Teams at Blue Cross Blue Shield of Arizona

Develops, maintains, and optimizes systems, databases, ETL packages, reports, and interfaces. Writes T-SQL, SSIS, SSRS, and .NET code; troubleshoots EDI; participates in SDLC, testing, project work, documentation, and occasional SCRUM responsibilities.

Review and resolve clinical and insurance inquiries by analyzing medical records, applying medical necessity and benefit criteria, documenting decisions, handling high-volume customer calls/correspondence, collaborating with internal/external stakeholders, and meeting quality, quantity, and timeliness standards while maintaining confidentiality and compliance.

Lead segment-specific cost-of-care efforts by identifying, evaluating, implementing, and monitoring affordability and quality initiatives. Partner with Analytics and cross-functional teams to analyze utilization trends, build business cases, drive value-based partnerships and provider network development, and advise leadership to achieve cost-savings targets.