Jobs at Blue Cross of Idaho

Review and adjudicate paper and electronic medical claims, determine payment/denial/return, investigate issues and escalate as needed. Verify claims for errors, apply business rules, policies and contracts, research via web-based systems, follow detailed workflows, and communicate findings clearly in writing and verbally.

Identify and advance strategic client opportunities within targeted segments through research, discovery conversations, consultative selling, and account planning. Build and maintain pipelines, develop proposals and presentations, collaborate with internal teams to align solutions to client needs, maintain CRM records, provide market feedback, and participate in client-facing and industry activities to drive business growth.

Lead design, implementation, and optimization of dbt-based ELT pipelines on Snowflake. Build and maintain dbt Cloud projects, implement CI/CD, enforce testing and data quality, document lineage, mentor teammates, and optimize performance and costs for analytics and downstream use cases.

Lead planning, development, and execution of marketing strategies and campaigns across brands and products. Manage budgets, agency partners, compliance, go-to-market and Medicare-focused initiatives, performance reporting, and cross-functional collaboration to drive brand awareness, acquisition and retention.

Manage client relationships for major/national accounts to achieve membership growth and retention. Handle renewals, benefit design, account implementation, documentation, customer service via phone/email, resolve issues, explain benefits and claims processes, and maintain account administration and reporting.

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.

Lead enterprise transformation by directing a portfolio of strategic initiatives: prioritize intake, govern delivery, modernize execution capabilities, report outcomes to executives, and build change leadership and team capabilities to ensure sustained adoption and measurable business value.

Build and maintain provider relationships to improve risk adjustment performance. Provide education, outreach, and training; perform medical record reviews and coding; analyze provider performance reports; implement improvement plans and ensure regulatory compliance for risk-adjustment programs.

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.

Design, implement, and optimize Snowflake-based data warehouses and pipelines. Build ELT processes using SQL and Python, automate deployments with CI/CD and IaC (Terraform), enforce data governance and security, tune performance and costs, and mentor peers while documenting solutions.

This internship will develop skills in communication, risk assessment, and provider relationship management within the health insurance industry.

Lead enterprise operational performance across claims, customer service, membership, and payment integrity. Own KPI governance, dashboards, quality assurance, compliance monitoring, vendor oversight, and continuous improvement. Drive analytics, predictive modeling, AI/automation adoption, and operational controls to improve quality, efficiency, and member experience. Build and lead a team of analytics, quality, and performance professionals.

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.

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.