Jobs at Blue Cross of Idaho

Reviews insurance claims to determine approval, denial, or need for further investigation. Applies business rules, policies, and contracts; identifies and escalates issues; and audits existing claims for errors and omissions.

Develops and executes strategic plans for complex healthcare accounts, driving retention, growth, cross-selling, and long-term partnerships. Builds executive relationships, leads consultative benefit discussions, coordinates cross-functional teams, analyzes market and account data, identifies strategic opportunities, and communicates performance, risks, and recommendations to senior leadership. Requires extensive enterprise account management experience, healthcare industry knowledge, underwriting familiarity, and strategic selling capabilities.

The AI Technical Lead designs and delivers scalable AI systems, providing technical leadership, mentoring teams, and ensuring effective deployment of machine learning solutions across the organization.

Investigate and manage member grievances and appeals, ensuring accurate case classification, regulatory compliance, and policy interpretation. Prepare case histories and documentation for committees, audits, and independent specialty review. Determine information needs, apply contract and business rules, and present appeal cases to cross-functional committees. The role requires health industry experience, medical terminology, ICD-10 and CPT knowledge, contract interpretation, and strong communication skills.

Lead the design and implementation of a multi-tenant enterprise data architecture on AWS and Snowflake. Oversee data engineering standards, mentor teams, and ensure efficient data management and integration for business needs.

Designs, develops, maintains, and troubleshoots software systems and infrastructure with emphasis on automation, CI/CD, testing, and operational monitoring. Builds automation tools and scripts, supports deployments, mentors engineers, and follows Agile/SAFe practices.

The VP, Claims & Payment Integrity Operations oversees enterprise strategy and operations for claims and payment integrity, ensuring compliance while driving improvements in accuracy and financial outcomes.

Support the Office of the CIO by analyzing IT processes, governance, and performance; develop metrics and dashboards; manage vendor and financial governance; prepare governance materials; coordinate stakeholders; recommend operational improvements and support change adoption.

Lead art direction and manage a creative services team to produce visual experiences across print, digital, social, web, video, and presentations. Translate brand and marketing strategy into visual storytelling, oversee creative workflows, mentor designers and UX professionals, ensure brand consistency, manage production and asset systems, and improve creative operations.