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. This Delegation Oversight Specialist RN role involves oversight of delegated activities to ensure compliance with NCQA accreditation standards, CMS, and state regulatory requirements. Ideal candidate will be an excellent communicator (written and verbal) who is detail oriented, organized, able to read and interpret regulations and able to meet tight deadlines while handling multiple audits. Responsibilities: Coordinates, conducts and documents required predelegation assessments and annual NCQA assessments as necessary to comply with applicable state, federal and accreditation requirements, Conducts necessary monitoring and auditing work to ensure vendors comply with state, federal, NCQA and other applicable...

Responsibilities Provide daily/weekly/monthly forecasts and analysis of call volume, average handling time, shrinkage, and other relevant variables for up to 300 associates across several lines of business. Publish schedules for associates and manage schedule exceptions (i.e., shifts, training, vacation, meetings, overtime, offline work, exceptions, etc.) to ensure that daily service level and ASA objectives are met. Provide analysis and trends of forecast data to assist in the ongoing improvement, efficiency, and effectiveness of the organization. Review and analyze intraday segments and daily call volume, AHT and staffing requirements to ensure call volume is aligned to forecast, adjusting as needed. Develop and provide expert reporting and analysis in staffing levels, schedule effectiveness, time bank management, attendance, and training strategies. Monitor all time audits and oversee all edits related to time bank management in the workforce system. Maintain the...

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 Senior Strategy Analyst Reports to the Director of Strategy supports the development of corporate, segment, and functional strategic priorities. This role partners with business leaders and members of the Strategy Office to conduct business analyses, evaluate strategic opportunities, support Board of Directors reporting, and develop insights and recommendations that inform decisionmaking. The Senior Strategy Analyst supports strategic planning efforts through data analysis, benchmarking, business case development, and executivelevel reporting. This role helps assess strategic alternatives, evaluate business impacts, and identify opportunities to improve organizational performance and achieve strategic objectives. This...

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 Behavioral Health Case Manager position functions as a primary clinical resource for members living with behavioralhealth related challenges. The Behavior Health Case Manager collaboratively engages members in strengthsbased approaches in order to facilitate increased understanding of each member's behavioral and physical health needs. Through this process, members gain the...

Description External 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. Associate Research Support Specialist: • Evaluate escalated business incidents to ensure that information provided is complete and displays a clear definition of the issue. • Determine the appropriate assignment group for incident based on incident protocols. • Decide the next steps needed to bring an issue to resolution. • Research the applicable source systems to figure out the nature of the issue. • Identify which business areas need to be engaged to bring the issue to resolution. • Provide clear and complete work notes so users clearly understand the progress and status of every incident. • Ensure a root cause is identified for each issue; the...

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. 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 Provider Claim Recovery Analyst's responsibilities include, but are not limited to: Collaborative interaction with...

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. Job Summary: We are seeking a highly skilled and motivated Senior Research Analyst to join our team. The ideal candidate will have extensive experience working with health care claims and insurance data. This role requires strong technical skills, understanding of statistical methods as well as the ability to collaborate effectively with business stakeholders and understand user needs. Key Responsibilities: Analyze health care claims and insurance data to identify trends, patterns, and insights. Develop reports and implement processes that will support business decisionmaking. Collaborate with business stakeholders in Sales, Product, Care Management and other internal teams to...

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. This position is assigned to the Philadelphia Center City Office . The Associate Account Executive works with the Account Sales Rep, Account Manager, and Functional Management to manage external customer, client, consultant, or broker relationships. Assists in the development and execution of sales strategy for each group customer or prospect. Participates in sales meetings, presentations, and site visits to cultivate account relationships. Ensures all sales and account related issues are addressed. Builds effective relationships with customers, clients, consultants, or brokers in which maximize sales opportunities Participates in sales meetings, presentations, and site visits to cultivate account relationships with Group...

• Reviews ID cards and verifies accuracy. • Confirm benefits on detailed benefit templates. • Updates ID Card templates/formats as needed, based on business direction. • Takes initiative to check questions or unusual situations with management in accordance with established guidelines. • Ensures thorough and timely completion of request for ID cards. • Contacts internal customers about discrepancies and documents for future reference. • Investigates requests from internal customers for special handling, investigation of status of ID cards. • Notifies the Manager of situations that will impact the release of cards. • Handles ID card request received via system, i.e., INSINQ and SNOW from other departments (as backup) • Assists others in responding to and resolving all inquiries in a courteous, professional, and timely manner. • Maintains established quality and quantity production Standards. • Acts as liaison with other business partners and alerts them to...

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. At Independence Blue Cross 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 Lead Configuration Solutions Analyst works on endtoend configuration...

Role Summary This role serves as a trusted strategic partner to the EVP, General Counsel & Corporate Secretary and is responsible for managing executive priorities, corporate governance activities, executive communications, special projects, and the efficient operation of the Office of the General Counsel. The successful candidate will combine exceptional organizational capabilities, independent judgment, project management expertise, and executive presence to support department and enterprise objectives while managing highly confidential matters with discretion. Strategic Executive Support Serve as a trusted strategic partner to the EVP, General Counsel & Corporate Secretary, proactively managing priorities, identifying conflicts, and recommending solutions to optimize executive effectiveness. Anticipate executive needs and independently initiate actions to ensure the efficient use of EVP's time and attention. Track and monitor key action items, commitments,...

Position Summary The Appeals Supervisor oversees day‑to‑day operations of the administrative (nonclinical)appeals. This role ensures timely, accurate, and compliant processing of member and provider administrative appeals in accordance with NCQA standards, contractual obligations, and organizational policies. The Supervisor leads a team responsible for documentation, review, correspondence generation, and workflow coordination nonclinical appeals. The position supports Commercial (PA & NJ), and SelfFunded (Level Care, BCBS Global Solutions (formerly GeoBlue)) products as well as external appeals for Caritas and collaborates closely with regulatory teams, quality, and operational partners to ensure highquality appeal resolution and member experience. Key Responsibilities Leadership & Expertise Provides expertise, guidance, and technical support to the Administrative Appeals team to ensure compliance with NCQA and state requirements and organizational standards....

The Director of Reporting & Analytics is responsible for leading the operational reporting, analytics, and insight generation. This role is accountable for transforming operational data into executive‑ready insights that drive performance improvement, cost containment, and member experience outcomes. This role manages multiple managers and/or senior leads and is responsible for elevating the organization's analytical maturity from reactive reporting to proactive, insight‑driven decision support. This role reports into Operations business area. Key Responsibilities Strategy & Execution Establish and own the multi‑year vision and roadmap for Operations Reporting & Analytics, aligned to operational priorities and transformation initiatives Establish standards for reporting quality, analytical rigor, and insight generation. Advance the organization from reactive reporting to proactive issue and opportunity analytics. Serve as a trusted advisor to senior...

Description Internal 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. Associate Research Support Specialist: • Evaluate escalated business incidents to ensure that information provided is complete and displays a clear definition of the issue. • Determine the appropriate assignment group for incident based on incident protocols. • Decide the next steps needed to bring an issue to resolution. • Research the applicable source systems to figure out the nature of the issue. • Identify which business areas need to be engaged to bring the issue to resolution. • Provide clear and complete work notes so users clearly understand the progress and status of every incident. • Ensure a root cause is identified for each issue; the...

Responsibilities • Responsible for supervising and overseeing team responsible for benefits, medical policy and product operations enablement. Solutions for complex benefit exceptions in FOS and HRP. • Supervises team and implement departmental policies and procedures with all internal and external business partners. • Evaluates projects, mandates, initiatives, capacity plans and efficiency of department and takes actions to assign resources and estimate work effort appropriately. • Responsible for overseeing ticket inventory to ensure timely resolution across client setup teams. • Responsible for identifying trends to improve quality and inform training and DLP needs. • Ability to synthesize data to develop a clear course of action based on information from a variety of sources. • Develop and ensure timely, complete, and accurate responses to business partners. • Collaborate with Operational leaders to identify business process improvement opportunities. •...

About the Department: The Accounts Payable department is responsible for the accurate processing and reconciliation of payments to providers, members, groups, and vendors. Coop Job Description: The Accounts Payable Coop will support daily operations by assisting with inquiries, researching payment issues, and contributing to both recurring tasks and adhoc projects. This role offers handson experience in financial operations and exposure to crossfunctional collaboration. Key responsibilities may include (but are not limited to): • Respond to internal and external customer inquiries via email and inquiry systems. • Research and resolve address discrepancies, update information in the payment system. • Investigate and document returned claims. Support recurring operational tasks and assist with special projects as assigned. Required Skills and Qualifications: The ideal candidate will demonstrate: • Strong analytical and problemsolving abilities • Effective...

Department Overview: The Product Services team supports plan inventory management through the Product Configurator application and related data entry. The department also develops templates for booklet and contract production, contributing to efficient and accurate product documentation. Coop Position Description: The Product Services Coop will primarily support the Product Configurator team during peak periods, with additional responsibilities assisting the Booklet & Contract Development team on automationrelated projects. This role offers exposure to both technical and businessfacing aspects of product configuration and documentation. Key functions and responsibilities of the department include: • Participate in discovery discussions for Change Requests • Translate business discussions into functional specifications • Execute application model changes within the Product Configurator • Perform quality assurance (QA) testing • Support system and data...

About the Hiring Department: Cash Application is responsible for applying both premium and nonpremium payments into the appropriate systems as well as reconciling these payments. Collaboration with Billing, AR, Customer Service, Sales & Marketing is required to ensure there is minimal customer impact. Coop Job Description: The Coop will be assigned recurring job responsibilities as well as adhoc projects and tasks. Some are deadline driven while others require completion by end of day. A trending and analysis project will be assigned to assist with reducing unnecessary inquiries. Projects will be assigned along with a presentation to our business partners on results of research on trends. a { textdecoration: none; color: #464feb; } tr th, tr td { border: 1px solid #e6e6e6; } tr th { backgroundcolor: #f5f5f5; } Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without...

Job Summary The Client Solutions Specialist is responsible for researching, resolving, and tracking client and partner inquiries in a timely, accurate, and professional manner for all Level Care Health Carpenter Funds. This role requires strong attention to detail, effective written and verbal communication, sound judgment, and the ability to manage multiple priorities in a fastpaced healthcare operations environment. A successful candidate will demonstrate initiative, accountability, teamwork, and a processoriented approach while collaborating with internal and external partners to support highquality service delivery. Key Responsibilities • Research, investigate, and resolve daily inquiries accurately and within established department guidelines. • Monitor assigned inquiries from receipt through resolution, ensuring timely followup and clear documentation. • Provide regular status updates on outstanding tasks, open inquiries, and pending followup items via email, internal...