Independence Blue Cross LLC

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve. The Claim Payment Policy Lead is responsible for generating policy driven innovative medical cost opportunities as well as investigating, reviewing, and applying clinical and/or coding expertise in the development and application of reimbursement or medical policies.   DUTIES AND RESPONSIBILITIES: Lead cross-functional collaborations with key business areas to generate policy driven innovative medical cost savings ideas, validate feasibility, and execute successful implementation. Monitor industry trends, regulatory changes, and reimbursement practices to ensure compliance and alignment with organizational goals. Develop and maintain claim payment policies that reflect nationally...

The Director of Business Solutions is a leadership role responsible for driving end-to-end solution design, delivery, and operational transformation across IBX business functions. This role partners with executive leadership, operations, and technology teams to design scalable solutions, improve operational performance, and enable strategic initiatives across the enterprise. This position: Drives complex initiatives independently and delivers measurable outcomes Navigates ambiguity and leads through transformation Connects business strategy to execution across multiple domains Influences at the executive level while staying close to operational detail Key Responsibilities 1. Strategic Solution Leadership Lead the design and execution of enterprise business solutions aligned to IBX strategic priorities Translate business needs into scalable, cross-functional solutions spanning operations, technology, and vendor ecosystems Identify opportunities to modernize...

The Provider Network Services  Sr. Provider Partnership Associate supports Integrated Delivery Health Systems (IDS) and community providers including but not limited to primary care physicians, specialists, ancillary, behavioral health, and institutional providers in Pennsylvania and Delaware.  Independently researches, analyzes, and addresses provider issues and concerns to achieve expected goals/outcomes within the set timeframes.  Proactively educates providers on new initiatives and policy changes that impact their claims payments, including outreach for UM Vendor Management Programs.  Establishes and maintains professional and effective relationships between IBC and network providers to continually improve provider satisfaction.  Ensures the resolution to issues related to complex claims payment, provider data file maintenance, Quality Incentive Payments (QIPS), capitation, and medical policy.  Maintains and updates the appropriate tracking issues database with current...

We are seeking a Senior Data Insight & Reporting Analyst to support the delivery of data-driven insights and reporting solutions that enable operational decision-making. This role plays a key part in transforming complex data into actionable insights, supporting performance management, and ensuring the integrity of enterprise reporting. Key Responsibilities Data Analysis & Insights Analyze large and complex datasets to identify trends, risks, and opportunities Translate business questions into data-driven insights and recommendations Support operational performance monitoring through ongoing analysis Reporting & Dashboard Development Design, develop, and maintain operational reports and dashboards Ensure reporting solutions are scalable, accurate, and aligned with business needs Enhance existing reporting to improve usability and efficiency Build and maintain visualizations using Tableau Data Quality & Governance Validate data accuracy...

  Our organization is looking for dynamic individuals who love to learn, thrive on innovation, and are open to exploring new ways to achieve our goals.   If this describes you, we want to speak with you. You can help us achieve our vision to lead nationally in innovating equitable whole-person health. At Independence, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve. The Manager of Enrollment Services is responsible for ensuring...

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together, we will achieve our mission to enhance the health and well-being of the people and communities we serve. The Auditor, Payment Integrity role conducts pharmacy claim audits for Independence Blue Cross to ensure accurate provider payments, detect fraud, waste, or abuse, and improve audit processes. It requires a Certified Pharmacy Technician with at least four years of experience, including pharmacy and audit work, strong analytical skills, and proficiency in Microsoft Office and pharmacy claims systems. Conduct audits of claims submitted to Independence Blue Cross (IBX) to ensure accuracy of provider payments and charges. Analyze provider billing patterns to detect potential fraud, waste, or abuse. Perform audits through daily reviews, live audits, and desk audits to identify inappropriate billing...

Bring your drive for excellence, team orientation and customer commitment to AmeriHealth Administrators. Help us renew and reimagine our business and shape the future of health care.  Our organization is looking to diversify, grow, innovate and serve, and we are looking for committed, empowered learning-oriented people to join our team.  If this describes you, we want to speak with you.   In this role, the Associate Account Executive is responsible for the following functions: Assists Sales Representative and Functional Manager in the management of external and internal customer relationships. Assists Sales Representative in the development and execution of sales strategy for each group customer or prospect. Participates in sales meetings, presentations, open enrollments, and site visits to cultivate account relationships Works with Sales Representatives to understand and effectively communicate funding arrangements and stop loss...

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve. Summary The Senior Provider Reimbursement Analyst leads the development, evaluation, and governance of reimbursement methodologies to ensure accurate, compliant, and market-competitive provider payment. This role serves as a subject matter expert, driving complex financial analyses, shaping reimbursement strategy, and influencing contract design and implementation. The position partners closely with Contracting, Actuarial, Configuration, and leadership to support network performance and advance organizational financial objectives. Key Responsibilities ·        Lead complex reimbursement analyses to evaluate payment accuracy, financial impact, and market positioning across provider specialties,...