Current Career Opportunities
Current Openings
Responsibilities:
- Prepare and review all facility, professional, and ancillary provider contracts, amendments and delegation agreements, including negotiating contract terms. Support negotiation of contract terms with providers as necessary.
- Review and interpret state and federal statutes and regulations that impact the provider/payer relationship and contracting process.
- Participate in payment policy development and maintenance.
- As needed, assist with provider-related matters including assistance with litigation discovery, research, or monitoring ongoing developments in the federal or state realm.
- Contribute to the development and maintenance of credentialing, quality, medical, and operational policies as it relates to the provider network.
- Provide accurate and timely legal support to all departments regarding provider contracting issues.
Qualifications:
- J.D. from an accredited law school and member of the Vermont Bar
- 3-5 years practicing law in a law firm or corporate legal department, or an equivalent combination of contracting, health care or insurance expertise and law firm or corporate legal department experience
- Experience working with and negotiating and drafting contracts required.
Responsibilities
- As a storyteller and skilled writer, balance “big picture” thinking with relevant, targeted messaging to reach and motivate target audiences.
- Plan, write, and edit long- and short-form content within required deadlines, carrying the brand voice through a variety of internal and external communications channels, both digital and print.
- Excel as a strong listener, interviewer, and investigator who translates complex business and healthcare information into meaningful and effective content.
- Work closely with organizational leaders and internal partners to develop, implement, and evaluate communications and project plans that support organizational priorities and goals.
- Ensure organizational priorities, initiatives, and updates are clearly communicated in a relevant, timely, and targeted manner.
- Establish evaluative criteria for monitoring the effectiveness of communications activities to help ensure desired results and the appropriate tracking methods.
- Plan and coordinate special projects, events, or other tasks as needed.
Qualifications
- Bachelor’s degree, preferably in communications, journalism, or public relations, or equivalent work experience.
- Minimum of 6+ years of professional writing or journalism experience, preferably with a communications or marketing team or agency. Healthcare industry experience a plus.
- Demonstrated experience writing for a variety of audiences.
- Prior management of complex projects and advising leadership.
- Proven ability to work with clients across all levels of the organization.
- Solid problem-solving and time-management abilities.
- Outstanding verbal and written communication skills.
- Excellent interpersonal and teamwork skills.
If you’re looking to start a career in an ever-changing health insurance industry with best-in-class benefits, competitive pay and clear paths for advancement, we want to speak with you about our Customer Service openings. Candidates will combine high attention to detail with the ability to rapidly master new information, communicate effectively, and resolve intricate issues.
This role requires an 8-week in-person training program at our Berlin, Vermont office. Following training, a 2-3 month, full-time in office period is required. Afterward, employees within 50 miles will transition to a hybrid schedule, working from the office on Wednesdays and remotely the remainder of the week.
Responsibilities
- Provides oversight and direction to the Blue Cross VT pharmacy program, Vermont Blue Rx.
- Functions as the business owner of the overall commercial pharmacy program and provides consultative subject matter expertise for other business owners within the Company.
- Contribute to the overall corporate strategic activities and participate in client engagement activities.
- Responsible for oversight of Blue Cross and Blue Shield’s contracted PBM vendor for the purpose of ensuring contractual compliance, performance evaluation and accurate claims adjudication.
- Responsible for on-going maintenance of current pharmacy benefits and revising and implementing new benefits so that Blue Cross VT maintains a competitive pharmacy benefit offering to its customers.
- Establish best practices for pharmacy customer/member services through ongoing surveys and assessments of constituent satisfaction. Ensure the timely analysis of this information and implementation of appropriate improvements.
Qualifications
- Unrestricted license, either as a Registered Pharmacist (RPh) with advanced clinical pharmacy training, or a Pharm D with clinical residency, required.
- Minimum of ten years' pharmacy program experience partially performed within a health care domain.
- Demonstrated knowledge of Health Plan pharmacy benefit and policy, benefit cost analysis, and account management.
Minimum Qualifications
- Bachelor’s degree or equivalent experience in business administration, communications, or a related field.
- Minimum of 5 years of experience supporting senior executives, preferably at the C-suite level.
- Proven ability to manage complex calendars and coordinate multiple priorities simultaneously.
- Strong written and verbal communication skills.
- Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and virtual meeting platforms.
Preferred Qualifications
- Experience working in a fast-paced corporate environment or nonprofit sector.
- Familiarity with project management tools and software.
- Advanced skills in data organization and presentation design.
- Ability to work independently with minimal supervision and exercise sound judgment.
- Prior experience supporting a President, CEO, or equivalent executive leader.
Responsibilities
- Manage and maintain the President & CEO’s calendar, including scheduling meetings, appointments, and travel arrangements.
- Prepare, review, and edit correspondence, reports, presentations, and other documents on behalf of the CEO.
- Coordinate and facilitate communication between the CEO and board members, executives, clients, and other stakeholders.
- Organize and support executive meetings, including preparing agendas, taking minutes, and following up on action items.
- Handle confidential and sensitive information with the utmost discretion and professionalism.
- Assist with special projects and research as requested by the President & CEO.
- Serve as a gatekeeper, prioritizing inquiries and requests to optimize the CEO’s time and focus.
Responsibilities
- Lead the development of print and digital marketing and communications materials, from concept through completion, and support the production of advertising campaigns.
- Employ “big picture” thinking and proven experience to support the strategic, tactical, creative, and operational facets of marketing, communications, and branding.
- Work regularly with internal subject matter experts, cross-departmental teams, and external vendors, such as designers, photographers, and videographers.
- Monitor and recommend ideas to improve the value, quality, and impact of marketing communications materials and the brand experience for our members, providers, and customers.
Qualifications
- Bachelor’s degree, preferably in marketing, business, or communications.
- Minimum of 5+ years of related experience in marketing communications, preferably for healthcare, health plan, or nonprofit organizations.
- Minimum of 5+ years of writing experience for marketing, advertising, communications, or corporate initiatives.
- Demonstrated experience in comprehensive project management and the creative development of print and digital materials.
- Strong understanding of art direction, print production, list coordination, direct mail processes, digital distribution, and reporting.
- Excellent written and oral communication skills, including and beyond copywriting, editing, and presenting.
- Excellent people skills, with thorough understanding and use of effective interpersonal communication skills.
- Experience with Microsoft Office is required, with preferred experience with Adobe programs.
Responsibilities:
- Provide administrative support services for the medical and payment policy channels.
- Provide the medical and payment policy committees and the Health Care Programs & Medical Coding Analyst with administrative, research, and project coordination to assist the policy teams in developing, implementing, and maintaining corporate policies.
- Drafting and editing policy language, coordinating with internal stakeholders, and managing documentation to ensure policies are consistent, current, and stored by corporate and regulatory standards.
Qualifications:
- Associate’s degree in a business administration or health-related field, or equivalent experience with knowledge of Microsoft Office applications required
- Minimum three years specialized training or experience in healthcare, insurance, or similar setting that demands recurrent research and maintenance of documented policies required.
- Experience in administrative coordination required.
- Medical coding/billing experience preferred.
Responsibilities
- Provide data, reporting, and analytical expertise to strategic teams focused on physician, hospital, and ancillary reimbursement and value-based care initiatives.
- Develop benchmarks; calculate, monitor and track performance, utilize sales data to support informed business decisions, and participate in the decision-making process.
- Prepare financial and utilization models to illustrate the impact of changes to provider reimbursement, contract provisions, medical policies and practices, benefit plans, products, and quality improvement activities.
- Prepare and maintain documentation related to standard operating procedures as well as routine and special projects. Write documentation to describe program development, logic, coding and corrections. Write manuals for users to describe content, definitions, and procedures.
- Participate in meetings with external parties (employer groups, providers, regulators, etc.), develop presentations, and convey information to advance the Plan’s strategic objectives and fulfill the Plan’s obligations.
- Mentor junior staff as required.
Qualifications
- Bachelor’s degree in health care, business, statistics, math or a closely related field required, advanced study desirable.
- Five to seven (5-7) years of closely related experience with one to three (1-3) years of demonstrated independent work required.
- Three to five (3-5) years of managed care and health insurance experience, including experience in reimbursement methodologies, data research and reporting preferred.
- Advanced Microsoft Excel required, and SAS programming knowledge strongly preferred.
Responsibilities:
- Responsible for the overall systems infrastructure including engineering, implementation and integration, and technical services and support.
- Design, implement, install, maintain, and administer infrastructures including hardware, software, and various configurations.
- Monitor overall performance to proactively identify potential issues and tune appropriately
- Perform root cause analysis on failed components and implement corrective measures
- Work with others to establish and improve processes and procedures
- May have sole responsibility for projects and participate in disaster recovery exercises.
Qualifications:
- Bachelor’s degree in computer science or equivalent field, or equivalent experience.
- At least seven (7) years professional experience in information systems and/or network administration with significant network or systems engineering and architectural experience.
- Proven ability to work with infrastructure production support teams and management of external service providers.
- Professionally delivered, information architecture or systems engineering training resulting in industry certification at the network engineer or architect level (e.g., MS Certified Professional).
- Experience within the US healthcare industry is desired.
- Experience with Information Security solutions is desired.
Blue Cross and Blue Shield of Vermont strictly prohibits discrimination against or by any Blue Cross and Blue Shield employee on the basis of race, color, religion, gender, age, national origin, place of birth, sexual orientation, gender identity, ancestry, disability, pregnancy, genetic information or marital status. Blue Cross and Blue Shield will not discriminate against an employee having a positive test result from an HIV related blood test, nor will Blue Cross and Blue Shield request or require an applicant or employee to have an HIV-related test as a condition of employment. Blue Cross and Blue Shield of Vermont will not discriminate against protected veterans.