Jobs at Blue Cross & Blue Shield of Mississippi

Support healthcare actuarial analysis by extracting and cleaning claims data, analyzing pricing, reserves, trends, and healthcare economics, and preparing exhibits and documentation for leadership. Collaborate with analysts and credentialed actuaries on operational activities while applying statistical modeling and maintaining strong communication, organization, accuracy, and time-management standards.

Paid 10–12-week summer internship rotating between Accounting and Internal Audit. Responsibilities include evaluating internal controls, monitoring controls, analyzing vendor contracts and budget variances, preparing financial statements and statutory reports, supporting monthly close, analyzing cash flow, preparing GAAP journal entries, reconciling investments, and learning payment fraud prevention.

Technology interns support IT systems, networks, security protocols, software development, troubleshooting, infrastructure projects, technology research, and process documentation. The 10–12-week paid internship requires enrollment in a relevant bachelor's or master's program, junior standing by Spring 2027, a minimum 3.0 GPA, and foundational knowledge of programming, networking, operating systems, data, or cybersecurity.

Design, develop, deploy, and maintain machine learning and AI solutions for clinical care and business operations. Coordinate the machine learning lifecycle, implement CI/CD and model-training practices, analyze large datasets, create visualizations and leadership reports, document models, and translate technical findings for business stakeholders. Lead cross-functional projects involving clinical leaders, data engineers, developers, and administrative teams.

Manage and maintain provider contracting documentation, network provider directories, and contract templates. Validate provider contract completeness, update provider profiles and location changes, publish GeoAccess and SAS reports, coordinate contract changes and mail-outs, perform credentialing for Disease Specific Pharmacy providers, and back up Provider Service Specialist for provider inquiries.

Provides centralized administrative support, including communications, customer guidance, memo and report preparation, document control, workflow improvement, calendar and meeting coordination, travel arrangements, phone support, expense review, budget maintenance, check requests, and purchase orders.

Answer inbound customer calls, listen empathetically, identify needs, provide solutions or resources, troubleshoot issues, and document accurate notes for follow-up. The role requires strong communication, active listening, computer proficiency across multiple applications, organization, time management, and a customer-focused approach. It is a structured, team-oriented entry-level position with training and opportunities for growth.

Reviews prescription drug prior authorization requests and appeals for coverage and medical necessity. Researches clinical and benefits information, makes objective determinations, consults physician reviewers, communicates decisions to providers and members, and supports pharmacy benefits administration through drug utilization analysis and recommendations.

Serves as the primary account representative for assigned insured groups, supporting Group Leaders, agents, and members throughout their insurance journey. Responsibilities include relationship management, welcome and enrollment meetings, benefit education, inquiry research and resolution, account administration, escalation, and reporting. The role requires strong communication, empathy, presentation skills, Microsoft Office proficiency, and occasional travel.

Reviews medical records, claims, analytical findings, complaints, referrals, and appeals for inappropriate care, utilization, billing, and potential fraud, waste, and abuse. Applies clinical guidelines, provider contracts, benefit plans, medical policies, and coding standards. Consults with medical and legal teams, recommends corrective interventions, and prepares objective, evidence-based audit reports and conclusions.

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

Analyze healthcare costs, risk, pricing, and forecasting by gathering, cleaning and analyzing data, updating actuarial models, and preparing financial and enrollment reports to support corporate decision-making.

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 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.

Implement and maintain provider reimbursement updates, including fee schedules, facility rates, pricing rules, and claims testing. Serve as the subject-matter expert for network reimbursement within the medical claims processing system and act as a technical consultant for reimbursement inquiries. Develop and execute test plans and ensure accurate documentation and communication across projects.

Process and review medical claims accurately and timely using policy guidelines; research correspondence and communicate to resolve claim issues; meet established timeliness and accuracy benchmarks while supporting continuous development and potential career growth within the company.

Develop and enhance on‑site web applications to integrate BCBSMS business systems, prevent technical disruptions, and perform systems and business function analysis. Build/consume REST services, use source control, and follow full development lifecycle processes.

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.

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.