Blue Cross and Blue Shield of Nebraska (BCBSNE) Jobs | Check Latest Current BCBSNE Jobs in USA

BCBSNE Jobs 2024 Consultant,Manager and Various Jobs In United State. Current BCBSNE Vacancies 2024. BCBSNE USA government Jobs 2024. BCBSNE Recruitment Portal for Jobs in Omaha. Latest Blue Cross and Blue Shield of Nebraska Jobs in USA.

BCBSNE Jobs 2024 in Omaha Apply

For Consultant,Manager and Various Job Opportunities

BCBSNE USA Jobs 2024:- If you are looking for job opportunities in Omaha 2024, then there are various BCBSNE vacancies that you can explore. Blue Cross and Blue Shield of Nebraska Omaha offers many emplaoyment opportunities for candidates seeking rewarding careers and personal growth. BCBSNE recruitment post on Blue Cross and Blue Shield of Nebraska job portal presents various vacancies for people from United State. In this article, we will talk about the perspective of BCBSNE vacancies, highlight the BCBSNE job employment prospects and career growth opportunities in the country.

The BCBSNE USA conducts regular recruitment drives to identify and select best candidates who possess the necessary skills, and commitment to serve in the United State. The Blue Cross and Blue Shield of Nebraska recruitment process typically involves several stages. Prospective candidates are required to fill out an BCBSNE application form provided by the Blue Cross and Blue Shield of Nebraska. This BCBSNE Application Form collects personal information, educational qualifications, and other relevant details.

BCBSNE Jobs 2024 Updated Summary

Name of Recruitment BCBSNE Recruitment
Name of Post Consultant,Manager and Various
Salary Not Disclosed
Job Location Jobs in Omaha, Nebraska
Trending Category USA Jobs

List of BCBSNE Jobs 2024 With Requirements

Name of Post Requirements
Medicare Advantage Talent Network
  1. Tell us a little about yourself by sharing your career experience and aspirations through this form. We promise it’s super easy and you can update it whenever you’d like.
  2. We’ll keep your info on hand and reach out to you about any potential opportunities that may spark your interest.
  3. Please set up job alerts or keep an eye on our job postings.  If a position opens up that you are interested in – please fill out a formal application.
Registered Nurse Care Manager
  • Bachelor’s degree in healthcare field.
  • Certification in Case Management, Managed Care, and/or Health Coaching.
  • Clinical experience in multiple levels of care.
  • Experience in discharge planning, Health Coaching, case management, or disease management.
  • Knowledge of accreditation standards and regulatory requirements.
  • Medicaid and Medicare Care Management experience.
Community Health Worker
  • High School diploma or GED required.
  • Willingness and ability to travel to BCBSNE member homes and community-based settings in NE.
  • Experience working with underserved and diverse populations in community settings.
  • Experience in navigating health and social service systems.
  • The ability to support, coach and motivate patients to reach their goals.
  • Good interpersonal skills with ability to relate to diverse groups of people and people on all levels.
  • The ability to meet or exceed the attendance and timeliness requirements of their departments.
  • Ability to prioritize workload and manage multiple tasks with different deadlines.
Health Data Analyst
  • Proficiency working within an environment that utilizes Agile and/or Project Management techniques.
  • Successful experience with creating analytic models based on data trends, business program ROI, data Quality Analysis, etc.
  • The translation of data findings into informative reports and visual outputs trusted by stakeholders to make business decisions.
  • Experience designing or building self-service content.
  • Advanced SQL knowledge.
  • Understanding of Health Insurance Operations knowledge including claims, enrollment, payment mechanisms, care management, employer reporting and the ability to stay current on healthcare industry knowledge.
  • Strong knowledge of the MA risk adjustment models, concepts, payment methodologies and submission requirements.
  • Ability to use advanced-level calculations in the transforming of data sets into usable data.
  • Ideal candidate would have experience using data manipulation tools such as R and/or Python.
  • Proficiency of visualization best practices as well as Proficiency with visualization tools such as PowerBI and/or Tableau.
  • Experience with Microsoft Azure DataBricks.
  • Ability to translate technical requirements into business deliverables.
  • Skilled in navigating relationships with external partners such as vendors, providers, groups, brokers, etc.
  • Master’s Degree in Business, Analytics, Information Technology or a Related Field.
Sr Business Analyst
  • Bachelor’s degree and 3+ year of experience in a similar Business Analyst role. An understanding of how to perform requirements analysis according to several SDLC (software development life cycle) methodologies in a team environment. General knowledge of project management concepts.
Medicare Advantage Consultant
  • Bachelor’s degree in business, finance, or healthcare industry experience.
  • Five (5) years of leadership in Medicare, PDP, or healthcare Medicare operations.
  • Strong knowledge of compliance and regulatory strategies in insurance, financial services, and healthcare industries.
  • Expertise in healthcare laws and regulations, especially in Medicare, Medsupp, EGWP, and PDP operations.
  • In-depth understanding of health plan operations, finance, quality, coding and reimbursement systems, fraud, waste and abuse programs, and risk management.
  • Healthcare industry experience, especially related to Medicare Advantage Operations/Compliance, as well as audit leadership in the Medicare or healthcare sector is advantageous.

How to Apply for BCBSNE Vacancies 2024?

  • Identify BCBSNE Job Search Criteria: For BCBSNE job, determine the industry, position, location and any specific qualifications or requirements for it.
  • Prepare Your Documents: Update your resume to highlight your relevant skills and experiences. Make sure it is well organized and tailored to the job you are applying for. Prepare any other necessary documents like cover letter, copies of certificates and identity proof.
  • Company websites: Visit the official page of BCBSNE company/Department interest you. If they have any open positions that match your skills, follow their application process. Some companies may have an online application form, while others may ask you to email your resume and cover letter.
  • Social Media: Follow the social media pages of BCBSNE company you’d like to work for. Some companies post job openings on their social media platforms, and you can apply directly through those channels.
  • Local Contacts: If you have any friends, family, or acquaintances working in United State, ask them for advice or referrals. Sometimes, word-of-mouth can be a powerful tool in finding job opportunities.
  • Follow Instructions: When applying for jobs, read the job description carefully and follow the application instructions provided by the employer. Submit all required documents and information as requested.
  • Be Persistent and Patient: Job searches can take time, so be persistent and patient throughout the process. Keep applying to relevant positions and continue to improve your skills and qualifications.

Always remember to tailor your application to each job you apply for, highlighting how your experience and skills match the specific requirements of the position. Good luck with your job applications in United State!


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Blue Cross and Blue Shield of Nebraska (BCBSNE) Jobs – Apply for Nurse Care Manager I Jobs In Omaha, Nebraska

Blue Cross and Blue Shield of Nebraska (BCBSNE) Jobs in Nebraska:– Great news for job seekers. Blue Cross and Blue Shield of Nebraska (BCBSNE) Jobs site publish notice for various jobs vacancy in their offices. Currently Blue Cross and Blue Shield of Nebraska (BCBSNE) Nurse Care Manager I Jobs available now. Candidates who are looking for Nurse Care Manager I Jobs in Omaha with relevant required experience can apply for Blue Cross and Blue Shield of Nebraska (BCBSNE) Jobs Employment. Candidate will get after selection great Salary $641328.00 Per Year.

Blue Cross and Blue Shield of Nebraska (BCBSNE) Jobs in Nebraska Employment 

Name of the Recruitment Agencies/ Department: Blue Cross and Blue Shield of Nebraska (BCBSNE)

Name of the Vacant Position: Nurse Care Manager I

Job Location: Omaha

Jobs Type: Jobs in Nebraska

Salary: $641328.00 Per Year

Full Job Description

Blue Cross and Blue Shield of Nebraska (BCBSNE) is more than just an insurance company; we exist to be there for people in the best and hardest moments of their lives.

Our team is the power behind that promise. And, as the industry rapidly evolves and we seek ways to optimize business processes and customer experiences, there’s no greater time for forward-thinking professionals like you to join us in delivering on it!

As a member of Team Blue, you’ll find purpose, opportunities and the support you need to build a meaningful career and make a powerful impact in our community.

BCBSNE is happy to offer four work designations for our Omaha area employees: 100% in-office, Hybrid – 3 days in office, Hybrid – 2 days in office, 100% remote. Occasional visits to the office. 

This position works collaboratively with health care providers to ensure that members receive high quality, medically necessary care in a timely fashion in a setting that maximizes benefit coverage and health outcomes. The incumbent educates members to understand innovative benefit structures that promote transparency and affordability and empowers consumers to make informed decisions regarding their healthcare options, coverage, and financial risk. The incumbent assists members to navigate the complex health care settings and ensures they get the support they need throughout the episode of care to optimize health status.

What you’ll do:

  • Follow the nursing process of assessment, planning, implementation, and evaluation of member-centric goals and interventions for members enrolled in the case management program.
  • Certification and authorization reviews to assess the medical necessity of inpatient admissions, outpatient services, out-of-network services, and appropriateness of treatment setting by utilizing and accurately interpreting applicable medical policy, clinical criteria, standards of care, contract language, benefits, and member eligibility. Facilitate appropriate and timely transitions of care utilizing member’s contract language and clinical criteria. Identify members at risk for post-discharge complications or potentially preventable readmissions and follow-up with members after return home to ensure member is able to obtain medically necessary care, understands discharge instructions and plan of care, understands warning signs of complications and knows what actions to take to address changing health status.
  • Responsible to collaborate and consult with healthcare providers, members, and internal team of clinical support specialists, nurses, physicians, medical directors and pharmacists to ensure medically appropriate, high quality, cost-effective care, promote positive member outcomes, effective use of resources, optimize member benefits, and support business initiatives.
  • Screen and triage members for levels and types of nurse advocacy and medical management programs, including but not limited to: discharge follow-up for potentially preventable readmissions, onsite visit program, care coordination, light touch care management, member outreach, palliative and hospice care management, and complex case management.
  • Act as a resource within the department and to other departments regarding medical management issues and activities.
  • Educate members about their benefits and coverage, and guide members to appropriate programs, community resources, and in-network providers.
  • Facilitates accreditation by knowing, understanding, and adhering to accrediting and regulatory requirements and standards
  • Responsible for maintaining professional licensure and practicing within the scope of licensure.

To be considered for this position, you must have:

  • Associates Degree in Nursing or Certified Practical Nurse and three (3) years clinical practice experience in a health care setting.
  • The Nurse Care Manager must hold a current, unrestricted Registered Nurse or Licensed Practical Nurse license from the state of Nebraska or a state in the consortium in which Nebraska participates.

An equivalent combination of education and experience may be substituted for this requirement.

The ability to meet or exceed the attendance and timeliness requirements of their departments.

The ability to work well in a team environment, and be capable of building and maintaining positive relationships with other staff, departments, and customers.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and or ability required.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned.

The strongest candidates for this position will also possess:

  • Bachelor’s Degree in Healthcare field
  • Certification in Case Management or Managed Care
  • Clinical experience in multiple levels of care
  • Experience in discharge planning, utilization management, case management, or disease management
  • Knowledge of accreditation standards and regulatory requirements
  • Medicaid and Medicare Care Management experience

Apply Now

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