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

Consultants are seasoned, subject matter experts who apply specialized knowledge, typically as an individual contributor, in matters that require special interpretation or expertise. Incumbents use their discipline specific and/or institutional knowledge to perform department activities. They participate in and/or lead critical, high risk, complex initiatives, programs an

Performs medical record validation audits and interpretation of medical documentation to ensure capture of all relevant coding based on CMS Hierarchical Condition Categories (HCC) conditions that are applicable to Medicare Risk Adjustment reimbursement initiatives. Performs risk adjustment validation audits using external Electronic Medical Records (EMR) system access. Pe

The Onsite Account Executive is responsible for managing and directing the front line relationship with the client including, but not limited to, key decision makers HR leadership, distributors (brokers), and C level partners, and internal staff delivering the total healthcare benefit solution. They are responsible for managing the relationship, performing analysis and as

The Cybersecurity Endpoint Protection Manager is accountable for communicating, planning and providing leadership to their assigned team. Cybersecurity Managers provide direction to project and functional resources within and outside their reporting structure, gather, support and develop the resources needed to execute the plan, champion the tactical direction of work and

Retail Member Advisor's primary responsibilities are in the servicing of existing members through issue resolution and product consulting as well as in obtaining new and renewal business. Essential Functions The essential functions listed represent the major duties of this role, additional duties may be assigned. Provide a customer friendly service experience for customer

This position manages SIU staff who are responsible for complaint or case investigations involving fraud, waste and abuse allegations which are moderate to complex. This position will involve oversight functions to ensure appropriate regulatory and compliance requirements are met and high quality outcomes are achieved. Included in responsibilities are mentoring and develo

Understand strategic direction of the business unit and organization and provide guidance to senior management based on subject matter expertise. Represent as the business lead for high profile, high risk, multi million dollar program initiatives such as; Provider Interoperability (~$6M), CMS/ONC Interoperability APIs (~$9M), Availity Strategic Initiatives (~$1M), WebTPA,

The Sr Director Sales Distribution & Channel Strategy is a critical leadership role serving as the primary lead driving distribution strategy and channel performance for all distribution channels that support GuideWell Commercial Markets. This role is responsible for defining the key requirements to achieve various market objectives while managing channel conflict and ens

The position of Sourcing Specialist requires talented, experienced, professionals with good business acumen, legal acuity, product knowledge, project management and organization skills. These skills, combined with a suite of competencies designed to successfully navigate the enterprise and vendor community, are necessary to produce well constructed, mid complexity solutio

Senior IT Developer Jacksonville, Florida Job Duties Performing software application development; Developing, programming and coding of Information Technology solutions; Documenting detailed specifications; Participating in unit testing and maintaining of planned and unplanned internally developed applications; Evaluating and performance testing of purchased products; Inc

Independently and autonomously leads and executes on contracting activities for Value Based Programs (including but not limited to negotiation, implementation, contracting campaigns, data delivery, redlining, appeals, contract loads, etc.). Independently support and decision creation of contractual language changes, necessary legal documents, amendments, letters, proposal

Manage system/application environment, configuration, policy and required operational activities on assigned technical security solutions Research, evaluation, validation and recommendation of technical security solutions while assisting with Build, Test, and Implementing for the enterprise and its subsidiaries Coordinates with product vendors and service providers suppor

Associate IT Developers are responsible for development, programming, coding of Information Technology solutions. Associate IT Developers are responsible for documenting detailed system specifications, participation in unit testing and maintenance of planned and unplanned internally developed applications, evaluation and performance testing of purchased products. What are

What can a Retail Sale's intern at Florida Blue expect? SALES OPERATIONS Provide consultative sales and service experience for customers seeking information and education on available products to support health, wellness, and income protection. Use web based tools and sales systems to analyze prospective customer needs and match to appropriate company products and service