Teams at Blue Cross of Idaho

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 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.