Jobs at Blue Cross & Blue Shield of Rhode Island

Manage strategy and execution for clinical interoperability capabilities, including CMS-0057 compliance, FHIR data ingestion, Azure-based pipelines, and bi-directional EHR integrations. Translate clinical and technical needs into product requirements, oversee agile backlogs, ensure HIPAA and data governance alignment, and coordinate with engineering, clinical, compliance, EHR vendors, providers, and payer stakeholders. Support risk adjustment, care gap initiatives, adoption, and evolving healthcare interoperability standards.

Leads medium-to-large IT and operational projects through planning, execution, governance, budgeting, risk management, and stakeholder communication. Develops transformation roadmaps integrating technology, business processes, operating models, and change adoption. Coordinates cross-functional teams, suppliers, and partners while ensuring delivery within scope, timeline, budget, compliance, and quality expectations.

Leads the design and delivery of secure healthcare integrations across payer, provider, EHR, HIE, clinical data, FHIR, and external partner platforms. Defines API, messaging, batch, event-driven, and data pipeline patterns; implements FHIR interoperability capabilities; directs clinical data transformation and reconciliation; and oversees testing, monitoring, security, vendor integration, production reliability, and technical documentation. Provides technical direction across engineering, data, architecture, security, infrastructure, and operations teams.

Leads systems analysis and technical requirements definition for complex healthcare insurance systems. Translates business needs into technical specifications, evaluates solutions, maps data sources, reviews vendor designs, and supports system modifications. Provides technical guidance, mentors analysts, leads projects, and advises business partners on technology and process improvements. The role requires expertise in APIs, batch systems, web and client-server applications, healthcare claims platforms, and cloud integrations.

Lead solution and technical architecture for medium-to-high complexity systems. Produce HLDs and design artifacts, evaluate trade-offs, run POCs, enforce enterprise standards, ensure scalability/resilience, mentor junior architects, manage risks/assumptions, and align solutions with business, compliance, and EA principles throughout the project lifecycle.

Lead technical execution of a Salesforce delivery pod across Sales, Service, and Configuration workstreams. Provide hands-on development, architecture guidance, code and config reviews, CI/CD and release management, integration and data migration oversight, production troubleshooting, security and governance adherence, and mentor team members to ensure high-quality agile delivery.

Leads enterprise content strategy and editorial development across consumer, stakeholder, digital, and traditional communications. Translates business priorities into compliant, audience-centered content; establishes editorial standards and governance; oversees web strategy, accessibility, UX, research, legal reviews, and multimedia content. Partners with cross-functional stakeholders to support growth, retention, member experience, brand trust, and operational effectiveness while managing complex editorial projects and mentoring others.

Support actuarial and financial functions for pharmacy benefit programs by analyzing claims, utilization, cost trends, and financial performance. Build statistical and actuarial models for pricing, forecasting, and reserve adequacy. Extract and analyze data from databases, prepare regulatory reports, and participate in projects and departmental initiatives.