Independence Blue Cross LLC

Bring your drive for excellence, team orientation and customer commitment to Independence Blue Cross; 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. Under the direction of a manager and licensed health professionals, the Pre-Cert Specialist processes precertification requests in accordance with established corporate guidelines and in compliance with all state and federal regulations.   Major Activities: Answers incoming telephone calls in a high-volume Call Center environment from members and health care professionals regarding requests for precertification of health services. Verifies member eligibility by accessing multiple eligibility systems Verifies participation status of professional and facility providers, by...

The Sales Delivery & Optimization Specialist provides specialized support to Sales team members and external stakeholders, including clients and broker/consultant partners. The position owns complex front-end processes related to renewals, administrative changes, and new business implementations, ensuring accuracy, timeliness, and client satisfaction at every stage. Responsibilities include full accountability for coordinating account details, finalizing product selections, generating pricing outputs, and driving accurate execution across underwriting, enrollment, billing, and document production. The Specialist actively engages with internal teams and external partners to plan, monitor progress, resolve issues, and implement process improvements. Success in this role requires strong analytical and consultative skills, a commitment to excellence, and the ability to deliver results that enhance operational efficiency and customer experience. Responsibilities ·...

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 Director of Legal Operations is responsible for overseeing the operational, financial, and reporting functions of the legal department. This role manages knowledge systems, communications (including operational reports and newsletters), and drives efficiency in relationships with external law firms, alternative legal service providers, and vendors. The Director will implement strategies to reduce costs, enhance transparency, and strengthen controls. Working closely with department leadership, this position will identify and deploy tools to support legal operations, including testing, training, and ongoing support. The Director will also lead knowledge management initiatives, organize subject matter training, and...

Job Duties    Responsible for the final assessment of credentialing files in preparation for the credentialing determination. Utilizes corporate, state, federal, and accreditation credentialing standards. The Credentialing Quality and Assurance Coordinator assures that routine applications meet all participation and credentialing requirements and that non-routine files are identified and processed to meet all requirements for committee review. Records decisions with appropriate documentation and rationale in the credentialing database. Assures the confidentiality and integrity of all aspects of the Credentialing Quality and Assurance process. Desirable organizational, decision making, written and verbal communication skills.  

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 Talent Management / Employee Relations Specialist provides essential operational and administrative support to Human Resources Business Partners (HRBPs) and Employee Relations (ER) Specialists. This role supports a wide range of human resources activities, including employee relations intake, corrective action tracking, compliance reporting, separations support, and regulatory documentation. The Specialist ensures accuracy, consistency, and adherence to company policies and applicable legal requirements across the organization. Key Responsibilities: Employee Relations & Talent Management Support Serve as the first point of intake for employee performance management and employee relations...

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. Responsibilities: The Strategy Director works closely with senior leadership to develop and execute IHG’s corporate strategy, including multi-year strategic plans and roadmaps. The role plans, analyzes, recommends, and executes organizational strategies and corporate initiatives and operational planning. As an internal consultant, the role helps to ensure strategic initiatives from business units roll up into integrated enterprise strategy and drives collaboration of strategy leads to ensure business strategies line up with enterprise strategy. This includes leading annual processes to coordinate the governance of corporate strategic priorities, providing creative insights to help identify, clarify, and resolve...

Responsible for performing the invoicing, reconciling and maintenance of self-funded customer accounts Perform Self-Funded Billing Account Maintenance, Invoicing, and Cash Application as directed by the Supervisor Participate in continuous process improvements efforts Prepare ACH request forms for automated payment customers Responsible for ensuring the assigned portfolio of customer accounts are maintained and reconciled on a weekly and monthly basis Responsible for reconciling claims data to billing totals, and billing totals to accounting (general ledger) Responsible for cash application at the invoice level for assigned customer accounts Document specific customer issues (over/under payments, setup issues, etc.) Escalate setup and billing issues to appropriate levels of management Coordinate with Corporate Accounting on resolution of general ledger posting error

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. Senior Executive Assistant plays a critical role in navigating day‑to‑day complexities, managing competing priorities, and enabling executive effectiveness in a fast‑paced, highly confidential environment. This is a unique, high‑visibility opportunity to serve as a trusted partner to the Executive Vice President, Chief Strategy and Growth Officer for Independence Health Group, supporting enterprise‑wide Growth, Strategy, Strategic & Project Portfolios, Continuous Improvement, and Transformation across IBX and Family of Companies. The successful candidate will demonstrate exceptional judgement, executive presence, and the ability to build strong relationships across all levels of the organization. This role requires a...

Job Description The Clinical Pharmacist is responsible for executing the daily activities associated with the clinical components of the pharmacy benefit.   This position reviews data, resolves issues and coordinates tasks associated with pharmacy clinical programs. This position also provides clinical support to inter-disciplinary teams to improve healthcare outcomes, ensure patient safety, recommend cost-effective medication strategies, ensure compliance, and coordinate care efficiently and effectively.   Responsibilities ·          Ensure clinically appropriate, cost-effective, and accurate formulary by providing appropriate drug review and formulary placement recommendations. ·          Provide support for formulary maintenance such as but not limited to member, provider, and other external communication. ·          Collaborate with cross-functional teams for various project work. ·          Ensure all regulatory guidelines...

Government Markets is seeking a Data Insight & Reporting Analyst to join the Government Markets Reporting Team. This role is responsible for data analysis and the development of reporting used by the Stars team and Government Markets to support and improve Independence’s CMS Star Ratings. Key Responsibilities: •    Partner with management and department leaders to define business requirements for reporting and analysis •    Analyze and interpret CMS Stars data, including HOS, CAHPS, HEDIS, and Pharmacy measures •    Perform statistical analysis, benchmarking, and quality rating forecasting •    Program evaluation  •    Collaborate with internal and external stakeholders to drive improvements in Star performance •    Develop, maintain, and enhance dashboards, reports, and data extracts  Required Experience •    Bachelor’s degree in Information Systems, Computer Science, Mathematics, Statistics, Public Health, or a related field •    3+ years of data...

The Senior Accountant (Cash and Investment) is responsible for ensuring accurate and timely recording of daily bank activity within the general ledger, maintaining compliance with accounting standards, and meeting all company close and reporting deadlines. ·         Ensures all daily bank activity is recorded systematically or manually in the general ledger. Examine bank transactions to ensure accounting methods are consistent and compliant.   Recommend corrective actions as necessary ·         Ensures all company deadlines are met as it relates to certain general ledger accounts ·         Actively participates in the completion of the monthly, quarterly & annual close processes. This includes monthly journal entries and balance sheet reconciliations ·         Develops non-standard reports or analyses and addresses problematic issues and activities related to general ledger accounts ·         Actively supports all reporting (Management, Statutory, and GAAP) as it...

Employer:                   Independence Blue Cross, LLC Position:                     Manager, Data Engineering Office Location:         Philadelphia, PA   Duties: Lead a team of Data Engineers, Business Systems Analysts, Application Developers, and Testers to support the standards and conventions set by Data Architecture and Data Governance teams in the BTS Enterprise Information Management team. Assign work and work schedules, and monitor the completion of the team’s core duties, responsibilities, assignments, and projects. Identify and establish strategic direction for all matters related to data engineering, data acquisition, extracts, reports, application interfaces and enrichment processes. Abide and enforce corporate and information technology policies. Mentor team member and conduct peer reviews. Demonstrate a solid understanding of the Independence business processes and requirements. Engage with business teams to understand their needs and develop...

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  Quality Business Analyst or  blends subject matter expertise, a...

The Supervisor Quality Operations is responsible for overseeing and maintaining high standards of quality in all operational transactions. This role ensures that all processes, transactions, and member interactions comply with regulatory requirements and internal policies. The supervisor leads a team, monitors performance, and implements quality control strategies to drive continuous improvement. Additionally, the supervisor is expected to proactively identify areas for improvement and implement innovative solutions that enhance operational efficiency and member satisfaction. Key Responsibilities: Supervise and guide the quality team in reviewing transactions, documents, and processes for accuracy and compliance. Reassign work based on deadlines and priorities. Escalate staff concerns and issue trends to management. Conduct regular audits, analyze findings, and report results to management, recommending corrective actions when necessary. Train staff on systems and...

Seeking strong Business Analyst to support BlueCard daily operations.  This support will assist to move forward resolution of operational challenges, improve current processes and support project management initiatives.  You will work closely with other team members and cross functional teams such as configuration and Account Management to resolve discrepancies and improve claims processing experience for BlueCard members Support the processing team with analysis of claim issues and inquiries. Perform root cause analysis and course correct identified issues for full resolution. Work with other plans to resolve issues for members Research root cause of incorrectly processed claims,  failed DF and RFs.  Provide solution and coordinate with appropriate team members to repair the claim and provide re-education to the processor or submit ticket for system enhancement. Focus on applying technologies to continuously increase claims process improvements with the use of data,...