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For more than 70 years, Blue Cross and Blue Shield of Kansas has built a reputation of trust. As we move forward in this new era of health care we want to continue that tradition. Whether a member needs Blue Cross to cover an annual check-up or give them peace of mind during a major medical crisis, we want our members to know they can trust BCBSKS to meet their needs.Β  Our mission: Being the insurer Kansans trust with their health. Our Commitment to Diversity, Equity, Inclusion, and Belonging At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of diversity, equity, inclusion, and belonging (DEIB), where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law. We believe that embracing diversity and authentically promoting inclusion, equity, and belonging among our team members is crucial to our collective success. By intentionally recruiting, developing, and retaining a diverse pool of talent, we cultivate an environment where everyone feels valued, heard, and empowered to contribute. Accommodations are available for applicants with disabilities upon request, ensuring an inclusive and accessible hiring process for all.

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πŸ‘₯ 5001-10000πŸ’° $378,215,525 Post-IPO Equity almost 4 years agoπŸ«‚ Last layoff over 1 year agoMessagingSMSMobile AppsEnterprise SoftwareSoftware
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πŸ“ United States

πŸ’Έ 83280.0 - 99000.0 USD per year

πŸ” Health Insurance

  • Bachelor's degree in business, economics, finance, data analytics, or a related field.
  • Minimum of 3+ years' experience in competitive intelligence, market intelligence, strategy, research, or a related field.
  • Strong data synthesis, visualization, and insights development skills using Microsoft Office, Visio, Tableau, and Power BI.
  • Strong analytical and problem-solving skills, able to synthesize data into actionable insights.
  • Clearly articulates insights and recommendations, both verbally and in writing. Tailor messaging to different audiences, including executives and cross-functional teams.
  • High attention to detail and organizational skills, ability to manage multiple projects simultaneously. Ensures accuracy in data analysis, reports, and competitive profiles.
  • A natural curiosity for answering questions, solving problems, and navigating unclear or evolving research needs.
  • Commitment to customer service in effectively managing research requests from teams and stakeholders at all levels within the organization.
  • Familiarity with CMS datasets, regulatory filings, benefit design, formularies, and provider network structures.
  • Ability to work independently to complete CI deliverables while also collaborating effectively as a team member of cross-functional teams.
  • Strict adherence to organizational and industry standards for confidentiality and ethical conduct in all competitive intelligence gatherings.
  • Serve as the internal subject matter expert for a defined portfolio of health insurance competitors, markets, and special topics.
  • Track and analyze competitor plan designs, pricing strategies, enrollment trends, market entries and exits, partnerships, marketing collateral, and other strategic actions.
  • Support the execution of recurring competitive intelligence deliverables, including upkeep of the CI Research Repository, weekly CI newsletter development, distribution of industry trend reports, and quarterly updates to competitor battlecards and profiles.
  • Monitor a broad range of ongoing healthcare industry developments, including provider network activity, competitor updates on industry-relevant AI use cases, emerging care delivery models, regulatory shifts, pharmacy trends, point solutions, and other potentially disruptive forces.
  • Perform in-depth research using a blend of public data sources (e.g., CMS public use files, state SERFF filings, Medicare Plan Finder, etc.), third-party intelligence platforms (e.g., Mark Farrah, Competiscan, etc.), and internal performance data.
  • Analysis of large datasets, uncovering trends and actionable insights through meticulous attention to detail.
  • Develop accurate, visually polished slide decks and reports that distill complex insights into digestible, stakeholder-friendly formats.
  • Fulfill ad hoc research requests of Sales, Marketing, Government Programs, Product teams, and others during bid planning and product strategy development.
  • Participate in strategic analysis and decision-making models, such as VRIO, PrOACT, PESTLE, etc.
  • Support the work of the Business Intelligence team in advancement of enterprise strategy goals.
  • Collaborate with the Strategic Intelligence team to identify market threats, opportunities, and differentiators.
  • Provide and maintain competitor data to inform the development of enterprise dashboards and strategic initiatives.
  • Together with the Business Intelligence and Strategic Intelligence teams, provide regular updates to internal stakeholders, such as divisional strategists, Strategy Council, and Steering Committee.

SQLBusiness IntelligenceData AnalysisData MiningTableauStrategic ManagementCommunication SkillsAnalytical SkillsMicrosoft ExcelCI/CDProblem SolvingCustomer serviceMicrosoft OfficeRESTful APIsAttention to detailOrganizational skillsPresentation skillsWritten communicationReportingMarket ResearchData visualizationStrategic thinkingResearch skillsData modelingData analytics

Posted about 6 hours ago
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πŸ“ United States

πŸ’Έ 20.42 - 24.3 USD per hour

πŸ” Health Insurance

  • High school diploma or equivalent required
  • Previous experience in healthcare claims processing, medical billing, medical terminology, or health insurance is required.
  • Accurately review, analyze, and verify healthcare claims.
  • Ensure all necessary documentation, coding, and data are included and correct.
  • Enter and process claims information into the system.
  • Apply appropriate insurance guidelines, including deductibles, co-pays, co-insurance, and maximum coverage limits.
  • Approve or deny claims based on policy coverage.
  • Perform adjustments to processed claims as needed for corrective action.
  • Correspond with healthcare providers, patients, and internal departments to clarify or resolve discrepancies.
  • Investigate and resolve complex or escalated claim issues.
  • Ensure compliance with state and federal healthcare regulations.
  • Maintain detailed and accurate records of all claims processed.
  • Meet individual and team performance targets.
  • Participate in ongoing training to stay updated on changes in health insurance policies and claims processing technologies.
  • Monitor and work daily reports to ensure timely claim control.

Communication SkillsProblem SolvingMicrosoft OfficeAttention to detailOrganizational skillsData entry

Posted 1 day ago
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πŸ“ United States

πŸ’Έ 54880.32 - 65030.4 USD per year

πŸ” Healthcare

  • Ability to analyze, solve problems, make decisions, and present facts in a logical manner that may or may not be documented by established procedures.
  • Ability to work independently to meet critical deadlines.
  • Demonstrated ability to develop, document and maintain operational policies and procedures.
  • Experience with documenting detailed process flows.
  • Ability to interpret new product and benefit designs and translate them into code.
  • Excellent verbal and written communication skills are necessary to effectively resolve problems and interact with all levels within the company.
  • Knowledge of Product Machine, Plan Configurator, Eligibility, and components is preferred.
  • Knowledge of Product Machine relationships with all downstream systems is preferred.
  • Familiarity with Rally, SBM (Serena Business Manager), and QA Complete is preferred.
  • Familiarity with healthcare insurance rules and regulations (HIPAA).
  • Requires a high degree of analytical skills.
  • High school education or equivalency required.
  • College degree in Business Administration, Management, or Communications preferred.
  • Five years of membership experience is preferred.
  • Responsible for the establishment of common benefit coding structures within the enterprise.
  • Responsible for running claims impact reporting for identified issues.
  • Responsible for analyzing claims impact reporting for identified issues, communicating recommended steps to downline areas.
  • Responsible for assisting in the BT compare process to identify potential gaps or issues in benefits/products.
  • Implements and documents the capturing of product business rules, coverage, and benefit rules within the Product Machine.
  • Creates new structural components such as Benefit Types (BT), accumulators, etc.
  • Coordinates with impacted downstream systems regarding rollout of product changes.
  • Independently determines the best approach to solve problems.
  • Requires the ability to run multiple projects simultaneously.
  • Coordinates departmental communication regarding system problems, modifications, and upgrades.
  • Identifies and documents system problems, modifications and notifies Supervision and Information Services.
  • Evaluates, researches, and resolves user identified system problems and documents the conclusions.
  • Develop policies and administrative procedures.
  • Provides research, instruction, and assistance to all users.
  • Performs job related projects as assigned by leadership.
  • Represents and leads the Membership Department on cross-divisional teams or projects impacting Membership Systems or processes.

SQLData AnalysisCommunication SkillsAnalytical SkillsProblem SolvingWritten communicationData modeling

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πŸ“ United States

πŸ’Έ 83280.0 - 99000.0 USD per year

  • Bachelor’s degree in research, analytics, marketing, statistics, health informatics, or a related field.
  • Minimum 5 years of progressively responsible and relevant experience in data analysis, customer research, healthcare analytics, or digital experience analytics is required.
  • Minimum two years of experience using data analytics software such as Power BI, Tableau, SPSS, R, or Python.
  • An intermediate level understanding of database management, SQL, ETL processes, data extraction tools, and data modeling is required.
  • Identify, extract, organize, store, analyze, report, and model data from both internal and external sources to support Marketing and Customer Experience (CX) initiatives.
  • Process, cleanse, and verify the integrity of data used for analysis, and extend company data with third-party sources as needed.
  • Organize and maintain databases with data joined across multiple sources, ensuring accuracy and validity of information displayed.
  • Create and maintain reporting and dashboard visualizations using tools like Power BI and Tableau to support data-driven decision-making by division leaders.
  • Analyze external and internal customer data and marketing data using database queries (SQL), spreadsheet (Excel) models, web analytics tools (Adobe Analytics), and statistical analysis tools (Python, R, SPSS).
  • Provide actionable overall marketing, customer, and division data insights to address key strategic questions and track, report, and analyze the performance of customer experience and marketing activities.
  • Evaluate customer interaction behavior and feedback to provide insights and recommendations for further enhancements to the overall customer experience.
  • Model and frame business scenarios that impact critical customer-facing issues and help navigate process improvements/decisions.
  • Implement automated processes for data efficiency and create PowerPoint presentations to provide analytical insights for various customer experience and marketing stakeholders.
  • Serve as data subject matter expert for marketing data, customer sentiment, interactivity data, and maintain an expert understanding of analytics software.

Project ManagementPythonSQLData AnalysisETLTableauCommunication SkillsWritten communicationData visualizationData modelingData analytics

Posted 3 days ago
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