As a Senior Enterprise Competitive Insights Advisor you will lead the data collection and analysis of intelligence, as well as external research efforts, guided by leadership, to collectively understand the overall health care operating environment (competitive, regulatory, financial). You will participate in the development, execution, and communication of competitive re

Perform all types of utilization management (UM) reviews, including but not limited to Pre service, Post service, Concurrent Review and Appeals Discuss cases with physician providers (Peer to Peer) Apply health plan review hierarchy to member contracts, medical policy, clinical guidelines and other approved resources to render timely decisions on medical necessity request

The Medical Review Nurse reviews, authorizes, coordinates, and responds to requests for services for Florida Blue members. This position also communicates telephonically with providers and their offices, and occasionally with members. Makes decisions based on established policies and procedures, Florida Blue medical coverage guidelines, benefits, InterQual criteria, nursi

Retail Sales Interns are critical to delivering on the sales, renewal, retention, and community penetration objectives of the Florida Blue Centers. This internship will entail developing and then demonstrating the knowledge, skills, and competencies of a sales professional through effectively consulting with prospects and existing customers. Sales Interns will also perfor

Retail Sales Interns are critical to delivering on the sales, renewal, retention, and community penetration objectives of the Florida Blue Centers. This internship will entail developing and then demonstrating the knowledge, skills, and competencies of a sales professional through effectively consulting with prospects and existing customers. Sales Interns will also perfor

Specialists apply discipline specific or institutional knowledge and skills in the performance of departmental activities which support the Company's operations. Specialists typically prepare for their role by earning a post secondary degree in a specific field, obtaining certification, or by on the job training and work experience. Incumbents may directly manage a small

Specialists apply discipline specific or institutional knowledge and skills in the performance of departmental activities which support the Company's operations. Specialists typically prepare for their role by earning a post secondary degree in a specific field, obtaining certification, or by on the job training and work experience. Incumbents may directly manage a small

Responsible for ongoing Individual Agent management Responsibilities include the establishment of production goals and compliance thresholds, along with the communication and ongoing enforcement of these established expectations with each assigned agent. Essential Functions The essential functions listed represent the major duties of this role, additional duties may be as

This position will be responsible for reviewing and analyzing Requests for Proposals (RFPs) and preparing health and ancillary quotes.The Mid Group Pre Sale Analyst works closely with the Senior Director of Sales, Mid Group New Sales Executive, brokers and internal business partners to ensure an accurate and competitive Florida Blue quote is generated.This position will w

Retail Sales Interns are critical to delivering on the sales, renewal, retention, and community penetration objectives of the Florida Blue Centers. This internship will entail developing and then demonstrating the knowledge, skills, and competencies of a sales professional through effectively consulting with prospects and existing customers. Sales Interns will also perfor

Retail Sales Interns are critical to delivering on the sales, renewal, retention, and community penetration objectives of the Florida Blue Centers. This internship will entail developing and then demonstrating the knowledge, skills, and competencies of a sales professional through effectively consulting with prospects and existing customers. Sales Interns will also perfor

Florida Blue Medicare Sales Agents will work in the field in a designated territory to sell products and services to Medicare eligible individuals, and build long term relationships with customers and external business partners. They will also meet with eligible participants with the goal of enrollment and presenting product information for Medicare Advantage HMO, Medicar

Project management support of Enterprise wide facility planning projects and all subsidiaries, that enable the achievement of the enterprise mission, vision, values, and goals. Job Duties include but are not limited to Organize and maintain construction and Facility Planning interior renovation project documents, digital database development, floorplans, finish plans, det

Florida Blue Medicare Sales Agents will work in the field in a designated territory to sell products and services to Medicare eligible individuals, and build long term relationships with customers and external business partners. They will also meet with eligible participants with the goal of enrollment and presenting product information for Medicare Advantage HMO, Medicar

As the Senior Manager, Enterprise Competitive Insights role you will lead the development, project management, and communication of competitive research, as well as business insights associated with GuideWell's growing scope of operations. You will be accountable for effectively integrating insights from multiple sources to form a holistic view of GuideWell's customers, m