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Job Title: | Medicare-Sr Health Business Analyst |
Company: | Florida Blue |
Experience: | 4+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Develop analysis and provide insights, analysis and reports. Accountable for identifying and quantifying key drivers for the Health Business, investigating areas of opportunity, evaluating effectiveness and making recommendations. The Senior Health Business Analyst is relied upon to apply business knowledge to Analytics projects and provide value added insights to directl… | |
Job Title: | Analyst IV Business Support |
Company: | Florida Blue |
Experience: | 4+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
will include a full range of activities from leading small to mid level projects to complex projects related to operational functions Participate on or lead larger, more complex departmental and/or divisional projects. Plan, organize, monitor and control projects to ensure the effective use of resources and adherence to project management standards and reporting requiremen… | |
Job Title: | Medicare-Pre-Serv Medical Review RN |
Company: | Florida Blue |
Experience: | 3+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
This position serves as Florida Blue Medicare’s clinical expert in working with providers, facilities and subscribers in overseeing the well being of subscribers while ensuring the proper administration of benefits, cost effectiveness, and the coordination of the delivery of quality care. What Will You Be Doing Review and resolve complex processing issues and utilization … | |
Job Title: | FL Blue Medicare- Community Health Associate |
Company: | Florida Blue |
Experience: | 2+ years |
Employment Type: | Full Time |
Job Location: | Miami, FL |
Florida Blue Medicare is a technology leveraged health plan. However, we will never abandon our commitment to human contact and service. We embrace meeting members where they are and that may not be electronically. To meet that commitment, Florida Blue Medicare has developed a Field Based Community Health Program (CHP). The purpose of the CHP is to provide member and fami… | |
Job Title: | IT CMS Business Systems Analyst (Remote) |
Company: | Florida Blue |
Experience: | 3+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
We are interested in every qualified applicant who is eligible to work remotely in the United States.However, we are not able to sponsor VISAs. Are you an IT CMS Business Systems Analyst with experience in Web Development and UI Screens ? Are you looking for your next opportunity? If so, consider joining us on our mission of helping our communities achieve better health! … | |
Job Title: | Retail Sales Consultant (Jacksonville, FL) |
Company: | Florida Blue |
Experience: | 2+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Get To Know US! The Florida Blue Retail Centers are and will continue to become more visible and vital to achieving our market segment objectives to deliver a best in class customer experience, create value for the membership, drive market share and profitable growth, and deliver a differentiated experience to drive long term retention of the membership. Retail Sales Cons… | |
Job Title: | FL Blue Medicare- Medication Adherence Tech. |
Company: | Florida Blue |
Experience: | 2+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
The pharmacy technician is responsible for making phones calls to members to support them with getting their prescriptions refilled. Responsibilities also include identification of medication adherence barriers and assisting with resolution of the identified barrier. The technician will work with the medication adherence team to support achievement of the overall pharmacy… | |
Job Title: | Lead Decision Support Analyst (REMOTE) |
Company: | Florida Blue |
Experience: | 4+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
The Decision Support Analytics team resides within the Health Business’ Enterprise Shared Services (ESS). Decision Support Analytics team members provide analytical and operational support to the core processes of ESS; act as consultants and analytical support for the Enterprise; engage with Information Technology (IT) to define, prototype, and operationalize business sol… | |
Job Title: | Onsite Florida Blue Center Bilingual Customer Advocate |
Company: | Florida Blue |
Experience: | 1+ years |
Employment Type: | Full Time |
Job Location: | Estero, FL |
Get to know us! Florida Blue, a GuideWell Company, has been providing insurance to residents of Florida for 75 years. Driven by its mission of helping people and communities achieve better health, the company serves more than five million healthcare members across the state. We are looking for exceptional people who will bring our mission to life and succeed by putting th… | |
Job Title: | Senior Spark Developer-Remote |
Company: | Florida Blue |
Experience: | 5+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Provides input to technology strategy implementation based on leading edge industry standards, best practices, and comprehensive understanding of business operations. Write code, mostly for new programs, for the most complex system designs and provides consultative guidance on project with extensive size, scope and risk. Write programs that span platforms. Code to and/or … | |
Job Title: | Sr Actuarial Analyst – REMOTE |
Company: | Florida Blue |
Experience: | 2+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
This role is responsible for supporting Actuarial Management What You Will Be Doing Support and analyze activities related to the Direct Pay, Local Group and National Accounts Market Segment and all lines of business Maintenance and improvement of Actuarial analyses such as trend setting, gross margin reporting, and financial forecasting Rate analysis and development Actu… | |
Job Title: | Culture Program Manager (REMOTE) |
Company: | Florida Blue |
Experience: | 4+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
This Program Manager, Culture role is responsible for the implementation, management, and oversight of new and existing culture and change management programs while analyzing the effectiveness of and measuring the business impact and value of the programs. The Program Manager, Culture will partner closely with the Sr Director of Culture and Change Management, Sr Consultan… | |
Job Title: | Senior Consultant, Innovation Venture Design (REMOTE) |
Company: | Florida Blue |
Experience: | 6+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
The Principal or Consultant Program Management Venture Design will work with small multidisciplinary teams through the life cycle of solution focused projects from concept to business hand off. This role will work closely with the initiative lead to and use strong project management skills to drive initiatives through the various stages of development. The Principal or Co… | |
Job Title: | Sales Data Management Consultant – Remote |
Company: | Florida Blue |
Experience: | 3+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Analyzes and documents business and technical requirements, identifies impacted areas, systems and processes, and evaluates alternative solutions Researches and assists in designing solutions for general and project related requests to resolve, policy, system and data related problems Contributes to the creation and review of detailed system requirements and supports the … | |
Job Title: | Specialist V – Product |
Company: | Florida Blue |
Experience: | 5+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Support the Product Management functions by participating in product related initiatives, performing competitive analysis, acting as a SME for specific products, and creating robust presentations. What Will You Be Doing Provide support for competitive assessments, annual portfolio updates, product rationalization, and Go to Market activities for impacted segments. Indepen… | |
Job Title: | Sr IT Spark Developer (Remote) |
Company: | Florida Blue |
Experience: | 5+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
We are interested in every qualified applicant who is eligible to work remotely in the United States.However, we are not able to sponsor VISAs. Are you an Sr. IT Spark Developer with experience in Python ? Are you looking for your next opportunity? If so, consider joining us on our mission of helping our communities achieve better health! What Will be Your Purpose? Senior… | |
Job Title: | Florida Blue – Sr. Consultant Business Capability |
Company: | Florida Blue |
Experience: | 6+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
The business lead spearheads communication and digital activities across the enterprise for internal clients and business units to ensure alignment with the enterprise strategy and the delivery of differentiating initiatives, products and services for our customers. As a business lead, the role holder will be the face to a function or business unit and ultimately own the … | |
Job Title: | Local Market Leader South – Palm Beach/Treasure Coast |
Company: | Florida Blue |
Experience: | 7+ years |
Employment Type: | Full Time |
Job Location: | West Palm Beach, FL |
The Market Leader, as part of the local presence team, is accountable for developing, leading, and executing Florida Blue’s local strategy in the assigned sub region. This strategy includes the local execution of analytics, products, sales, provider networks, Care Programs, the optimized coordination of local GuideWell assets, as well as local marketing and community rela… | |
Job Title: | Sr Health Business Analyst – Commercial Analytics |
Company: | Florida Blue |
Experience: | 4 years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
As a Senior Analyst you will lead a diverse range of analytical projects within Commercial Markets Analytics. Our Analytics Department supports many key functional areas across the organization including Actuarial, Care Management, HEDIS, Network Management, Value based Contracting, Provider Performance, Risk Adjustment, the Federal Employee Program and more, requiring th… | |
Job Title: | Health Business Analyst – Commercial Analytics |
Company: | Florida Blue |
Experience: | 2 to 4 years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
As an Analyst you will support a diverse range of projects within Commercial Markets Analytics. You will be accountable for identifying and quantifying key drivers for the Health Business, investigating areas of opportunity, creating reports, evaluating effectiveness, and making recommendations. Our Analytics Department supports many key functional areas across the organi… | |
Job Title: | Data Scientist – Commercial Analytics (Remote) |
Company: | Florida Blue |
Experience: | 3+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Data Scientists produce innovative solutions driven by exploratory data analysis from complex and high dimensional datasets. Apply knowledge of statistics, data modeling, machine learning and advanced mathematics to recognize patterns, identify opportunities, pose business questions, and make valuable discoveries. Use a flexible, analytical approach to design, develop, an… | |
Job Title: | Medicare Sales-Sr Issue Management Specialist |
Company: | Florida Blue |
Experience: | 4+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
The primary purpose of this position is to assist Medicare Sales to support dynamic needs and effectively manage the internal and external issues by providing service to build mutually beneficial partnering relationships. What Will You Be Doing Monitors, researches, and resolves internal and external sales issues and inquiries related to Medicare sales, our tools, our pro… | |
Job Title: | Enterprise Third Party Risk Manager (REMOTE) |
Company: | Florida Blue |
Experience: | 6+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
This role serves as a senior level consultant with experience implementing and influencing the adoption of Third Party risk management (TPRM) capabilities. TPRM is a critical function needed to both ensure value creation and management of financial, information security, legal, operational, regulatory/contractual, reputation and strategic risks. The role helps ensure the … | |
Job Title: | Local Market Leader – SW Florida |
Company: | Florida Blue |
Experience: | 7+ years |
Employment Type: | Full Time |
Job Location: | Fort Myers, FL |
The Market Leader as part of the local presence team is accountable for developing, leading, and executing Florida Blue’s Local strategy in the assigned sub region. This strategy includes the local execution of analytics, products, sales, provider networks, Care Programs, the optimized coordination of local GuideWell assets, as well as local marketing and community relati… | |
Job Title: | Enterprise Third Party Risk Analyst (REMOTE) |
Company: | Florida Blue |
Experience: | 4+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
This role serves as an analyst with experience applying broad audit, risk management or consulting techniques. TPRM is a critical function needed to both ensure value creation and management of financial, information security, legal, operational, regulatory/contractual, reputation and strategic risks. The role helps ensure the GuideWell enterprise employs a responsive, ta… | |
Job Title: | Medicare-Data Analytics Consultant |
Company: | Florida Blue |
Experience: | 6+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Develop analysis and provide insights, analysis, and reports. Accountable for identifying and quantifying key drivers for the Health Business, investigating areas of opportunity, evaluating effectiveness and making recommendations. Accountable for assisting leadership in evaluating key business drivers. Utilizing strong analytics, technical and communication skills as wel… | |
Job Title: | Medicare-Vendor Performance Specialist |
Company: | Florida Blue |
Experience: | 5+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
The Vendor Performance Specialist will be responsible for facilitating vendor payment, monitoring vendor spend, and producing vendor program performance reporting. They will provide general support to vendor relationship managers including, but not limited to, monitoring team mailboxes and facilitating issue resolution with internal and external partners. To perform in th… | |
Job Title: | Innovation Venture Design Consultant (REMOTE) |
Company: | Florida Blue |
Experience: | 6+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
The Innovation Consultant, Venture Design will work within a small multidisciplinary team through the life cycle of innovation projects from concept to business hand off. This role will work closely with innovation and client business unit leaders to use strong project management and product management skills to drive initiatives through the various stages of development…. | |
Job Title: | Analyst IV Business Support |
Company: | Florida Blue |
Experience: | 5+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
will include a full range of activities from leading small to mid level projects to complex projects related to operational functions that affect provider satisfaction Assists with requirements gathering, data analysis, trends, and ad hoc reporting Ensure through data analysis that the organization’s programs are consistently administered in compliance with organizational … | |
Job Title: | Florida Blue – Claims Representative III, Remote |
Company: | Florida Blue |
Experience: | 1+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Roles in the Federal Employee Program Claims sub family review and adjudicate claims; determine whether to return, deny or pay claims following policies and procedures; process subrogation, workers’ compensation and other claims where third party liability may exist; recover overpayments, and answer inquiries from other internal departments, insurance adjustors, attorneys… | |
Job Title: | FEP Accountant III (REMOTE) |
Company: | Florida Blue |
Experience: | 3+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Do you have an interest in working in FAR regulated governmental accounting? Do you have a completed undergraduate degree in Accounting or Finance? Have you had experience working in Hyperion from an accounting financial systems perspective? If so, read on and get ready to apply! The FEP Accountant III supports cost reporting and analysis, budgeting, forecasting and admin… | |
Job Title: | Medicare Enrollment Assoc QIP |
Company: | Florida Blue |
Experience: | 2+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
The role of Medicare Enrollment Associate is focused on Medicare and OIG’s requirements for enrollment, disenrollment, reconciliation, maintenance and billing for our Medicare Advantage and Supplement members. It requires Subject Matter Expertise support to current or potential customers and customer support functions (which are defined as members, providers, agents, brok… | |
Job Title: | Medical Review Nurse RN-Remote |
Company: | Florida Blue |
Experience: | 3+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Are YOU ready to expand your nursing career where you can achieve work life balance? If so, read on and get ready to Apply! We offer benefits, work life balance, flexible work arrangements, opportunities for growth and development, and a great place to work across our enterprise. Just think no nights, weekend, or shift work! What will you be doing The incumbent will serve… | |
Job Title: | FEP HEDIS Quality Service Advocate V |
Company: | Florida Blue |
Experience: | 3+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
The FEP HEDIS Quality Service Advocate is a member of the FEP Quality team and will work with internal and external partners on clinical quality improvement initiatives related to FEP HEDIS. The role of a Service Advocate is focused on servicing current FEP Members. The major accountability of this role is conducting FEP member telephonic outreach to assist previously ide… | |
Job Title: | Direct Sales Business Solutions Analyst |
Company: | Florida Blue |
Experience: | 2+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Get to know us! Florida Blue, a GuideWell Company, has been providing insurance to residents of Florida for 75 years. Driven by its mission of helping people and communities achieve better health, the company serves more than five million healthcare members across the state. We are looking for exceptional people who will bring our mission to life and succeed by putting th… | |
Job Title: | Network Management Supervisor |
Company: | Florida Blue |
Experience: | 3+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Get to know us! Florida Blue, a GuideWell Company, has been providing insurance to residents of Florida for 75 years. Driven by its mission of helping people and communities achieve better health, the company serves more than five million healthcare members across the state. We are looking for exceptional people who will bring our mission to life and succeed by putting th… | |
Job Title: | IT Systems Analyst- Remote |
Company: | Florida Blue |
Experience: | 4+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Are you an Software Licensing Analyst with a background in software licensing for enterprise environments? Are you looking for your next opportunity? If so, consider joining us on our mission of helping our communities achieve better health! GetToKnow Us! GuideWelland its family of forward thinking companies are focused on helping people and communities achieve better hea… | |
Job Title: | Medical Director Care Management – Florida Blue Medicare |
Company: | Florida Blue |
Experience: | 5+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
Perform all types of utilization management (UM) reviews, including but not limited to Pre service, Post service, Concurrent Review and Appeals Discuss cases with physician providers (Peer to Peer) Apply health plan review hierarchy to member contracts, CMS National & Local Coverage Determinations, Florida Blue medical policy, clinical guidelines and other approved resour… | |
Job Title: | Principal Corporate Development & Strategic Investments |
Company: | Florida Blue |
Experience: | 7+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
The Principal provides direction and leadership to strategic investments and business development initiatives, including mergers/acquisitions, joint ventures/alliances/ |
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Job Title: | Consultant, Portfolio Strategy and Management (REMOTE) |
Company: | Florida Blue |
Experience: | 6+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
The Consultant of Portfolio Strategy and Management will work closely with Directors and RMs to identify the highest priority opportunities to positively impact experience, business improvement and innovate to create value, drive top and bottom line growth and develop better healthcare solutions to promote more affordable health care. The Consultant will help develop prob… | |
Job Title: | Concurrent Review Nurse RN – Remote |
Company: | Florida Blue |
Experience: | 2+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
You will serve as a point of contact for providers to assist in navigating them through the continuum, educate regarding benefits, identify candidates for Care Programs and provide information pertaining to the network and network access. Evaluate members in the Hospital, Skilled Nursing Facility, LTAC, Acute Inpatient Rehab for benefit determination, medical necessity, a… | |
Job Title: | Case Manager RN – Remote |
Company: | Florida Blue |
Experience: | 2+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
This key position is responsible for assisting members within a geographical (local, statewide and/or other) area make effective health care choices for self management of their acute and /or chronic condition(s). Utilizing a member centric approach they assist members, and their families understand and manage their disease process by reinforcing the physicians’ plan of t… | |
Job Title: | Sr IT Developer (Remote) |
Company: | Florida Blue |
Experience: | 5+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
We are interested in every qualified applicant who is eligible to work remotely in the United States.However, we are not able to sponsor VISAs. Are you an Sr IT Developer with experience in HR and Payroll systems ? Are you looking for your next opportunity? If so, consider joining us on our mission of helping our communities achieve better health! What Will be Your Purpos… | |
Job Title: | Accounts Payable Associate III (Jacksonville, FL Based) |
Company: | Florida Blue |
Experience: | 3+ years |
Employment Type: | Full Time |
Job Location: | Jacksonville, FL |
This Accounting Associate III role resides in Corporate Finance Corporate Payables team and is responsible for accounting related functions of trade payables. This team member interacts with internal and external customers on supplier payment activities and employee travel and business expense reports. Additionally, incumbent will be responsible for analyzing, researching… | |
Job Title: | Onsite Florida Blue Center Bilingual Navigation Nurse (RN) |
Company: | Florida Blue |
Experience: | 1+ years |
Employment Type: | Full Time |
Job Location: | Winter Park, FL |
Get to know us! Florida Blue, a GuideWell Company, has been providing insurance to residents of Florida for 75 years. Driven by its mission of helping people and communities achieve better health, the company serves more than five million healthcare members across the state. We are looking for exceptional people who will bring our mission to life and succeed by putting th… |
About Florida Blue:
Advancing health has always been at the center of our story. From the critical coverage that delivers peace of mind to the full breadth of health solutions that care for every aspect of your well-being, you can rest assured that Florida Blue is always looking out for you, your family and your community as we have done for more than 75 years.
We are so much more than an insurer. We’re your health partner, working to lower your costs, make your benefits easy to access and providing you with a broad range of health services that include traditional medical care, mental well-being, preventive care and so much more. As a policyholder-owned not-for-profit, we invest resources to keep health care costs lower and work hard to ensure as many people as possible have access to high-quality, affordable and equitable care.
We’re always working, always investing and always advancing toward a better state of health.
Visit Florida Blue’s Jobs Portal by following this link:
http://careers.floridablue.com/us/en/search-results