Jobs at BSC Industries, Inc.

Perform and oversee utilization management delegation audits (pre-delegation, annual, follow-up), track/report delegated entity compliance, write corrective action plans, educate vendors, and support regulatory audits and reporting to ensure UM delegation oversight and compliance.

Lead product and technical strategy for a commissions platform integrating SAP and Informatica. Define roadmaps, design integrations and reconciliation, drive CI/CD and observability, mentor teams, ensure security/compliance, and coordinate incident response and performance tuning to deliver enterprise solutions.

Develop actuarial models and analyses to support provider contract negotiations, pricing, reserving, forecasting, and benchmarking. Use statistical and machine learning methods with R/Python/SQL/SAS, prepare executive presentations, and collaborate across teams to inform financial and provider reimbursement strategies.

Lead WFM forecasting, modeling, and performance tracking for HQA. Provide complex data analysis, capacity planning, process improvement, coaching, and reporting to optimize staffing and productivity across channels.

Lead advanced threat detection, threat hunting, and incident response using SIEM, EDR, SOAR, and network tools. Perform tier-3 containment, RCA, lessons learned, and produce NIST 800-53 compliance evidence. Develop incident response plans, procedures, and coordinate SIRT communications.

Lead ASO product modernization: translate employer, broker, member, operational, and market needs into prioritized capabilities, measurable outcomes, and roadmaps. Drive portfolio strategy, benefit design, billing modernization, data/vendor integrations, and cross-functional implementation readiness to enable profitable self-funded growth.

Lead end-to-end development of broker- and employer-facing content across print and digital channels. Partner with creative, marketing, sales, and subject-matter experts to translate complex benefits and capabilities into clear, compliant, data-informed messaging. Manage multiple projects, maintain updated content in CMS and other platforms, use metrics and AI tools to optimize materials, and present work to stakeholders.

Serve as strategic service partner for a portfolio of high-tech employer clients: retain business, resolve complex issues, support onboarding, lead enrollment and education, build presentations, create scalable service models, and coordinate cross-functionally to enhance client experience.

Design, develop, and deploy secure cloud-native applications on Azure. Build and maintain CI/CD pipelines, infrastructure-as-code, automated testing, and monitoring. Implement DevSecOps practices, support high-volume APIs and integrations, and collaborate with cross-functional teams to ensure scalable, production-ready solutions.

Lead and manage pharmacy finance programs: prioritize and track billable work, validate vendor invoices, reconcile financial forecasts, track credits, create integrated program plans, run stakeholder meetings, and support Pharmacy Strategy and Operations with process implementation and reporting.

Lead actuarial subject matter expert designing pay-for-value programs, performing pricing, reserving, forecasting, risk assessment, and predictive analytics. Partner cross-functionally to model financial impact, develop decision-support tools and dashboards, guide junior staff, and translate complex actuarial findings into strategic recommendations to support implementation and provider payment strategies.

Lead a small actuarial team to design and evaluate value-based payment models, pricing, forecasting, reserves, and provider reimbursement strategies. Perform advanced analytics using Python, SQL, SAS, Excel and machine learning, develop executive reporting and dashboards, drive cross-functional initiatives, and advise senior leadership on strategic, financial, and operational decisions.

Lead Medi‑Cal financial compliance, delegated provider oversight, regulatory interpretation, and audit readiness. Evaluate regulatory impacts, advise senior leadership, drive process and policy improvements, partner across departments, and represent the organization with external stakeholders to strengthen financial controls and reporting.

Lead and execute monthly close, maintain the general ledger, review journal entries and reconciliations, resolve complex GAAP issues, prepare financial statements and disclosures, support audits, implement accounting policies and controls, coach staff, and improve accounting processes to ensure accurate, audit-ready reporting.

Provide advanced nutrition expertise and medical nutrition therapy for complex, high-risk members. Assess needs, develop and implement dietary care plans, counsel members and families, coordinate with physicians and multidisciplinary teams, apply evidence-based guidelines for chronic disease management, and support care management initiatives and pilots.

Lead actuarial pricing and forecasting for large fully insured groups using statistical and machine learning techniques. Develop and audit pricing analyses, customize group pricing, prepare financial reporting, and partner with Rating Systems and Underwriting to implement actuarially sound pricing solutions.

Manage and respond to regulatory agency and executive-level complaints and inquiries. Prepare detailed file summaries, research member/provider timelines and claims data, gather missing information from third parties, and resolve complex, high-impact grievances and appeals while meeting compliance, quality, and production metrics.

Manage a team to perform subsidiary and affiliated entity accounting, month-end close, reconciliations, intercompany activity, and audit support. Ensure accurate US GAAP financial reporting, drive controls and process improvements, partner with Finance/Tax/Treasury, and support reporting deliverables and system enhancements.

Provide fraud subject-matter expertise to internal audit: identify fraud risks, perform proactive detection using data analysis, advise on controls, support investigations, develop detection logic and monitoring, collaborate with stakeholders, and produce executive-ready findings and remediation recommendations.

Lead sourcing strategy and execution for IT procurement: advise stakeholders, analyze supply market, run RFx/competitive bids, manage supplier onboarding and risk, promote supplier diversity, and negotiate complex technology contracts ($5M–$100M+). Partner with Legal, Security, Finance and drive TCO/BATNA strategies to reduce cycle time and risk.