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

Design, develop, test, implement, and support departmental website using Visual Studio, HTML, ASP, and SQL Server. Partner with others to identify and implement the tools, technologies, applications, and practices used to collect, integrate, analyze, and present data to create insightful and actionable business information; establish interactive visualizations and web bas

Jobs in Provider Solutions provide provider services/network management support to the provider community by serving as a liaison between the provider and the Company on education, reimbursement, administrative/medical policy and non routine provider issues, by supporting network contracting by researching issues that may impact future provider negotiations or jeopardize

Specialists apply discipline specific or institutional knowledge and skills in the performance of departmental activities which support the Company's operations. Specialists typically prepare for their role by earning a post secondary degree in a specific field, obtaining certification, or by on the job training and work experience. Incumbents may directly manage a small

Supports cost reporting and analysis, budgeting, forecasting and administrative cost controllership for the Federal Employee Program (FEP). Provides management with technical reporting, in depth financial analysis, consulting support and resolution of issues for cost accounting, reporting and compliance related to the Federal Employee Program (FEP). What You Will Be Doing

As a Senior Enterprise Competitive Insights Advisor you will lead the data collection and analysis of intelligence, as well as external research efforts, guided by leadership, to collectively understand the overall health care operating environment (competitive, regulatory, financial). You will participate in the development, execution, and communication of competitive re

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, medical policy, clinical guidelines and other approved resources to render timely decisions on medical necessity request

The Medical Review Nurse reviews, authorizes, coordinates, and responds to requests for services for Florida Blue members. This position also communicates telephonically with providers and their offices, and occasionally with members. Makes decisions based on established policies and procedures, Florida Blue medical coverage guidelines, benefits, InterQual criteria, nursi

Retail Sales Interns are critical to delivering on the sales, renewal, retention, and community penetration objectives of the Florida Blue Centers. This internship will entail developing and then demonstrating the knowledge, skills, and competencies of a sales professional through effectively consulting with prospects and existing customers. Sales Interns will also perfor

Retail Sales Interns are critical to delivering on the sales, renewal, retention, and community penetration objectives of the Florida Blue Centers. This internship will entail developing and then demonstrating the knowledge, skills, and competencies of a sales professional through effectively consulting with prospects and existing customers. Sales Interns will also perfor

Specialists apply discipline specific or institutional knowledge and skills in the performance of departmental activities which support the Company's operations. Specialists typically prepare for their role by earning a post secondary degree in a specific field, obtaining certification, or by on the job training and work experience. Incumbents may directly manage a small

Specialists apply discipline specific or institutional knowledge and skills in the performance of departmental activities which support the Company's operations. Specialists typically prepare for their role by earning a post secondary degree in a specific field, obtaining certification, or by on the job training and work experience. Incumbents may directly manage a small

Responsible for ongoing Individual Agent management Responsibilities include the establishment of production goals and compliance thresholds, along with the communication and ongoing enforcement of these established expectations with each assigned agent. Essential Functions The essential functions listed represent the major duties of this role, additional duties may be as

This position will be responsible for reviewing and analyzing Requests for Proposals (RFPs) and preparing health and ancillary quotes.The Mid Group Pre Sale Analyst works closely with the Senior Director of Sales, Mid Group New Sales Executive, brokers and internal business partners to ensure an accurate and competitive Florida Blue quote is generated.This position will w

Retail Sales Interns are critical to delivering on the sales, renewal, retention, and community penetration objectives of the Florida Blue Centers. This internship will entail developing and then demonstrating the knowledge, skills, and competencies of a sales professional through effectively consulting with prospects and existing customers. Sales Interns will also perfor