11 benefit analyst jobs found in Detroit

Departmental Summary: The Application Developer II will support ancillary lines of business Dental, Vision, EOB IT, CDH and Pharmacy, ensuring reliable execution of production processes and day-to-day operational stability. Responsibilities include monitoring and supporting batch and real-time workflows, triaging and resolving defects, and implementing enhancements to core business logic in alignment with evolving business needs and compliance   requirements . The role will participate in initiatives such as claims processing, membership reporting and reconciliation, and benefit updates, emphasizing accuracy, timeliness, data quality, and SLA adherence. This position will also contribute to strategic initiatives across Dental, Vision, and CDH products. As part of ongoing modernization, the analyst will help transition business functionality to distributed platforms and services (e.g., APIs, microservices, data pipelines), including analyzing existing logic and...

Description The Technical Consultant II provides highly complex consultative services to an assigned group of customers within a specialty segment or territory. Conducts on-site evaluations, evaluates data, and creates/implements service plans to control customer's source of risk, losses and costs. Provides risk assessment services and information to track progress and demonstrate the value of doing business with Liberty Mutual. Serves as a trainer/mentor to less experienced consultants in their specialty area at the discretion of their manager. Enhances the Company's leadership position in the safety field through speaking engagements at conferences and developing key relationships.   ***Must have property and casualty experience****   Responsibilities:   Provides an array of expert consultative services to an assigned group of customers within a specialized technical area or territory. Conducts on-site evaluations, evaluates...

As a Health and Benefits Senior Associate, you will contribute to a wide variety of complex projects involving the design, financing and ongoing management of the full spectrum of health and benefit programs. You will serve as the lead project manager on select projects, interface with vendors and key clients internally and externally, create client deliverables and ensure quality standards are met. You will have the opportunity to significantly grow your health and benefits business acumen as well as your financial, project management and client relationship skills by working on cutting edge projects alongside leaders in the industry.  The Role   Materially contribute to core health and benefits projects involving the design and management of group medical, dental, life, disability and time off benefits for large, complex clients including:   Benefit plan analysis, design, cost savings and funding strategies  Vendor procurement, negotiation and optimization...

Departmental Responsibilities: Develop, maintain, publish, distribute, and manage EIS policies, standards, guidelines, and procedures. Provide guidance on policy requirements, interpretation, and compliance. Provide strategic input to the development and enhancement of EIS policies, standards, and procedures to ensure accuracy, consistency, and simplification. Proactively identify continuous-improvement opportunities related to policy compliance, reviews, and supporting documentation. Engage key stakeholders and entities to track and influence implementation of policy requirements. Lead and participate in governance engagements related to EIS policies and supporting documents. Coordinate with key stakeholders and entities to deliver timely communications (e.g., newsletters and announcements). Coordinate across entities on policy and standard language to ensure consistency and alignment. Manage the policy and process management lifecycle for BCBSM and...

Shift – 8:30am-5:00pm M-F; shift bidding process based on seniority. Site/Location: Detroit, MI Status – Regular Full Time       Provide thorough analysis and investigation of authorization requests for specialized medical/surgical/outpatient procedures in an expeditious and accurate manner ensuring provider, hospital/facility, Primary Care Group (PCG), and member quality customer service. Provide information and assistance pertaining to the Medical Management program to providers, hospitals, PCGs and members. Assess and investigate requests for medical service authorization and authorize select services that do not require clinical judgment. Collect and record appropriate data to issue authorization and route request for services that require medical review to appropriate team member(s).  Facilitate communication with providers regarding status on authorizations and referrals. Identify relevant issues and route to appropriate department for action and resolution....

SUMMARY:  This position is responsible for the Medication Adherence program for BCBSM senior members. The Director will design and execute a multi-year strategy that improves adherence rates and achieves Star measure performance goals. The Director will report to the Managing Director of Pharmacy Quality and oversee a large, multidisciplinary team of pharmacists, pharmacy technicians, data analysts, and external vendors. This role requires strong cross‑functional collaboration with clinical, operations, IT, finance, and external partners to integrate adherence initiatives, drive performance, and apply emerging digital tools and analytics to scale impact. The ideal candidate combines deep pharmacy expertise with proven leadership, strategic thinking, change-management skills and the ability to influence stakeholders at all levels. RESPONSIBILITIES/TASKS: • Serves as the department lead and subject-matter expert for CMS Star Medication Adherence measure performance; interpret...

Employment-based non-immigrant visa sponsorship and/or assistance is not offered for this specific job opportunity. We will only consider candidates who are currently authorized to work in the United States and who will not require sponsorship now or in the future. Please note student visas, CPT, OPT, H-1B, TN, and other temporary work authorizations are considered restricted forms of employment eligibility. Once these expire, the candidate must be able to present another valid form of work authorization.   Detroit: Fully remote/hybrid Create a career that goes in the direction you choose. Get to know opportunity. The Business Join one of the fastest growing areas of our retirement business!  The Actuarial Delivery Group (ADG) is a growing group of colleagues within the North American Retirement Line of Business who focus on operational excellence and systems expertise. As integrated members of client teams in a variety of offices, they provide high quality and...

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Auto Field Appraiser- Detroit or Lansing, MI PRIMARY PURPOSE : To handle field appraisal assignments for our corporate fleets and insurance clients with an emphasis on Auto's. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Set appointments same day, inspect within 24 hours and write estimate car side Depending on location - appraiser is expected to write 6 to 10 estimates per day Ensures proper vehicle tear down Determine repair time allotments and required labor...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   Position Description Paralegal II – The Auto Club Group What you will do: This role is Hybrid, with training occurring in office. Once training is complete, the role will move to 3 days Work From Home, 2 days in office. Schedule and Hybrid status subject to change based on business need. Under direction and guidance of the organization’s attorneys, performs a variety of intermediate to complex law-related tasks in support of legal matters.  Conducts legal research, investigate issues and drafts/prepare legal documents to support attorneys and contract administrators.  Supports all aspects of document discovery, including e-discovery, document management, the litigation hold process, and document production.  Assists counsel with the coordination of responses to...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   This is a hybrid position reporting to our Detroit office 2 days a week. Senior Trial Attorney – AAA/The Auto Club Group Reports to: Supervising Practice Leader Responsible for litigation of Circuit and Federal cases of unlimited exposure where there is a multiplicity of complicated legal and factual issues involving the more serious injuries, excess damages, and high exposure litigation of identified legal issues which the Company may pursue through the appeal process.  Primary Duties and Responsibilities: Case Management and Preparation: Analyzes, files, reviews all allegations, and renders legal opinions to Claims personnel regarding evaluation and disposition of injury cases. Prepares responses to civil complaints, files and...

Responsible for financial performance functions, including budgeting and forecasting, performance metrics, and assisting with the planning, organizing, and directing of the company’s financial plans and policies. This position is responsible for the customer experience related to financial analyses and reporting and ensures financial viability through proactive analysis and sound administration of policies and procedures. This role is responsible for communication and coordination of financial matters with Senior Health Services executive leadership. This position also supports the establishment of the financial vision and strategic direction of the business unit in support of corporate goals and objectives, and implements and monitors leading and lagging KPIs to assist leadership in directing outcomes RESPONSIBILITIES/TASKS:  Build influential partnerships across the enterprise and provide a profit and loss perspective.  Oversee how the parent company of Blue Cross Blue...