This role serves as an analyst supporting the execution of the Enterprise Risk Management workplan for the GuideWell Mutual Holdings Corporation. The role supports multiple risk management programs, such as Enterprise Risk Management, Enterprise Business Resiliency, and Enterprise Third Party Risk Management. This role will enable the proactive identification, assessment,

Coordinate with execution teams to add AI capabilities to existing applications, improve operational efficiency and drive innovation within our organization of a multiyear AI technology roadmap Architect services that leverage AI and LLM models and frameworks to solve business problems and improve performance across various domains, and support adoption of those models an

The Sr Director, Risk Adjustment Strategy and Program Management is responsible for leading risk adjustment strategy and related revenue management for Florida Blue Medicare. This individual leads development and implementation of programs and initiatives to improve coding accuracy, including education; retrospective and prospective review processes; vendor reliance; acco

Get to Know Us! The Florida Blue Retail Centers are and will continue to become more visible and vital to achieving our market segment objectives to deliver a best in class customer experience, create value for the membership, drive market share and profitable growth, and deliver a differentiated experience to drive long term retention of the membership. Retail Sales Cons

The Service Advocate IV Network Management is part of a specialized call center who provides education and assistance for contracting, credentialing and Availity issues. This Service Advocate IV role assists the provider in maintenance and directs them on how to request changes to their contract. The position is responsible for providing the group or individual with the t

GuideWell and its family of forward thinking companies are focused on helping people and communities achieve better health and are at the forefront in the transformation of health care. We offer competitive salariesandbenefits, work life balance,flexible work arrangements, opportunities for growth and development, and a great place to workacross our enterprise! What is yo

This role requires on site presence in the Miami, FL area and is not eligible for remote work. What is my Impact? The Community Engagement Advocate is under the direction of the Sr Director of Regional Business Development and working closely with the Market Development Manager. The Community Engagement Advocate will provide administrative and operational support for regi

Get to know us! Florida Blue, a GuideWell Company, has been providing insurance to residents of Florida for 75 years. Driven by its mission of helping people and communities achieve better health, the company serves more than five million healthcare members across the state. We are looking for exceptional people who will bring our mission to life and succeed by putting th

The purpose of this position is to manage all aspects and functions in the Florida Blue Retail Center to ensure that the customer's experience is meaningful, informative, supportive in center encounters that result in high customer satisfaction. Important Information This is a hybrid position with leadership and managerial oversight of 5 locations to include Kissimmee, E.

Retail Member Advisor's primary responsibilities are in the servicing of existing members through issue resolution and product consulting as well as in obtaining new and renewal business. Essential Functions The essential functions listed represent the major duties of this role, additional duties may be assigned. Provide a customer friendly service experience for customer

Understand strategic direction of the business unit and organization and provide guidance to senior management based on subject matter expertise. Represent as the business lead for high profile, high risk, multi million dollar program initiatives such as; Provider Interoperability (~$6M), CMS/ONC Interoperability APIs (~$9M), Availity Strategic Initiatives (~$1M), WebTPA,

Participate in the design and execution of research on various projects ranging from exploratory research to concept validation. Collaborate effectively with interaction and visual designers within the Experience Design team to deliver formative and summative research in cadence with the team's design process. Work on cross functional product teams, partnering closely wit

The Telesales Business Analyst is responsible for providing 3rd party data insights and reporting to the Telesales leadership team and provide peer or leadership support as needed on existing projects. Analysts will understand pain points, identify gaps in channel performance, and execute process improvement initiatives to support increased sales conversion rates and impr

Serve as a liaison between internal clients and functional departments; help clients achieve their objectives by serving as a resource in the interpretation, application and compliance with internal and external laws, regulations, policies, procedures, standards, and practices. Identify risks, evaluate controls, and prepare findings and recommendations. Implement complian

Retail Member Advisor's primary responsibilities are in the servicing of existing members through issue resolution and product consulting as well as in obtaining new and renewal business. Essential Functions The essential functions listed represent the major duties of this role, additional duties may be assigned. Provide a customer friendly service experience for customer