Work with our business partners to collect and vet requirements for new technology solutions benefitting the lives of our members, providers and employees, while simultaneously improving efficiency and effectiveness of our supported business processes.
Create an environment to allow the team to prosper and grow, hiring quality talent and facilitating career development of the team. Own and improve the new product design processes, including methods, tools and techniques.
The Senior IT Infrastructure Architect develops actionable blueprints, principles, models, designs, standards and guidelines for assigned projects / initiatives to ensure information technology architecture is consistent, usable, secure and adds value to the business.
Provide necessary support to the anti-fraud program which involves conducting reviews of organization or functional activities related to alleged fraud, waste, and abuse perpetrated by providers, members, facilities, pharmacies, and /or groups.
Leads and manages complex initiatives. Acts as a critical liaison with external Florida Blue. Assists with development of the strategic direction, implementing policies and managing initiatives to maximize member Star gap closures.
Design, enablement, and controllership / performance of the Provider Reimbursement Administration Strategy. Ensure the Plan's compliance with HIPAA, Regulatory Agencies, and Enterprise & BCA policies and procedures.
Responsible for ensuring claims are paid according to the provider and member contracts as well as ensuring that standard claims processing guidelines and billing procedures for each type of service and type of provider were followed.
Work with internal and external stakeholders to design proof - of - concepts and beta deployment with minimum viable products to illustrate market traction. Ensure feedback and learning from customers, partners and in - house teams are incorporated into iterative development cycles.
The MS will work with the Media Director to provide insights and input on all facets of the media planning process and buying process, including competitive placements, budget planning, market insights, digital media/social media and traditional media.