Jobs at Blue Cross & Blue Shield of Mississippi

Support corporate compliance by developing and maintaining policies, administering the HIPAA Privacy Program and Privacy Office, managing the Code of Conduct and hotline, administering Ethidex software, performing OFAC/exclusion monitoring, conducting compliance reviews, providing training, and supporting vendor contracting compliance.

Coordinate hospital quality improvement by reviewing KPIs, designing and leading evidence-based projects, ensuring regulatory and accreditation compliance, conducting audits, developing corrective actions, and presenting actionable data to improve provider performance and patient outcomes.

Develops and manages maternal and women's health quality programs, partners with providers and hospitals, analyzes clinical data, documents best-practice guidelines and technical measure specifications, presents performance data to providers, and aligns initiatives with value-based reimbursement models to improve patient outcomes.

The Business Intelligence Developer designs and develops BI applications, conducts data analyses, and implements reporting applications to support business processes.

The Staff Accountant will manage long-term investment accounting, record transactions, reconcile accounts, prepare reports, and support cash management activities.

The Senior Systems Analyst analyzes business requirements, creates technical specifications, develops mainframe applications, and maintains claims applications while providing expert consultative support.

The Treasury Analyst monitors daily cash positions, prepares cash forecasts, executes financial transactions, and submits regulatory reports to support the company's financial needs.

As a Claims & Adjustment Specialist, you'll review and process medical claims, ensure accuracy, conduct research for resolutions, and maintain performance levels while providing quality customer service.

The Marketing & Development Manager drives sales, partners with agents for training and marketing, and ensures retention goals are met.

The Senior Systems Programmer will install and maintain systems software, assist with vendor software integration, and ensure system capacities meet business needs while managing recovery plans and tests.

The Senior Clinical Compliance Auditor reviews clinical data, assesses billing practices, coordinates with the medical team, and prepares findings for corrective actions.

Plan, install, configure, document and maintain network infrastructure (routers, switches, load balancers, firewalls). Ensure high availability/security, support business recovery tests, troubleshoot with vendors and internal teams, and monitor network performance and security.

The Manager of Financial Reporting oversees financial statement accuracy, manages the Financial Reporting area, ensures compliance with GAAP and Statutory guidelines, and leads special projects.

Conduct comprehensive audits of Network Providers for compliance, identify provider fraud, waste, and abuse, and collaborate with teams to implement monitoring controls.

The Senior Internal Auditor examines and evaluates company processes and systems, performs audits, drafts reports, and conducts special projects to enhance efficiency and risk management.

The Senior Actuarial Analyst develops pricing models, analyzes claim trends, prepares financial statements, and updates financial forecasts.

The Chief Actuary develops pricing models, monitors trends, oversees financial reporting, and supports corporate initiatives, requiring extensive experience in health actuarial roles.

The Plan Performance and Quality Reviewer evaluates internal controls ensuring quality outcomes in claims processing and customer service, identifies performance opportunities, and coordinates audits.