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 wellbeing of the people and communities we serve. We are seeking an actuarial professional with a background in Medicare Part D pricing to join our Government Markets team. This role will have meaningful responsibility for the development and ongoing enhancement of Part D pricing models, with increasing ownership over time. Ideal candidates will have handson experience with Medicare Part D bid development or prior pharmacy experience. Key Responsibilities: Design, build, and maintain Part D pricing models to project memberlevel drug utilization, cost sharing, plan liability, and CMS payments. Translate Part D benefit designs, formularies, and CMS rules into detailed model logic. Perform reconciliation of model results to aggregate bid components and financial...

Responsibilities The Workforce Management Supervisor is responsible for leading a team of specialists who manage the realtime performance of the call center through schedule optimization, performance analysis, and intraday adjustments. The supervisor also supports the workforce analyst team, who produce schedules and reporting for the call center. The WFM supervisor is also expected to be able to generate detailed analytics and presentations for business stakeholders related to call center metric data. Key functional responsibility includes the ability to demonstrate a strong understanding of how planning/forecasting staffing requirements translate to a longterm capacity and staffing plans, as well as understanding how shortterm forecasts and optimal agent schedules support multidepartment contact center operations. Key Responsibilities include: • Responsible for managing departmental staff to effectively provide: o Consistent and insightful realtime analysis is provided...

Responsibilities Reviews submitted complex enrollment requests sent via the enrollment queues. Manage reconciliation efforts within Commercial & Medicare membership to ensure that key systems are in sync. Process request according to established productivity goals while maintaining established quality goals. Reviews files to develop best practices for analysis, reconciliation, and resolution. Takes initiative to check questions or unusual situations with management in accordance with established guidelines. Triage validated enrollment discrepancies and documents to the manual enrollment team via One Hub or SNOW, to update a members record as needed. Notifies the Supervisor of trends that will impact internal and external customers. Performs other duties or ad hoc projects as assigned. Must be able to work required overtime as dictated by business needs. Qualifications Education • High School Diploma or College Degree preferred Experience •...

Responsibilities Reviews submitted complex enrollment requests sent via the enrollment queues. Manage reconciliation efforts within Commercial & Medicare membership to ensure that key systems are in sync. Process request according to established productivity goals while maintaining established quality goals. Reviews files to develop best practices for analysis, reconciliation, and resolution. Takes initiative to check questions or unusual situations with management in accordance with established guidelines. Triage validated enrollment discrepancies and documents to the manual enrollment team via One Hub or SNOW, to update a members record as needed. Notifies the Supervisor of trends that will impact internal and external customers. Performs other duties or ad hoc projects as assigned. Must be able to work required overtime as dictated by business needs. Qualifications Education • High School Diploma or College Degree preferred Experience •...

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 wholeperson health. The Quality Coach supports Supervisors and Managers in the Independence Blue Cross Family of Companies contact centers. The Quality Coach role is responsible for the creation and execution of comprehensive integrated coaching and learning strategies with a focus on performance improvement in KPIs and the customer experience. In addition, this role identifies current and leadingedge workplace learning best practices, trends, and infrastructure options and builds strategies that foster a culture of coaching and continuous learning. This includes the professional practice of supporting the development of professionals across the contact centers through direct teaching, coaching, and...

Responsibilities • Effectively supervises team associates, ensuring that productivity and quality standards, attendance policies, corporate training and performance management timelines are being maintained. • Facilitates the required research to resolve internal and external customer issues and problems that are deemed sensitive. • Proactively schedules associates to achieve daily work processing time frames and priorities, tracks problem trends and issues and facilitates solution resolution as required. • Oversees the timely and accurate completion of all member reconciliation activities, ensuring that all new and ongoing member enrollment is completed according to the customer requirements, departmental and corporate objectives. • Maintains and executes daily enrollment task lists, including all SOC 1 and MAR requirements, fallout and error reports, etc. • Ensures all workable inventory is being addressed on a daily basis, and all controls are being maintained....

Role: Quality Business Analyst Description: The Quality Business Analyst collaborates with various business areas to ensure compliance with established metrics, company policies, and procedures. Through auditing, the analyst identifies areas for improvement, system inconsistencies, and training opportunities that enhance operational excellence and support the delivery of highquality service to clients and members. Key Responsibilities: Specific duties include, but are not limited to: Review operational activities endtoend to ensure accuracy and completeness. • Provide timely, documented feedback on issues identified at the processor and/or system level, and initiate escalation procedures when necessary. • Collaborate with business areas to identify improvement opportunities and operational efficiencies. Also responsible for: • Audit operational transactions, including provider, member, and vendor communications, claims, appeals, grievances, enrollment, billing...

Role: Quality Business Analyst Description: The Quality Business Analyst collaborates with various business areas to ensure compliance with established metrics, company policies, and procedures. Through auditing, the analyst identifies areas for improvement, system inconsistencies, and training opportunities that enhance operational excellence and support the delivery of highquality service to clients and members. Key Responsibilities: Specific duties include, but are not limited to: Review operational activities endtoend to ensure accuracy and completeness. • Provide timely, documented feedback on issues identified at the processor and/or system level, and initiate escalation procedures when necessary. • Collaborate with business areas to identify improvement opportunities and operational efficiencies. Also responsible for: • Audit operational transactions, including provider, member, and vendor communications, claims, appeals, grievances, enrollment, billing...

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 wellbeing of the people and communities we serve. Summary: This is a unique, seniorlevel opportunity to partner with the SVP, Chief Information Officer to help navigate the daily complexities, find opportunities, solve challenges, set goals and explore new ideas to the benefit of our organization. The successful candidate will be skilled at performing critical administrative tasks which require the development of internal/external relationships with all levels from staff to executives, strong communication skills, flexible work methods and managing multiple, often overlapping priorities. Need to be able to trust this individual to deal with and safeguard confidential information. Responsibilities: • Plan, organize, and execute meetings for the CIO. Prepare documents...

The Specialty Services Assistant Product Manager will work in a matrix environment supporting Product Managers, Specialty Sales and Vendors to manage and complete projects, develop and maintain reporting, as well as identify and implement process improvements. This position will also support Product Managers with product development and daytoday product management responsibilities. This role also includes supporting initiatives to improve the value proposition of the Specialty portfolio that will ultimately ensure profitability, market growth and customer satisfaction. Recommends streamlines to processes, identifies short and longterm process improvement opportunities, and creates efficiencies to drive implementation of solutions. Partners with subject matter experts in Specialty Services, along with other business areas. Works closely with Specialty vendor partners to ensure smooth product delivery, coordinate and provide reporting, resolve product delivery challenges, and...

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 wholeperson health. The ideal candidate for the Manager Operations role will have a passion for effectively leading and developing a team of associates with the goal of driving operational strategies that support the growth of the business. This job can provide excellent opportunities for growth as the candidate many be required to support varying lines of business. Managing associates in completing department functions and ensuring areas of responsibility are delivering cost effective service in a quality manner by providing prompt, accurate, and professional responses. The successful applicant will have a track record managing in a fastpaced environment where competing priorities must be effectively...

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 wellbeing of the people and communities we serve. The Client Setup Analyst is responsible for setting clients up in the group setup and benefit administration system. This includes new sales, renewal changes, cancellations and maintenance of the client's account setup. The Client Setup Analyst investigates and resolves client setup issues. Role Summary: The Client Setup Analyst is responsible for setting clients up in the group setup and benefit administration system. This includes new sales, renewal changes, cancellations, and maintenance of the client's account setup. The Client Setup Analyst investigates and resolves client setup issues. Key Duties & Responsibilities: Setup groups in the group and benefits administration systems, including medical,...

Elevate how the organization engages clients, consultants, and brokers through compelling presentations, high impact meetings, and tailored engagement strategies. Partner closely with Sales, Account Management, Clinical, Network, and Product teams to craft client specific storylines that clearly articulate the company's value, differentiate offerings, and support growth and retention across new and existing accounts. Drive the ideation and execution of highprofile client events and forums that demonstrate the company's value and role as an industry thought leader. Responsibilities 1. Serve as a strategic advisor and partner to Sales by shaping and governing client specific narratives and storylines that align the company's capabilities, outcomes, and solutions to each client's unique needs, priorities, and challenges. Set standards and direction to sales teams on presentation structure, messaging flow, and data visualization. 2. Managed and oversee the development of high...

The Provider Partnership Associate (PPA) will cultivate and maintain relationships with and provide service to institutional and/or professional providers. Institutional providers include all hospitals, hospital systems, and ancillaries. Professional providers include primary care physicians, specialist physicians and all other credentialed health care professionals. Either an institutional or professional provider may also include the understanding and maintenance of alternative payment arrangements, such as ACOs. Independently researches, analyzes, and addresses provider issues and concerns to achieve expected goals/outcomes within the set timeframes. The PPA will be proactive in providing comprehensive education on new products and networks, instruction on clinical initiatives (ACOs, etc.) and other quality programs, and resolution on matters involving claims and/or payments. MAJOR ACTIVITIES: 1. Performs research and analysis of all provider issues received both...

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 frontend 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 • Serve as a...

Bring your drive for excellence, team orientation, and customer commitment to Independence; help us renew and reimagine our business and shape the future of health care.  The Senior Audit Analyst assists as a senior audit professional responsible for leading external operational audits, managing audit issue resolution and remediation, ensuring compliance with audit standards and policies, serving as a key liaison between auditors and stakeholders, reviewing audit documentation and responses for quality and accuracy, and mentoring junior audit analysts. Serve in a senior role to ensure the timely completion of operational (and some financial) external audit projects in accordance with agreedupon audit criteria, sound audit practices, and the IBC Audit Policy. Develop strategies and discuss with management approaches to resolve audit issues. Ensure all assigned deliverables are completed with the written audit expectations for the external audit project. Address all...

The Provider Network Services Lead 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 statuses...

About the Hiring Department: Government Markets is looking for a Business Analyst Coop to join its Supplemental Program's team. Our department implements and manages retrospective and prospective programs that are designed to improve our Medicare and ACA members' experience with our health plan and the overall health care system to drive Risk Score, Quality and promote comprehensive care. We also support the Performance of the Government Markets division working alongside finance and our providers via Value Based Contract performance. Coop Job Description: The Business Analyst Coop position will report to the Supplemental Programs Manager. They will support the Supplemental Program team and other Stakeholders with various business operations and financial analysis tasks that support eye initiatives and projects. Their focus will be on data analysis, reporting, documentation, and problem solving. They will also oversee vendor activities for both prospective and retrospective...

About the Hiring Department: Corporate Accounting at Independence Blue Cross (IBX) is responsible for ensuring the accuracy, integrity, and timeliness of the company's financial reporting. The department oversees core accounting functions including general ledger, close and consolidation, statutory and GAAP reporting, internal controls, and policy compliance, while supporting strategic initiatives through sound financial analysis. Corporate Accounting partners closely with internal stakeholders to maintain strong financial stewardship and regulatory compliance in support of IBX's mission. Coop Job Description: The Corporate Accounting co‑op supports the accounting team with day‑to‑day financial activities and month‑end close processes. Responsibilities include assisting with general ledger reconciliations, preparing journal entries, supporting financial reporting (GAAP and statutory), and analyzing account variances. The co‑op also helps maintain documentation for internal...