡 Responsibilities

Serves as a liaison facilitating a collaborate process between multiple internal functional areas, clinical leadership, primary physicians, patients and Medical Director to assist with escalated cases that requires input from multiple areas with the enterprise, providers, facilities and vendors.
Practices nursing within the scope of licensure and adheres to policies, procedures, regulations, URAC standards and individual state regulations; making decisions based on facts and evidence to ensure compliance, appropriate level of care, and patient safety.
Integrates data from multiple data sources or functional areas, ensures data accuracy and integrity, and updates data as needed to develop models to be used for decision making and initiatives
Remain current with up-to-date medical and surgical procedures, products, healthcare services and drugs, general trends in health care delivery; and enterprise procedures, policies and contracts.
Other duties as assigned.
Serves on various committees and project teams related to policy changes, system enhancements, process improvement initiatives, etc.
Monitors and evaluates data and processes to ensure accuracy and identify changes to increase efficiency and effectiveness.
Serves as a resource to Medical Director(s) and Care Management team providing analysis, reporting and research on medical conditions, medical terminology, medications, lab work, medical records, healthcare processes, coverage policies, plan guidelines, and/or health/wellness.

Data AnalysisCommunication SkillsAnalytical SkillsMicrosoft ExcelMicrosoft OfficeAttention to detailOrganizational skillsTime ManagementWritten communicationDocumentationComplianceInterpersonal skillsCritical thinkingResearchVerbal communicationReporting

Posted 1 day ago

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🔥 RN Case Manager

Posted 4 days ago

📍 United States

🧭 Regular

🔍 Healthcare

🔧 Requirements

Registered Nurse (RN) with current active state license in good standing in the state(s) where job duties are performed required.
Case management certification required.
Minimum four (4) years' clinical practice experience in at least one of the following areas: case management, home health, critical care, medical/surgical, discharge planning, concurrent review, or obstetric/neonatal care.

💡 Responsibilities

Case Management (Excludes Behavioral Health): Assesses, plans, implements, coordinates, monitors, and evaluates options and services required to meet an individual’s health needs through the use of plan benefits and community resources to facilitate appropriate cost effectiveness and cost containment measures are met.
Communication: Serves as a liaison facilitating a collaborate process which includes patients, families/caregivers, physicians, hospital discharger planners, home care providers and other ancillary providers to promote quality of care, cost effectiveness, accessibility and appropriateness of service levels.
Compliance: Practices nursing within the scope of licensure and adheres to policies, procedures, regulations, URAC standards and individual state regulations; making decisions based on facts and evidence to ensure compliance, appropriate level of care, and patient safety.
Education: May be required to provide specialized education and knowledge on disease specific conditions.
Knowledge: Remain current with up-to-date medical and surgical procedures, products, healthcare services and drugs, general trends in health care delivery; and enterprise procedures, policies and contracts.
Other duties as assigned.
Workflow: Proactively work with referrals from multiple sources to identify appropriate candidates for case management, explaining services ensuring voluntary agreement of services and maintaining a minimum patient caseload in a timely matter.

Communication SkillsAnalytical SkillsCustomer serviceMicrosoft OfficeWritten communicationComplianceInterpersonal skillsCritical thinkingActive listening

Posted 4 days ago

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🔥 Systems Administrator

Posted 16 days ago

📍 United States

🧭 Regular

🔧 Requirements

Minimum three (3) years’ direct experience with server support and implementation to include maintaining and supporting open systems, operating systems and client server-based applications.
Solid level knowledge and experience with operations and procedures including configuring, tuning, monitoring, securing, and managing server software and hardware.
Knowledge of shell and kernel-level programming and system-specific requirements.
3+ years of Redhat Experience preferred or 3+ years of Ansible experience with Linux knowledge preferred.

💡 Responsibilities

Analyzes and evaluates user requests for server and technical operations, services, and support.
Assists in the developing comprehensive policy and procedure documents for the open systems server infrastructure
Assists other department teams with IT server management functions including configuration, operations, installation, maintenance, and performance tuning of all server hardware and software.
Monitors daily performance of systems and informs management of the status of the systems relative to previously established performance guidelines.
Performs technical duties assigned, as a member of department team(s) to enhance function and availability of the open system server environment.
Possesses knowledge of the strategic planning process in order to effectively maintain successful server management processes consistent with goals and objectives.
Researches and implements server components including software, hardware, security, administration, policies, and procedures.
Updates reporting mechanisms based on progression of projects.

LinuxAnsibleScripting

Posted 16 days ago

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🔥 Workplace Services Technologies Analyst Senior

Posted 16 days ago

📍 United States

🧭 Full-Time

🔧 Requirements

Minimum five (5) years’ related IT experience (acquisition, technology support, infrastructure design, and/or audio/visual, etc.).
Minimum two (2) years’ experience supporting end user technologies.
Minimum (1) year of experience in an IT role, leading and/or contributing to IT projects.
Knowledge of troubleshooting computer hardware and/or software.

💡 Responsibilities

Assists and is accountable for specified elements of large-scale projects.
Assists management with providing leadership and guidance to less experienced team members.
Completes routine monitoring of mission critical Enterprise applications and may participate in the testing of new applications.
Leads in coordinating resolution of technical/system incidents reported by end users ensuring incidents are resolved and implemented to agreed standards and timescales.
Listens, empathizes and reflects a sense of urgency while ensuring proper and professional interpretation, communication and recording in an accurate manner when resolving reported incidents.
Performs other duties as assigned.
Remains abreast of industry changes and enhancement, as well as product capability and availability.
Reviews and appends knowledge base articles for the end users to ensure that accurate and up to date information is available.
Work closely with peers in receiving and providing cross-training.

TroubleshootingTechnical support

Posted 16 days ago

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🔥 Financial Analyst Senior

Posted 19 days ago

📍 United States

🧭 Full-Time

🔍 Financial Analysis

🔧 Requirements

Bachelor’s degree in Accounting or related field.
Minimum five (5) years' financial analysis experience. OR applicable Masters in related field with minimum three (3) years’ experience.
Statistical knowledge.
High proficiency in Excel
Excellent Oral & Written Communication Skills
Proficiency using Microsoft Office suite, such as Word, Excel, Access and PowerPoint.
Excellent analytical skills and demonstrate expertise in developing and utilizing detailed financial models including the ability to build detailed models.
Ability to maintain confidentiality of sensitive information.

💡 Responsibilities

Assists with financial reporting audits, working with the internal audits, Arkansas Insurance Department, independent auditors, and/or Blue Cross and Blue Shield Association.
Assists with special projects, as requested
Builds and maintains detail financial prediction models, these could include long range forecast models, cash flow models, project finance models and/or other models as requested.
Conducts analysis and interpretation of financial information. Utilizing independent judgment and discretion, identifies trends, variances, and key issues to make recommendations for action and/or modifications regarding financial procedures, plans, and controls.
Interprets, summarizes, and presents financial findings and recommendations; thoroughly communicating with various business partners and leadership.
Other duties as assigned.
Performs moderate to complex financial analysis projects and/or reporting.
Serves as a financial consultant, or liaison, to the management and executive staff to provide analytical support for operations analysis and decision making.

Data AnalysisExcel VBAFinancial ManagementAnalytical SkillsMicrosoft ExcelAccountingCritical thinkingReportingBudgetingFinancial analysis

Posted 19 days ago

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