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Excellus BlueCross BlueShield - Rochester, NY - 9/24/2021
SummaryThis position provides technical assistance to internal and external electronic transaction (web, clearinghouse, etc.) users via telephone, email, and periodically in provider’s office. Additionally it monitors business practices, programming changes, project implementations and electronic transaction processing decisions to ensure that all meet the needs of both internal and external customers.Essential Responsibilities/AccountabilitiesLevel I Interacts with Business Support, IT, Prov...
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Excellus BlueCross BlueShield - Rochester, NY - 9/24/2021
SummaryResponsible for recording financial data and assisting in the preparation and analysis of various financial records and statements used to monitor and measure business activity within the limits of established practices, policies and procedures. Performs assigned basic financial analysis and/or assists in complex financial analysis for supervisory review. Creates models and makes recommendations based on analysis completed. Essential Responsibilities/AccountabilitiesAll Levels: Gathers...
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Excellus BlueCross BlueShield - Rochester, NY - 9/24/2021
Summary:The focus of this role is to ensure prompt, accurate, and efficient servicing of all broker, member and group administrator inquiries for all product lines. Inquiries received by an Account Service Consultant may be via telephone, email, written inquiries, and lobby walk-in customers or through on-site visits with an employer group. The Account Service Consultant maintains constant communication with the Sales staff, operating the BlueCard program and other Health Plan programs, as we...
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Excellus BlueCross BlueShield - Rochester, NY - 9/23/2021
Under the direction of the assigned Safety Net Intake Supervisor, the Intake Specialist receives provider requests for preauthorizations via phone, Care Advance Provider Tool, and fax for inpatient and outpatient procedures, behavioral health and durable medical equipment. The Intake Specialist will also work on project tasks and team efforts as indicated by Management. Essential Responsibilities/Accountabilities Deliver excellent customer centered service while providing information regardin...
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ESL - Rochester, NY - 9/22/2021
Hours: 40 hours Schedule: Monday - Friday to follow branch hours of Monday Thursday 9:00 a.m. – 5:00 p.m., Tuesday Wednesday 9:00 a.m. – 4:00 p.m., and Friday 9:00 a.m. – 6:00 p.m. Must be flexible to meet current and future business needs. Something wonderful happens when you love what you do. So consider a career at ESL. Since 2010, ESL has been consistently ranked one of the Best Workplaces in America by Great Place to Work ®. Great Place to Work and Fortune magazine have recently places E...
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Excellus BlueCross BlueShield - Rochester, NY - 9/22/2021
Summary: This position is responsible for the design and development of curriculum for instructor-led and online learning programs throughout the Enterprise. The Instructional Designer will partner with authors, managers and subject matter experts in curriculum development, course design and material. They will work closely with the curriculum developers and documentation coordinators to maintain learning support resources. Serve as a liaison between Learning Development and all training func...
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Excellus BlueCross BlueShield - Rochester, NY - 9/21/2021
Summary: The incumbent provides support in executing MedAmerica’s short- and long-term strategy in support of strategic development by driving multiple concurrent MedAmerica Project Office quality projects and programs associated with process optimization opportunities within the approved schedule and budget thresholds. In addition, conducts operational process analysis and process improvement identification and recommendations and executes action plans. Anticipates needs and proactively ensu...
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Excellus BlueCross BlueShield - Rochester, NY - 9/21/2021
Summary The Pega Developer is responsible for utilizing agile development methodologies to analyze, develop, and test system solutions in response to business requirements. Incumbents are expected to understand user stories, identify appropriate designs, code to the design specifications, and complete appropriate unit testing to ensure a quality solution delivery. Working with stakeholders across a broad array of IT and business teams through all phases of a project, including requirements-de...
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Excellus BlueCross BlueShield - Rochester, NY - 9/21/2021
Summary Under general supervision, the Actuarial Analyst performs actuarial services in support of Health Plan operations and monitors and maintains financial solvency through the understanding of current data environment and modeling of future events. Interacts with internal and external departments such as Rating Underwriting, Finance, Network Management, Provider Contracting, Health Informatics, Marketing Sales as well as BCBSA, NYSID and CMS. Establishes insurance rates, rating structures...
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Excellus BlueCross BlueShield - Rochester, NY - 9/20/2021
Supports corporate goals and objectives through the strategic planning, development, positioning, promotion of brand, product and service launches, go-to-market campaigns and acquisition, retention and loyalty initiatives for key target audiences. Manages internal and external agency partners for creative development, production, fulfillment and media buying and planning. Responsible for the internal and external oversight, implementation and management of corporate brand standards including ...
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Excellus BlueCross BlueShield - Rochester, NY - 9/20/2021
Talent Acquisition Business Partner: Kevin Leysath Grade: 211 Summary: The Strategic Implementation Leader is responsible for oversight of strategy development with regard to the Information Technology Key Initiatives project management delivery departments. This includes development of policies, procedures, guidelines, metrics, and reporting processes to allow project teams to provide the Senior Leadership Team and project sponsors information to meet goals and objectives. Responsible for co...
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Excellus BlueCross BlueShield - Rochester, NY - 9/20/2021
Summary Are you interested in helping us put our best (online) face forward? We are seeking 2 Java Software developers to expand our teams that build and support our company sites. Our developers design, develop, test, and debug the code that runs our websites and web applications. These roles require a high level of technical expertise and familiarity with both the Java programming language and related technologies such as Portal/Portlets, modern Spring, and relational databases. Our develop...
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Excellus BlueCross BlueShield - Rochester, NY - 9/17/2021
Supports corporate goals and objectives through the strategic planning, development, positioning, promotion of brand, product and service launches, go-to-market campaigns and acquisition, retention and loyalty initiatives for key target audiences. Manages internal and external agency partners for creative development, production, fulfillment and media buying and planning. Responsible for the internal and external oversight, implementation and management of corporate brand standards including ...
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Excellus BlueCross BlueShield - Rochester, NY - 9/15/2021
The Medical Services Care Coordinator is responsible for coordinating, integrating, and monitoring the use of medical and health care services for members, ensuring compliance with internal land external standards set by regulatory and accrediting entities. Refers appropriate cases to the Medical Director for review, identifies billing trends and refers possible medical fraud to the Special Investigations Unit. The Medical Services Care Coordinator may also perform a variety of technical and ...
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ESL - Rochester, NY - 9/14/2021
Hours: 40 Schedule: Monday - Friday 8:00 a.m. - 5:00 p.m. Hours may vary if under a BCDR evaluation. Must be flexible to meet current and future business needs. Primary Accountability Provide guidance and expertise implementing best practices for ESL’s Business Continuity Program. Ensure that all business recovery teams are trained in their respective roles for the broadest possible variety of emergency situations. Principal Accountabilities: Business Continuity Lead Corporate BCP Planning (E...
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ESL - Rochester, NY - 9/14/2021
Hours: 40 hours Schedule: This position requires availability to work the afternoon shift of 2:30 p.m. – 11:00 p.m. Must be flexible to meet current and future business needs. Primary Accountability: Provide support, and response for alarm events, access control, and communications with members, visitors, and vendors at ESL properties. Principle Accountabilities: Monitor and respond as defined in ESL security department procedures to all alarm events, including, intrusion, fire, environmental...
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Excellus BlueCross BlueShield - Rochester, NY - 9/14/2021
The Customer Experience Analyst is a forward thinking, innovative spirited and data driven position. This person should be highly collaborative with excellent verbal, written and interpersonal communication skills and able to build and maintain strong relationships across the organization. This person will provide detailed understanding of the customer experience across all lines of business and channels, by focusing on gathering data, analyzing and reporting to deliver key insights and telli...
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Excellus BlueCross BlueShield - Rochester, NY - 9/14/2021
Summary This position is intended to be part of our flexible workforce, meaning you would be working remotely and coming into the office only as needed. The ERCS Vendor Manager owns the vendor relationship and is accountable for the performance of vendors within the ERCS division and the Health Plan organization. This position supports ERCS by leading the identification and selection of vendors through maintaining industry contacts, directs the RFP process, partners with Finance on the financ...
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ESL - Rochester, NY - 9/13/2021
ESL Federal Credit Union’s rich history begins with roots in the Rochester Housing market. Now 100 years later we’re as committed as ever to providing mortgages to people in our local communities. Now we have a team focused on outside mortgage sales. Be a part of our story. ESL is Easy to Sell Conventional Fixed ARM, Home Possible, 2nd Home, Investment, FHA, Home Buyer’s Dream Program and Portfolio mortgage solutions Now offering VA USDA financing Great Rates and Lower Fees Mortgages are elig...
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Excellus BlueCross BlueShield - Rochester, NY - 9/13/2021
We are hiring an Applications Administrator within our Information Technology Division who will support the EDI (Electronic Data Interchange) Claims portfolio and will play a key role in application monitoring and system operations for the Edifecs platform. A working knowledge of IT Operations, Healthcare and EDI concepts is preferred, prior experience with Edifecs Smart Trading Platform and XEngine software is a significant plus. Essential Responsibilities/Accountabilities: Level I Assists t...
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