78 jobs found in Detroit

Why USAA? At USAA, our mission is to empower our members to achieve financial security through highly competitive products, exceptional service and trusted advice. We seek to be the #1 choice for the military community and their families. Embrace a fulfilling career at USAA, where our core values – honesty, integrity, loyalty and service – define how we treat each other and our members. Be part of what truly makes us special and impactful. We are proud to support active-duty military spouses. USAA roles may offer remote or hybrid flexibility for active-duty military spouses consistent with applicable policy and business needs. The Opportunity This is a field-based role in the Detroit, MI area. Candidates who are willing and able to work in Detroit are encouraged to apply.   Within defined guidelines and framework responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to...

As a Health and Benefits Financial/Actuarial Senior Director, you will serve as the financial lead for large, complex client assignments. You’ll leverage your experience as a benefits financial/actuarial expert to make strategic recommendations on funding, plan design and innovative financial solutions. You will apply your financial management and data analytics expertise to solve complex client problems and to lead the development of new H&B intellectual capital. The   Role Communicates   and   delivers   complex   concepts   and   financial/actuarial/analytic   results   to   effectively drive client action and improve plan performance Leads   Medium   to   Large   clients’   financial/actuarial   engagements Develops   and   delivers   the   financial/actuarial   strategy   for   a   portfolio   of   Medium   and/or   Large   clients Drives   revenue   growth   through   client...

Job Type: Full time   Exempt/Non Exempt:   Hourly Job Description:   Location: Dearborn, Michigan   Position Schedule / Shift: Rotating hybrid schedule Monday – Friday: 8:30 AM EST – 5:00 PM EST. In office reporting will rotate based on role responsibilities. All employees will be notified of in office reporting days as applicable. Training for this position will be in office for the first initial 90 days of employment. Rotating schedule will begin after training is completed. Position Summary: Join our Claims team in a role where your analytical skills, attention to detail, and problem-solving abilities make a direct impact on the customer experience and the financial integrity of our claims operations. As a claims operations professional, you'll take ownership of complex payment and reconciliation processes, resolve challenging issues, and serve as a trusted resource for teammates while helping ensure accurate, timely claim outcomes. If you...

                                                                   Moderate travel, including nationwide travel, is required (up to 50%) Department Summary Serve as a subject matter expert for UAW Trust benefits, claims, and member advocacy. Possess NASCO claims processing knowledge and experience. Demonstrate strong understanding of MAPPO, Medicare Advantage, Commercial, HMO, and PPO benefit structures and claim processing differences. Investigate and resolve complex claims issues, benefit processing concerns, and member escalations. Support member meetings and travel team activities, including direct member interactions and issue resolution. Attend and actively participate in internal and external workgroup meetings representing the Trust account. Coordinate, submit, and oversee benefit implementation requests and ensure implementations are accurately configured and tested. Partner with operational, benefit, provider, and claims teams to identify and...

Department Summary Responsible for end-to-end ownership of RFP and RFI outcomes, including prioritization, development, review, approval, and on time submission of all proposal responses. Provides leadership and performance management for the proposal team, ensuring accountability for overall proposal quality, compliance, and deadline adherence. Oversees workload balancing, process governance, and final approvals while serving as a senior subject matter expert on complex, jumbo, and high-profile proposals. ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following. Other duties may be assigned. Provide end-to-end ownership of all project responses, ensuring proposals are accurate, compliant, strategically positioned, and submitted on time. Serve as the reviewer and approver of proposal content prior to market submission, with accountability for quality, consistency, and adherence to Blue Cross template standards. Oversee proposal template governance across all responses....

Department Preferences Majors in Business or Strategy preferred Experience with AI tools, data analytics, presentation development and delivery Has a strong attention to detail Proficient in Excel and PowerPoint   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...

The Instructional Designer is responsible for designing learning experiences that solve business problems through the thoughtful combination of communications, eLearning, instructor-led training, performance support and other interventions. They ensure that high-quality, innovative, and effective learning solutions are designed, developed, and delivered by different teams in a timely manner to satisfy business needs. Engage with stakeholders from different parts of the business to rapidly analyze their needs and design high-level learning solutions that may include a range of low, medium and high-fidelity learning interventions   Plan, coordinate, and develop support materials and communications for divisional and/or corporate projects.   Report project statuses to various levels of management.   Develop performance-based training and development systems to meet operational needs and requirements.   Develop cross-trainings for various employees to carry...

Departmental Preferred Qualifications: Leads complex, cross-functional projects and coordinates internal and vendor resources. Manages project scope, timelines, budgets, risks, metrics, testing, implementation, and deliverables. Resolves barriers, improves processes, and ensures quality execution. Demonstrates NASCO system and operational knowledge, including GDO and SBP projects. Provides expertise in MAPPO, Commercial, HMO, and PPO products. Manages benefit administration, implementation, configuration, validation, and testing. Demonstrates strong organizational skills and sound judgment in ambiguous situations. Possesses customer service knowledge and may guide or supervise staff while performing other assigned duties. Communicates effectively and confidently with external customers and organizational leadership.   Accountable for and manages the development, implementation and ongoing maintenance of long-term project(s) typically spanning two years or more...

Department Summary  This position is dedicated to the State of Michigan account. The analyst responsibilities will include: Respond timely to membership and claim related escalations from customer for Blue Cross or BCN members Investigate and resolve membership discrepancies Investigate and resolve COB inquiries Investigate and resolve Medicare eligibility inquiries Assist with presenting at Benefit Open Enrollment and retiree meetings Demonstrated ability to function as an engaged and positive ambassador of BCBSM/BCN with attitudinal qualities to service and retain our State of Michigan customer Occasional travel is required    Department Preferences Bachelor’s degree preferred Three years’ customer service and/or membership experience preferably in the State of Michigan department with state benefits knowledge Working knowledge and experience in NCOMPASS/MEMBERSEDGE/FACETS/MARX Ability to provide root cause analysis to claims and membership problems Strong...

Under minimal supervision, perform complex duties related to payroll processing.  Responsible for troubleshooting and assisting personnel across the enterprise with payroll related inquiries, developing standard operating procedures, identifying opportunities for process improvements and performing complex account reconciliations. Candidates with current Oracle experience preferred.   Assist personnel at all levels across the enterprise by answering complex payroll related inquiries. Responsible for bi-weekly payroll and year-end W2 processing, tax filing, and monthly verification and closing of general ledger.  Verify and process employee timecards; process attendance corrections. Maintain employee records and enter complex transactions based upon submitted documentation (e.g. Employee Profile).  Process garnishment and withholding orders such as tax levies, child support judgments, etc. Provide guidance to lower level team members.  Develop standard operating...

Join the Health Care Value Strategic Informatics and Program Performance team where you will be responsible for leveraging advanced analytics, predictive modeling, and data visualization to generate actionable insights that improve healthcare outcomes, optimize program performance, and support strategic decision-making. This role partners with business leaders, clinical teams, pharmacy services, and operational stakeholders to analyze healthcare data, identify trends, evaluate program effectiveness, and provide data-driven recommendations related to cost, quality, utilization, and member outcomes. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Analyze large volume of health care claims data using advanced statistics/machine learning methods to understand existing and predict future health care trends and anomalies. Proactively discovers potential areas for medical cost improvement and management/healthcare initiative strategies....

SUMMARY:  The purpose of the Medicare Part D PGY1 residency program is to empower and educate the resident in all areas of Medicare Part D practice, including but not limited to:  • Formulary Management (including Rebates)  • Pharmacy and Regulatory Compliance and Audit  • Pharmacy Benefits Management  • Clinical Pharmacy Programs  • Plan Performance and Quality Assurance  • Medicare Part B and D Prior Authorizations and Appeals  • Product Development  • Administration and Leadership  RESPONSIBILITIES/TASKS:  • Assist Senior Leadership in the planning, development, and implementation of Medicare Part D products, programs, and services such as submission of the CMS bid.  • Help to develop, implement and maintain utilization management and drug utilization review programs.  • Serve as a key clinical support person for processing drug information inquiries.  • Participate in the Pharmacy & Therapeutics committee, making both clinical and financial formulary...

Responsible to plan, organize, control, direct and lead sales office and/or specialized sales area.  Accountable for development, planning and leadership to ensure increasing market share and membership for BCBSM and/or BCN to meet corporate goals and objectives.   Plan, organize, and direct activities of an assigned business area including but not limited to planning, training, motivation, staff development, staff selection and communication.     Develop sales and customer relation strategies for sales teams and/or customers and coordinate problem resolution to ensure that objectives are met, and problems are resolved to the benefit of customers, agents and the corporation.   Monitor and communicate to BCBSM and/or BCN management competitive products, practices, trends, attitudes and issues of customers, labor, community leaders, etc. Develop plans that ensure cohesive working relationships between constituents to maximize sales potential.     Ensure prompt,...

Department Preferences Experience creating training materials, presentations, job aids, videos, infographics, or digital content Strong written communication, editing, and content development skills Ability to analyze data, interpret results, and create reports or dashboards   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...

  Responsible for planning, coordinating and supervising assigned department(s)/area(s) to ensure an efficient and cost-effective area of responsibility in accordance with established corporate and departmental policies and procedures.   Supervise and promote the professional development of assigned staff through selection, development, and exploration of more effective methods of managing projects and time. Research (internally and externally), initiate, and plan strategic changes in assigned department(s)/area(s) to optimize technologies and personnel. Recommend and assist in acquisition of technology and other tools or equipment and resources to optimize departmental performance and output. Prioritize and assign work to employees and initiate corrective measures to resolve problems, including scheduling or adjusting overtime requirements as necessary. Interface with diverse levels of internal and external personnel to develop and maintain effective rapport and to...

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.  Job Description Allstate’s sales organization is growing its virtual workforce, and we are looking for highly motivated individuals that thrive in a fast-paced sales environment and enjoy being rewarded for their efforts. At Allstate, we are committed to offering a reputable product suite that protects people from life’s uncertainties so they can realize their hopes and dreams. As a full-time Insurance Sales Representative, you will: Engage with active insurance shoppers via inbound/outbound calls, live chat, SMS, and more in a work from home call...

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.   Contract Dates: June 2027 through August 2027 Other hiring locations for this role are: Boston, MA; New York, NY; Atlanta, GA; San Francisco, CA; Houston, TX; Dallas, TX We are in the business of transforming tomorrows. Join us and transform yours.   The Business   Create your future. In Health & Benefits (H&B), our purpose is that through our colleagues we help our clients make a difference in the lives of their employees. We help large and mid-size...

At Allstate, great things happen when our people work together to protect families and their belongings from life’s uncertainties. And for more than 90 years, our innovative drive has kept us a step ahead of our customers’ evolving needs. From advocating for seat belts, air bags and graduated driving laws, to being an industry leader in pricing sophistication, telematics, and, more recently, device and identity protection.  Job Description A day in the life of a Large Loss Field Property Adjuster, and what it takes to do the job! As a Large Loss Field Property Adjuster, you will provide exceptional service to our policyholders. Your primary responsibility will involve traveling to our customers' homes to conduct on-site inspections, investigate coverage, prepare estimates, and settle claims promptly and efficiently. Additionally, you will handle virtual claims countrywide, leveraging various platforms and software such as Xactimate and ClaimsX Video Collaboration....

This position is responsible for planning, organizing, and monitoring the audit coordination processes for the OGACC - Office of the General Auditor & Corporate Compliance – Emerging Markets (OGACC – EM). This position interacts routinely with the Company executives, directors, and managers, as well as BCBSM. This role requires exercising discretion and judgment in assisting the general auditor and internal audit staff. Discretion and judgment are also required when communicating with executives and staff throughout the enterprise and BCBSM. This position performs executive support tasks which may be highly confidential and sensitive in nature utilizing considerable independent judgment. Performing high-level administrative work, including organizing, scheduling, coordinating, researching, compiling, exchanging, and sometimes analyzing information for executive(s) and the department is also required. Leads on-site audit activities between OGACC - EM and the enterprise....

Provides technical, data and analytical support to customer departments such as Quality, Value Partnerships, Hospital Contracting, Care Management, Risk Adjustment and HCV.   ESSENTIAL DUTIES AND RESPONSIBILITIES  include the following. Other duties may be assigned.  Leads or participates, with some direction, in projects where data solutions are necessary. Provides programming and data expertise for simple and moderately complex projects and ad-hoc requests.   Presents data and solutions to internal and/or external customers in a logical way. Provides data support and analysis for programs supporting over 4 million BCBSM beneficiaries using administrative claims and supplemental data.    Provides analysis and data support for various corporate departments including Quality, Risk Adjustment, Value Partnership, Care Management, and Hospital Contracting, in support of major corporate initiatives such as EMR Connectivity, PGIP, Risk Adjustment, STARS and...