At Blue Cross and Blue Shield of Nebraska, we are a mission-driven organization dedicated to championing the health and well-being of our members and the communities we serve.
Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there’s no greater time for forward-thinking professionals like you to join us in delivering on it! As a member of Team Blue, you’ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.
Candidates applying to this position may be hybrid or remote and can live in one of the following states: Florida, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and Texas.This role is responsible for the configuration and maintenance of business rules/logic in the BCBSNE core processing system for the assigned process team (i.e., Claims, Product & Benefits, Enrollment & Marketing, Provider & Reimbursement, Medical Management, or Finance & Actuary). This role will work collaboratively to develop, enhance, test, troubleshoot and deploy configuration components to production. This position directly contributes to the success of product implementations, claims adjudication, reimbursement methodologies, medical policies, and overall business objectives.
What you'll do:
- Adhere to configuration designs/development and technical documentation while ensuring configuration Standard Operating Procedures and best practices are followed (Modular, Scalable, Reusable).
- Develop, update, and enhance cross functional configuration components on the HealthRules, Source and/or GuidingCare Platform.
- Identify system configuration enhancements to improve efficiency and auto adjudication rates.
- Ensure successful configuration implementations of BCBSNE products onto the HealthRules platform, while ensuring compatibility with system integrations and accomplishing the defined business objective.
- Develop and maintain inter-personal relationships with internal teams and all platform related vendors. (Stakeholders, HealthEdge, 3M, etc.).
- Facilitates recurring sprint activities (Migration, Open Question Time, etc.).
- Knowledge and adherence to the platform metrics that are utilized for enterprise reporting.
- Presenting/creating content for the enterprise through Discoveries/Proof of Concepts.
- Configuration support for additional applications (W3LL, CareFirst, etc.).
- Develop test scenarios and conduct configuration unit testing.
To be considered for this position, you must have:
- 2+ years of configuration experience within HealthRules, Source, or GuidingCare Platform or a similar platform.
- 2+ years of Clinical Systems configuration (EMR, EPIC, Cerner, etc.), Health Informatica experience and/or 4+ years of health insurance experience.
- Experience working in an Agile environment.
- Ability to interact with individuals of varying technical abilities.
- Effective communication skills (written and oral), with experience interacting with all levels of management regarding people, process and technology.
- Knowledge supporting processes related to problem management, incident management and conflict resolution.
- Requires a customer first focus as well as soft skills.
- Ability to adapt to change.
Learn more about what makes BCBSNE such an exceptional place to work by visiting NebraskaBlue.com/Careers.
We strongly believe that diversity of experience, perspective and background will lead to a better workplace for our employees and a better product for our customers and members.
What We Do
To millions of Americans, Blue Cross and Blue Shield symbolizes peace of mind when it's needed most. That’s because, collectively, the Blue Cross and Blue Shield brands represent the largest and most experienced health care benefit companies in the country. At Blue Cross and Blue Shield of Nebraska, our story is all about you – the people we’ve been serving since 1939. As a company born and raised in Nebraska, we believe it’s our responsibility to be an active member of the communities where we live and work alongside our customers. We envision a health care world without confusion that adds more good years to peoples' lives, and we consider it an honor to be there for you when you need us. Thank you for letting us be part of your story. 1939 was the beginning of a long tradition of health care coverage in Nebraska. Blue Cross and Blue Shield of Nebraska is a mid-size Nebraska business whose mission is to lead the way in supporting patient-focused care. We see the future of healthcare as one without confusion that adds more good years to peoples' lives. As a Nebraska-based company, we believe it’s our responsibility to be an active member of the communities in which our customers live and work.
