70 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 As a Sr. Auto Appraiser – Field, within defined guidelines and framework, will be responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate accuracy in compliance with state laws and regulations. Accountable for delivering...

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 As a Sr. TLE Auto Appraiser, within defined guidelines and framework, will be responsible for the investigation, negotiation, evaluation and appraisal of vehicle damage claims for both repairable and total loss vehicles to ensure estimate accuracy in compliance with state laws and regulations. Accountable for delivering...

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 As a dedicated Field Physical Damage Specialist, you will, within defined guidelines and framework, be responsible for building relationships and providing oversight of our third-party vendors through virtual or in person interactions with members, claimants, and third-party personnel. Drives USAA's financial strength by...

The Release Train Engineer (RTE) is the servant leader and coach for an Agile Release Train (ART), enabling cross-functional teams to effectively plan, execute, and continuously improve the delivery of business value. The RTE partners with Product Management, Product Owners, Scrum Masters, Business Owners, System Architects, and Agile Teams to foster alignment, remove impediments, and improve flow across the ART. This role champions the foundational principles and values of the Scaled Agile Framework (SAFe), promoting a culture of collaboration, transparency, continuous learning, and servant leadership. While primarily focused on the flow and effectiveness of the Agile Release Train, the RTE also partners with Enterprise Agile leadership to advance Lean-Agile practices and contribute to the organization's broader delivery of value. Experienced Lean-Agile leader who enables high-performing teams through influence rather than authority. Excel at facilitating alignment towards...

Employer: Blue Cross Blue Shield of Michigan Job Title: Application Developer III Job Location: 600 E Lafayette Blvd, Detroit, MI 48226 Job Type: Full-time, 40 hours a week, Monday  –  Friday Duties: Code applications or enterprise wide software systems using a disciplined development process. Integrate solutions with other applications and platforms outside the framework. Create data extracts and reports from system based on requirements. Support and/or execute all testing efforts across the life cycle. Create technical design specifications and assist in sizing technical requirements, as needed. Lead the deployment of new modules upgrades and fixes to the production environment, as needed. Make modules production-ready by moving them to libraries, completing forms and version control documents, following procedures, etc. Evaluate new application packages and tools and performs research on best practices. Provide recommendations for solutions. Troubleshoot...

Join Blue Cross Blue Shield of Michigan as a Senior Financial Analyst- Financial Reporting and help support accurate, timely, and well-informed financial reporting that drives business decisions and regulatory compliance. In this role, you’ll contribute to statutory and GAAP financial reporting, regulatory deliverables, audit support, account reconciliations and variance analysis while collaborating with finance partners, leadership, auditors, and key stakeholders. This is an opportunity to apply your financial expertise, attention to detail, and analytical mindset in a role that supports the integrity of critical financial information across the organization. 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...

Direct and lead the BCBSM Foundation’s grant programs, staff and administrative operations, including strategic planning and oversight of the Foundation’s investment portfolio in collaboration with Bricktown Capital. Responsible for the development, implementation, evaluation, and overall direction of Foundation activities. Partner with Enterprise to increase public awareness of the Foundation’s work through programs, presentations, publications, networking, and other communications. Provide strategic leadership and direction for the BCBSM Foundation, establishing priorities, goals, and initiatives that advance the Foundation's mission and align with BCBSM's strategic and Social Mission objectives. Ensure Foundation-funded programs and activities align with enterprise priorities, maximize community impact, and avoid duplication of efforts. Collaborate with customer-facing business units, Community Responsibility, Social Mission, Health Care Value, Commercial Markets,...

SUMMARY     T The Manager, Stars Data & Analytics will oversee activities in support of Stars data management including Stars projection generation, oversight of the Stars vendor performance, collaboration with IT teams, and reporting. 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...

Join Blue Cross Blue Shield of Michigan as a Financial Coordinator and play a key role in driving financial insights that support strategic business decisions. In this role, you will analyze and report on financial performance, including revenues, expenses, trends, and program profitability across business segments. You will also develop financial models and analyses that help guide future business initiatives. Working independently and collaboratively on cross-functional projects, you'll contribute to meaningful financial outcomes while managing multiple priorities in a fast-paced environment. DEPARTMENTAL PREFERENCES: Healthcare, insurance, or similarly regulated accounting and financial reporting experience preferred. Experience preparing or reviewing journal entries, account reconciliations, financial statements, regulatory reports, close activities, and financial analysis related to premiums, claims, provider payments, fixed assets, administrative expenses,...

The next part of your journey is right around the corner — with The Standard. A genuine desire to make a difference in the lives of others is the foundation for everything we do. With a customer-first mindset and an intentional focus on building strong teams, we’ve been able to uphold our legacy of financial stability while investing in new, innovative technologies that support the needs of our customers. Our high-performance culture focused on operational excellence thrives thanks to remarkable people united by compassion and a customer-first commitment. Are you ready to make a difference? As a Sales Analyst on the Employee Benefits team, you will manage the RFP (proposal) process for new business as well as existing/growing business through your blend of relationship management, customer service, and analytical skills. In addition to RFP management, your ability to build and maintain meaningful, effective relationships will be vital as you collaborate with internal...

Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members. May establish care plans and coordinate care through the health care continuum including member outreach assessments. Review, research and authorize requests for authorization of elective, direct, ancillary, urgent, emergency, etc. services. Contact appropriate medical and support personnel to identify and recommend alternative treatment, service levels, length of stays, etc. using approved clinical protocols. Analyze, research, respond to and prepare documentation related to retrospective review requests and appeals in accordance with local, state and federal regulatory and designated accreditation (e.g. NCQA) standards.  Establish, coordinate and communicate discharge planning needs 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 resolve...

  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...

Responsible for leading the development and implementation of programs and strategies by identifying insights that enhance business decision making capability. This includes developing or changing workflows and implementing process improvements to enhance organizational products, programs and service to our customers. Identify and analyze operational data and develop insights in support of business objectives. Develop and improve work flows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality. Identify and/or analyze business problems and develop recommendations for solutions to problems. Lead the development and implementation of projects and/or teams in order to produce desired results. Document and communicate project concepts, milestones and results. Recommend and assist with implementing standard policies and procedures. Ensure that corporate compliance is communicated, implemented and...

Departmental Summary This role is responsible for leading day-to-day IT delivery activities for the Epic implementation project, including planning, execution, dependency management, risk and issue tracking, delivery status reporting, and coordination across business, IT, Epic, vendor, and implementation partner teams. The IT Delivery Lead will partner closely with the Delivery Manager, Product Owner, Business Leads, Technical Leads, Architects, Business Analysts, Testing, Infrastructure, Security, Informatics, and other workstream teams to ensure scope, schedule, budget, quality, governance, and implementation readiness remain aligned throughout the project lifecycle. Preference is for a candidate with demonstrated experience leading large, complex programs or projects that span multiple teams, departments, workstreams, and stakeholder groups. Departmental Requirements Candidates must have proven experience managing complex IT delivery efforts, preferably within...

SUMMARY: Responsible for performing virtual and field audits in a multi-functional business unit. Reviews accounting and financial information, as well as, the business operations, to determine appropriate exposures and classifications for policyholders’ employees and subcontractors. Provide assistance with training, development and mentoring of the Premium Audit staff.  This position involves physical audits in addition to virtual audits and requires travel within the assigned market/territory. Residency within or in close proximity to the designated market is required to support job responsibilities. RESPONSIBILITIES/TASKS: Performs virtual and in person field audits. Collects all pertinent data and documents needed to calculate policyholder’s premium liability. Interviews policyholders to obtain further information concerning premiums, e.g. payroll and personnel records, and communicates completed audit information with contact and ensures...

Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   Location Details: Detroit, Michigan – Wayne, Oakland, and Macomb County Position Schedule / Shift: Hybrid – Field Schedule Monday – Friday: 8:30 AM EST – 5:30 PM EST. Position Summary: Join our team as a Field Property Claim Specialist serving the Metro Detroit area, where you’ll be the face of our claims experience and make a meaningful difference for customers during challenging times. In this role, you’ll inspect property damage, investigate claims, and work directly with homeowners to provide exceptional service and fair claim resolutions. If you enjoy working independently, building relationships, and combining problem-solving skills with field-based work, this is an opportunity to grow your career while helping customers recover and move forward. Now offering a $2500 sign on bonus to qualified candidates! Key Responsibilities: Reviewing assigned claims...

This individual will be responsible for providing Subject Matter Expert (SME) support for Corporate Projects and overseeing the governance of processes and documentation that represent all Service Operations Contact Centers.   Responsible for leading the development and implementation of programs and strategies by identifying insights that enhance business decision making capability. This includes developing or changing workflows and implementing process improvements to enhance organizational products, programs and service to our customers. Identify and analyze operational data and develop insights in support of business objectives. Develop and improve work flows and business processes within defined areas to improve customer service, decrease operational costs and improve overall quality. Identify and/or analyze business problems and develop recommendations for solutions to problems. Lead the development and implementation of projects and/or teams in order to produce...

Provides clinical program leadership and develops, implements and approves policies within recognized area of responsibility. Develop and maintain medical policy.  Establish rationale for approving inquires and appeals.   Assists with clinical research, writing documents, and documenting decisions.   Provide utilization management for prior authorization procedures.  Review cases and make decisions based on medical policy.     Provide clinical support to various areas of the organization.  Process requests for clarification, interpretation, or questions about policy or benefits.  Review potential impacts of clinical matters.   Serves as clinical resource and subject matter expert to both clinical and non-clinical staff.   Perform clinical reviews and conduct peer to peers.   Participate in JUMP committee meetings.   " Qualifications " Doctorate from an accredited school of medicine (M.D.) or osteopathy (D.O) required.   Seven (7)...

Our "Continuous Opening" opportunity is designed to help our talent acquisition team continue building a pipeline with outstanding candidates for future opportunities. While this is not an active opening at this time, we are open to connecting with qualified talent. The Opportunity At M3, our Client Executives offer advice and advocacy that instills confidence in our clients to manage risk and fuel growth within their organizations. In this role, you'll be at the forefront of prospecting, soliciting, quoting, and closing new commercial insurance accounts. But that's not all – you'll also play a crucial role in nurturing and advising our existing clients. Working closely with our Sales Leadership, you'll set and strive towards specific sales goals and service standards, ensuring excellence every step of the way. The ideal candidate will have a strong understanding of insurance policies and coverages, the ability to identify and prospect potential clients, build...