SUMMARY:  The Manager, HEDIS Data & Analytics will oversee activities in support of HEDIS data management including HEDIS rate generation, oversight of the HEDIS vendor, collaboration with IT teams, and HEDIS audit support. This position is responsible to plan, organize, direct, control, and lead the assigned business unit.  ESSENTIAL DUTIES AND RESPONSIBILITIES:  • Manages activities of a department including, but not limited to, planning, problem solving, staff development, and communication.  • Executes function/area objectives that support continuous improvement.  • Manages professional, exempt, and non-exempt non-bargaining and bargaining unit employees.  • Responsible for special projects and/or problem resolutions.  • Provides effective and efficient solutions to complex business problems.  • Provides high level oversight and leadership.  • Participates in development of annual departmental budget, monitors budget, and identifies budget discrepancies. Researches...

Status – Regular FT Hours of Operation:  9am to 5:30pm   This position is responsible for a variety of clerical duties in support of claims processing which requires a familiarization with standard work routines.  Receives sorts, ages and logs incoming mail/claims. Scans claim for completeness and aged multiple corporate receipt dates requiring priority. Checks basic subscriber, provider and eligibility information. Make corrections to claims. Handles general correspondence. Prepares internal claim forms and GI letters. Adhere to established standard as cited in Service Level Agreement. Process surveys and other seasonal corporate documents.  Prep internal documents from various departments for storage. Index claims for retrieval via Content Manager. Perform other related duties as assigned.  QUALIFICATIONS High school graduate or GED equivalent is required. Six (6) months experience in a high-volume processing area. Ability to use/operate office...

Non-Exempt/Bargaining Unit Posting Date Posted: 12/12/2025 Date Closed: 12/19/2025 Local/Seniority Unit – 2256/4105 (Lansing) or 2145/2101 (Grand Rapids) Department – 125960 Statewide Call In Pricing Salary Grade – E Number of openings – Multiple Shift – Mon-Fri Start between 7a to 9:30a, Shift Bidding by Seniority Site/Location: Lansing Capitol Building or Grand Rapids Steketee Status – Regular Full Time   Responsible for adjustment processing of claims received via telephone or written inquiry from internal customers. Handle telephone inquiries generated from all internal customer and provider servicing areas and adjust claims as appropriate based on nature of call. Contact internal and external resources via phone or written communication for additional information required to process claim payments. Complete written inquiries generated from all corporate customer and provider servicing areas and adjust claims as...

Department Summary and Preferences Responsibilities do not include building journeys within Salesforce Marketing Cloud, it does however require an understanding of consumer journeys and the requirements needed for other team members to build the journeys. Document and communicate project concepts, milestones and results leveraging the campaign business rules and project planning documents established to turn marketing strategies into actionable campaign journeys for the CRM team to begin development of Marketing Cloud journeys. Identify, evaluate, recommend and implement changes to marketing campaign execution problems and improve effectiveness of transitioning go-to-market plans into actionable experiences for development into Salesforce. Salesforce Marketing Cloud experience or similar martech operational knowledge.  Identify and analyze operational data and develop insights in support of marketing objectives. Develop and improve work flows and business processes...

SUMMARY: Develops and manages independent agency relationships including the development of new business and retention of existing business in greater Indianapolis, IN. Reviews, analyzes, approves or rejects complex business within letter of authority.  Serve as liaison with company personnel regarding company business opportunities and problem resolution. Responsible for assisting in establishing the territory’s or region’s overall agency plan. RESPONSIBILITIES/TASKS: Calculates, prepares and develops premium quotations using corporate underwriting guidelines within letter of authority. Determines underwriting eligibility for prospective policyholders and develops appropriate pricing for new business, renewals, and endorsements. Analyzes and reviews prospective accounts for insurability and accepts or rejects within letter of authority. Develops and manages agency relationships. Develops agency plans in cooperation with other staff. Addresses agents’...

Advise the customers of our updates to the Medicare policy and how the updates will benefit the members and impact the group’s experience and utilization. Assist specific area(s) in: deployment and operational activities and/or development, implementation, and maintenance of clinical operational processes.  Identify and/or analyze business problems and devise procedures for solutions to problems; prepare reports and/or analyze, documenting results.  Design, develop, modify, test, implement and maintain assigned systems, either independently or as part of a team. Troubleshoot problems and submit recommendations.   May be required to interface with other areas, both internal and external, to resolve problems.  Assist personnel (both external and internal) by answering questions, supplying information and training. " Qualifications " Associate's Degree in Nursing or RN Diploma required. Bachelor's Degree preferred. Two (2) to four (4) years of clinical experience....

The Enterprise Security Officer II position is an essential member of the enterprise security team and is focused on providing a safe, secure, and friendly environment for all individuals on our property.  The primary duties of a security officer II consist of Security Officer I responsibilities in addition to enterprise command center responsibilities.  Individuals in this position must be professional in their appearance and conduct and assist in the enforcement of corporate policies, guidelines, procedures, rules, regulations, laws, and ordinances. The security officer II will protect BCBSM property against damage, fire, theft, trespassing, and illegal or unauthorized entry. They will also provide an emergency response for major events and provide high quality customer service and educate stakeholders to take an active role in maintaining a secure workplace.  The Security Officer II must remain calm under pressure and can make decisions quickly to protect people or property...

The Internship Program at BCBSM is designed to enhance the skills and abilities of young professionals as well as to identify and attract future talent for our organization. Interns will gain practical hands-on work experience as well as a solid understanding of the health insurance industry. Our program is an excellent way for interns to get a good start on their careers by working on meaningful projects, learning valuable skills, and networking with employees throughout our organization, which could potentially allow interns to build a future career at BCBSM. Assist in preparing information and research materials to identify business problems, offer recommendations and assist  management with implementation of solutions.  Support leaders on projects designed to enhance the overall efficiency and effectiveness of the organization. Develop and maintain a solid understanding of BCBSM business, products, programs, data, organizational structure, controls, research.  Analyze...

The Accounts Payable Analyst position serves as a key resource with primary responsibilities for all duties related to Accounts Payable for the Enterprise.  Contacts include various customers including employees, agents, vendors and policyholders of the Enterprise. Duties may include invoice and accounting analysis, account reconciliation, payment transaction processing, check and cash management research and balancing, and employee expense reimbursement review. Prepares financial information and reviews for accuracy and completeness.  Performs detailed analysis when necessary. Other deliverables may include account reconciliations, impact studies, audit findings, budgets and business cases.  Assists with the preparation of various financial or regulatory reports and/or statements for management and/or parties external to BCBSM (e.g., auditors, customers, providers, BCBSA, FEP, OFIS, etc). Prepares financial reporting for a division, customer or segment that may...

Our internship program is designed to enhance the skills and abilities of young professionals as well as to identify and attract future talent for our organization. Interns will gain practical hands-on work experience as well as a solid understanding of the health insurance industry. Our program is an excellent way for interns to get a good start on their careers by working on meaningful projects, learning valuable skills, and networking with employees throughout our organization, which could potentially allow interns to build a future career at our company.   JOB DESCRIPTION: Performs duties related to the major functional areas of our business which include Finance. Prepares and delivers presentation(s) on assigned topic(s). Attends unit, departmental, and corporate meetings as assigned. Shows learning and both personal and professional growth and understanding of responsibilities. Gains an understanding of how company and business works. Shows...

SUMMARY This Senior Claims Representative position is within the company’s complex claim handling unit. The primary responsibility of this position is the management and resolution of the company’s most complex commercial casualty claims with minimal supervision. Claims managed by this position are among the most complex received by the claims department and often present the highest and most severe potential exposure. Further primary responsibilities include handling negotiations on any and all claims assigned, understanding and verifying coverage policy provisions, limitations, deductibles, and exclusions, taking statements or interviews when necessary, from all parties, coordinating referral of coverage requests, and assigning losses to defense firms and/or independent adjusters as necessary.    ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:   Other duties may be assigned. 1.            Promptly and efficiently adjust a caseload of the company’s most...

The Executive Assistant will provide high-level administrative and operational support to the Senior Vice President, General Auditor, and Chief Compliance Officer. This position plays a key role in ensuring the efficient management of day-to-day activities within the Audit and Compliance functions. The individual will handle a variety of administrative tasks, manage complex calendars, prepare professional communications and documentation, and coordinate department operations.   This role will also assist with supporting meeting logistics, materials preparation, and follow-up actions associated with Audit Committee of the Board of Directors. The ideal candidate is highly organized, detail-oriented, and capable of handling confidential information with discretion and professionalism.   ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Provide executive-level administrative support including calendar management, travel...

SUMMARY: The Expert Analyst is responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions. This role also coordinates projects for senior management.  ESSENTIAL DUTIES AND RESPONSIBILITIES:  • Develops documentation, reports and presentations for all levels within the organization including executive leadership.  • Responsible for trend analysis, report development, ad-hoc analysis and support  • Develop and present complex analytics concisely for consumption by upper management and Executive leadership  • Design and implement epidemiologic studies to evaluate the effectiveness of clinical programs  • Ability to manage multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters  • Compile data from a variety of sources and conduct analytics using software including Excel, Oracle (SQL) and SAS to support business decisions  •...

SUMMARY:       Accountable for and manages the development, implementation and ongoing maintenance of project(s) with moderate to complex scope and deliverables. Project scope may impact one or more business unit/function. Project scope typically impacts one or more of the following: process, system, function, product and/or service. The Project Consultant may also be responsible for supporting the Program Manager and Senior Project manager with project documentation, scheduling, and tracking.   RESPONSIBILITIES/TASKS:    Schedules and holds project meeting and provides notes.   Updates and tracks issues and risks.   Develop detailed project plans and schedules, identify goals, objectives, risks and resource allocation.    Monitor project status for significant deviations in quality, cost or schedule.  Interface with various departments, senior management and external individuals providing value and support for...

SUMMARY   Role provides oversight of property and casualty programs via a delegated underwriting authority model. Responsible for maintaining strong partnership with the MGAs/MGUs/ program administrators, delivering operational excellence, ensuring adherence to underwriting guidelines, and alignment with the overall business strategy. The Senior Program Manager will serve as the primary point of contact between the MGA/MGU/program administrator and internal stakeholders, driving collaboration, profitability, and growth across the business portfolio.  The Senior Program Manager will also serve as a mentor and trainer for other program managers.     ESSENTIAL DUTIES AND RESPONSIBILITIES Other duties may be assigned.   Manage complex program performance and profitability by monitoring key performance indicators, creating action plans when needed, handling underwriting referrals, and driving improvements in challenged segments through...

SUMMARY:     This position will be involved with supporting enterprise compliance goals through research and analysis of r egulatory claims and/or policy compliance items, assisting with the establishment and implementation of enterprise best practices, involvement with claims and product filings, and internal systems support.  This position will also assist with development of enterprise compliance procedures and training and participate in compliance audits to ensure consistent application of compliance-driven processes throughout the enterprise.    RESPONSIBILITIES/TASKS: Analyzes, researches and reports on regulatory claims and/or policy compliance trends, issues, laws, rules, regulations and assists with the establishment and implementation of best practices. Keeps abreast of compliance best practices and procedures for all applicable states and lines of business. Assists with the development and implementation of reference materials, training...

This role provides high-level administrative support to two directors and the lead director who oversees the Customer Service Contact Centers at BCBSM, ensuring seamless coordination across calendars, meetings, and departmental priorities. The position requires exceptional organizational skills, attention to detail, and the ability to manage confidential information while supporting strategic initiatives and team engagement. Candidates should be comfortable working in a fast-paced environment and proactively anticipating needs to keep operations running smoothly. Provide administrative support services to assigned business unit, exercising discretion and maintaining confidentiality in handling work objectives. Schedule appointments and meetings, maintain calendars and assure all required information is prepared for scheduled appointments and meetings. Prepare, edit and proofread general correspondence including memos, letters, spreadsheets, e-mails, corporate forms,...

As an intern, you will help support the team by pulling reports from scoreboard to support the Team Leader IIs, huddle creation and run through, Bluestar rewards support, and helping support other individuals on the team. This position will be located in Detroit but will require travel to Southfield for in-person staff meetings   Interns complete required reporting to help support servicing area, create huddle roll outs, support BlueStar Rewards, send out PEGA and Kudos email in a timely manner. In addition, the interns help support analysts, senior analysts and project consultants on tasks that are repetitive or time consuming to ensure the team continues to move forward.    The Internship Program at BCBSM is designed to enhance the skills and abilities of young professionals as well as to identify and attract future talent for our organization. Interns will gain practical hands-on work experience as well as a solid understanding of the health insurance industry. Our program is...

SUMMARY:  This position serves a key resource for Accounts Payable functions. Primarily responsible for all duties related to Accounts Payable for the Enterprise.  Contacts include various customers including employees, agents, vendors and policyholders of the Enterprise. This position requires working with multiple payable & accounting systems for multiple companies within the Enterprise in order to maintain accurate accounting of expenses with weekly/monthly journal entries and account reconciliations. PRIMARY RESPONSIBILITIES: •    Responsible for daily and monthly payable function by reviewing invoices and reports for accuracy. •    Reviews payable requests for compliance with Enterprise and Governmental policies.  •    Reconciles various general ledger accounts, proposing and making correcting ledger entries when necessary.  Reconciliations include but are not limited to, corporate projects, accounts payable and fixed asset accounts. •    Prepares, maintains and...

    Responsible for planning, coordinating, and supervising all administrative, operative and employee functions within assigned area(s) to ensure an efficient and cost effective area in accordance with departmental and corporate standards and objectives.   Supervise, coordinate, direct and monitor staff activities to ensure prompt, courteous and accurate response to customers; ensure an efficient and qualitative operation through effective planning, leading, controlling and organizing. Prioritize and assign work to employees and initiate corrective measures to resolve problems including scheduling or adjusting overtime requirements as necessary. Select, train, develop, appraise and counsel support staff personnel. Interface with diverse levels of internal and external personnel to develop and maintain effective rapport and to resolve issues and inquiries. Monitor and analyze proficiency and quality efforts subordinate personnel. Administer and...