Current Career Opportunities

Responsibilities:

• Complete a training program comprised of mentoring and on-the-job training that provides the Representative with the technical knowledge, analytical, and Customer Service skills needed to accurately process prior authorizations and other authorizations and requirements. 
• Provide accurate, prompt, and courteous responses to phone and written inquiries and to consistently provide outstanding customer service. Examples of such inquiries include, but are not limited to prior authorization questions and requirements, authorization issues such as requests or status checks, and initiating next steps for denied authorizations, underwriting guidelines, and internal policies and procedures.
• Contribute to excellent customer satisfaction by providing information and initiating appropriate corrective actions to resolve inquiries based on a comprehensive understanding of BCBSVT contracts, policies, systems, and procedures.

Qualifications:

• High school graduate or equivalent required. 
• Analytical and critical thinking skills required.
• Computer literacy and strong typing and spelling skills required. 
• One to two years of successful customer service experience, preferably in a health insurance or health care setting is desired.
• The ability to multitask, problem solve, and work independently is necessary.

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Responsibilities:

• Maintain a high level of quality by entering new individual membership enrollment and all subsequent group and membership changes to the system files
• Provide outstanding customer service with first call resolution and must maintain excellent relationships with our non-group, group customers as well as brokers and vendors
• Maintain regular contact with other departments across divisional as well as external vendors

Qualifications:

• High school graduate or equivalent with 1 – 3 years of either office bookkeeping experience, balance sheet account reconciliation, or insurance experience is desired
• Computer literacy and strong typing skills required
• Proven ability to multitask, problem solve, and work independently.
• Excellent communication and interpersonal skills, customer-oriented, and patient 

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Responsibilities:

• Serve as the strategic and relationship wellness interface with large group clients for the purpose of strategy development, solution discovery, service management, risk management and relationship management.
• Combine in-depth knowledge of population outcomes results, insurance business, wellness industry best practices, client relationship management, process improvement and current and planned business models to devise solution strategies. 
• Direct strategic activities as required by client, such as: environmental and conceptual assessment, market segmentation and targeted sales and account management strategies, competitive analysis and gap identification, product development and enhancement, marketing campaign design and development, new systems and processes design, vendor procurement and relationship management, and lessons learned facilitation and reporting.
• Manage health and wellness employer reporting process. Integrate population outcomes data and client-specific data as needed to develop, adjust, consult, explain, and optimize group outcomes and participation in wellness initiatives.
• Oversee needs assessments and on-going analysis of accounts to identify requirements for new product development and enhancements of existing programs.  Exercise creativity and resourcefulness in meeting client and policy maker needs. 
• Collaborate with sales teams to design sales and broker strategies to expand market share and support business development events.

Qualifications:.  

• Requires a bachelor's degree in a related area with certification(s) in wellness or similar areas required.
• Three to five years of experience in wellness management in an employer, healthcare, or insurance setting.
• Three to five years of account management experience in serving employer groups.

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Responsibilities

• Manage the day-to-day operations of the help desk team including the distribution of workload, tracking workload, and evaluating team member performance
• Oversee team productivity, training, and evaluation of the help desk operations to inform improvements to ensure high-quality technical support and enhance customer satisfaction
• Ensure service requests and incidents are handled timely, accurately, and requests are escalated according to defined standards
• Establish, maintain, and improve technology guidelines, operating procedures, and support documentation incorporating best practices throughout the entire technical support process in collaboration with the Director, Infrastructure Operations, and other applicable internal technical teams
• Establish specific customer service standards for help desk performance in collaboration with the Director, Infrastructure Operations, to optimize and support relations and perceptions between the help desk and company employees
• Recruit, train, mentor, and coach help desk team members with the goal of building a dynamic, high-functioning team and providing world-class customer service
• Assess the effectiveness of the help desk technical support process, seek improvements on existing procedures and provide recommendations on areas to improve to the Director, Infrastructure Operations

Qualifications

• BS in Computer Science, Information technology, or related field. Five years related work in lieu of a bachelor’s degree
• 3+ years of leadership experience in customer service, call center, or IT Help Desk environment
• 6+ years of experience working with desktops, laptops, printers, mobile devices, and related software
• Must be flexible in working hours, travel, and work environments
• Certifications such as ITIL v4, CompTIA A+, and Network +, desirable
• Experience/familiarity with the following hardware and software, desired: FreshService (or similar IT Service Management software), VMware vSphere, VMware Horizon View, Windows 10/11/Server, M365/Office, HP laptops, Azure, and healthcare market software products and healthcare communication standards (e.g., DICOM, HL7, IHE). BA
• Experience developing Knowledge-based authentication (KBA) and other relevant procedures, Service Level Agreements, and help desk metrics

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Responsibilities:

• Serve as a communication thought leader, proposing and delivering new ideas to better serve our members, employees, and customers.
• Lead a team of communicators to successfully develop and implement an annual communications strategy and manage the brand in all communications.
• Work closely with other departmental and organizational leaders to ensure the delivery of communications is successful and engaging.
• As an excellent writer and editor, develop content strategies and operate with a creative problem-solving approach and a consultancy mindset. 

Qualifications:

• Bachelor’s degree, preferably in Communications or Journalism
• Minimum of 8+ years of related experience in communications planning and development, including digital services and writing. Health insurance or ad agency experience a plus.
• Minimum of 4+ years of branding experience.
• Ability to move multiple projects forward simultaneously while retaining attention to detail and delivering high quality work.
• Desire and ability to continuously evaluate and improve upon current processes. 

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Responsibilities:

• Oversee maintenance of medical coding changes in our Payment Integrity programs
• Research requests using multiple systems (including: Sales Force, Jira, NPS) to provide all available details to reviewer
• Use Sales Force, Jira, and NASCO claim systems, to perform functions such as initial claim review, outcome reporting, and distribution based on triage 
• Correspond with providers regarding decisions about requested services and obtain medical records when necessary
• Review and respond to issues and questions from internal and external customers, both verbally and in writing
• Work collaboratively with other departments to obtain additional information to resolve inquiries      

Qualifications:

• Bachelor’s degree, or equivalent combination of education and experience, with a minimum of 3 years’ experience in medical coding; In-depth knowledge of CPT, ICD-9, ICD-10, HCPCS, DRG diagnosis and procedure coding
• Formal coding certification (eg: CPC, AAPC) is a must
• Experience with both professional and facility claims coding and in APC, HIPPS, or RUG coding and validation

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Responsibilities:

• Work closely with the Vice President of Consumer Services and Planning, Executive Management, and leaders across the organization in supporting the strategic planning process by coordinating and organizing the work that results in developing an approved strategic plan and budget.
• Provide support for the Strategic Plan and work with senior leadership team on content and presentations for the CEO and the Board, including gathering relevant data and preparing presentations to leadership and the Board.
• Gather strategic planning documentation from across the organization, coordinate the strategic planning process and support the development of a comprehensive written strategic plan with clear objectives and goals. Gather competitor intelligence to inform strategic plans. 
• Monitor and analyze key performance metrics to assess the effectiveness of strategic initiatives and identify areas for improvement.
• Align strategic planning cycle with budgeting and goal setting process.

Qualifications:.  

• Master’s degree in Business, Finance, Public Administration or Public Health, or equivalent experience 
• 7-10 years of experience in strategic planning or similar experience required 
• Excellent written communication, editing, and presentation skills
• Experience in health insurance industry or healthcare industry preferred

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