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.
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.
Responsibilities
- Provide outstanding customer service with first call resolution and must maintain excellent relationships with our non-group, group customers as well as brokers and vendors.
- Maintain a high level of quality by entering new individual membership enrollment and all subsequent group and membership changes to the system file.
- Maintain regular contact with other departments across divisional as well as external vendors.
Qualifications
- High school graduate or equivalent with 1-3 years of either office bookkeeping experience, balance sheet account reconciliation, or insurance experience is desired.
- Prior Customer service experience preferred.
- Computer literacy and strong typing skills a necessity.
- Proven ability to multitask, problem solve, and work independently.
- Excellent communication and interpersonal skills, customer-oriented, and patience.
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
- Support a variety of financial functions including but not limited to monthly, quarterly, annual financial statement reporting and analysis for a multi company business structure on both GAAP and STAT basis, cost accounting, budgeting and variance analysis, and tax compliance.
- Conduct and report on a variety of analyses concerning financial and tax-related matters.
- Coordinate annual administrative budget process; prepares monthly actual vs. budget analysis.
- Assist tax consultants in preparation of federal and state tax returns.
Qualifications
- BS degree in Accounting or Finance required.
- Experience with statutory financial reporting desired.
- 5-7 years of experience in accounting including financial analysis, including 3-5 years of financial reporting required.
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.