http://www.jobshq.com/feeds/rss.cfm/employer/2756/ Employment listings for Blue Cross Blue Shield of ND brought to you by JobsHQ Director Vendor ManagementJob ID: 13382Position Objective The Director, Vendor Management provides leadership, technical direction, and technical support in the areas of Enterprise Vendor Management as well as research, process management and improvement, measurement, total quality management, customer satisfaction survey, benchmarking, and compliance with administrative contracts via audits of performance against specific measures. The Director is also responsible to participate in development activities undertaken by the company and is accountable to pursue initiatives and activities that present a competitive advantage opportunity in the industry. Knowledge Knowledge Specific Knowledge and Skills: ¿Working knowledge of BCBSND and affiliates' policies, procedures and operations. In-depth knowledge of how other departments operate. Basic knowledge of compliance and regulatory issues. Working knowledge of BCBSA guidelines (i.e. Membership, Service Marks) In-depth knowledge of Windows and Microsoft Office Suite Software. Advanced technical and analytical skills. Project organization and project management skills. Ability to define and organize projects, develop plans, and initiate team efforts. Market research and customer satisfaction measurement and management skills. Process management/process improvement skills, leading, facilitating, or completing efforts.  Abilities Business Acumen: Understands the tie between revenue and expenses; utilizes financial data and information to make sound business decisions that promote cost effectiveness, profitability, revenue, and growth.Client Services: Demonstrates knowledge of internal client needs, both current and future; addresses complaints, makes realistic commitments, and effectively communicates needs (e.g., client may include internal and external clients or customers, peers, working teams, etc.)Consultative Skills: Demonstrates a combination of listening, communication, problem solving, and facilitation skills to thoroughly understand and diagnose client issues; partners with clients to design and implement solutions that are seen as adding value and contributing to bottom-line resultsCustomer Facing Skills:Requires the capacity to manage and develop customer relationships and perceptions to achieve mutual goals. People who demonstrate this competency build relationships with customers in order to more clearly understand their business needs and develop workable solutionsDecision Making:Makes timely decisions, takes bold, decisive action or makes commitments, despite risks, conflict or uncertainty, after considering the available courses of action and the needs and values of othersEthics and Integrity:Displays the highest standards of personal and professional conduct. Supports organizational ethical standards and values Leadership Consistently demonstrates the courage to do what¿s right for the business; consistently guides, focuses, and energizes a group to accomplish the firm¿s objectives even under stressful or ambiguous situationsNegotiation skills:The ability to engage in give-and-take discussions with other parties and to come to a point of mutual agreement and benefit keeping various commercial and financial factors in mindPlanning and Organization:Manages time effectively so that the right time is allocated to the right activityProject Management:Participates in and/or leads successful projects, using strong communication and organizational skills to balance conflicting priorities and manage resources.Relationship Management: Understands the diverse needs and agendas of various clients and is able to balance multiple and sometimes conflicting interests to support the organization¿s longer-term effectiveness SkillsWork in a team-oriented environment Ability to work with minimal supervision Organizational and prioritization skills Interpersonal skills Written and oral communication skills Analytical skills Ability to adjust to change and be flexible Ability to lead teams assigned to specific tasks Time management skills Problem solving skills Detail oriented Leadership skills Ability to manage technical, professional staff Ability to effectively define, lead and manage cross-functional projects Ability to present/explain technical material relating to business processes, quality improvement, measurement and market research. Ability to effectively lead and interact in a team environment with a variety of different departments, levels and organizations. Education and/or Experience College degree in business administration, management, information systems, computer science, finance or related field is required. Master's degree is preferred. Minimum of 10 years experience in vendor management is required. Prior supervisory experience is required. Equal Employment Opportunity An Equal Opportunity/Affirmative Action EmployerHow To Apply If you are interested in this job opening and wish to complete an application, please apply onlinePlease note: All job openings require a completed application in order to be considered in the employment process. Contact Primary Employment Representative: Vicki BirkholzPhone Number: (701) 282-1425Email: Victoria.Birkholz@bcbsnd.com  

]]> Temp/Intern/On-CallJOB ID: 13373Position Objective Responsible to perform specific tasks as assigned by immediate supervisor or manager for up to a 90 day period of time;KnowledgeGeneral office procedures; Basic PC operations;Abilities Effective communication skills; Interpersonal skills; Ability to interact with others in a team environment; Ability to meet deadlines; Ability to meet accuracy standards;Education and/or Experience Three months work experience preferred;Equal Employment Opportunity An Equal Opportunity/Affirmative Action Employer How To Apply If you are interested in this job opening and wish to complete an application, please apply onlinePlease note: All job openings require a completed application in order to be considered in the employment process. Contact Primary Employment Representative: Alison KruegerPhone Number: (701) 277-2408Email: Alison Krueger@noridian.com 

]]> Accountant/AnalystJOB ID: 13318Position Objective Key player in budget development; maintain accounting timesheet system; analyze budget vs. operating expenses; update and analyze cost accounting allocations; Knowledge Accounting Theories and Practices - In-Depth Knowledge Cost Accounting Theories and Practices - In-Depth Knowledge Federal Accounting Regulations - In-Depth Knowledge Cost Accounting Standards (CAS) - In-Depth Knowledge NAIC Codification Regulations PC Software: Windows, Excel, Access, Word, Smartstream Financial System, Outlooksoft CPM Mathematical/Analytical Background Abilities Clear, concise written and oral communication Organizational and analytical skills Problem solving skills Time Management, multi-tasking Accuracy Suggest and implement improvement to operating procedures in department Team Worker Adaptable to change Education and/or Experience Bachelors Degree in Accounting with One to Two Years Accounting and Cost Experience, or/Associate Degree in Accounting with Five years Accounting Experience Equal Employment Opportunity An Equal Opportunity/Affirmative Action Employer How To Apply If you are interested in this job opening and wish to complete an application, please apply onlinePlease note: All job openings require a completed application in order to be considered in the employment process. Contact Primary Employment Representative: Vicki BirkholzPhone Number: (701) 282-1425Email: Victoria.Birkholz@noridian.com  

]]> Manager Coding Education & ReimbursementJob ID: 13340Position Objective This position will be responsible for working with Health Network Innovations and Marketing to provide support in driving and developing program and initiatives relative to wellness. This will include conducting assessments, providing education, and assisting HNI Division in improving health behaviors for participating groups.Knowledge Management theories and practices Management information systems and practices Healh Care industry Population health management Disease management Wellness programs, procedures and general business principles Medical theories and practices CPT-4 and ICD-9 coding Utilization management Leadership skills Communication (interpersonal, verbal, written) Organize and prioritize workload (self & others) Problem solving Analytical skills Respect confidentialityAbilities Willingly cooperates and works collaboratively towards solutions which generally benefit all involved parties; works cooperatively with others to accomplish company objectives; promotes collaboration and partnerships.Demonstrates a combination of listening, communication, problem solving, and facilitation skills to thoroughly understand and diagnose client issues; partners with clients to design and implement solutions that are seen as adding value and contributing to bottom-line results.Encourages and vlues creativity; expresses unique ideas whilst taking action that generates viable solutions.Displays the highes standards of personal and professional conduct. Supports organizational ethical standards and vaules.Consistently demonstrates the courage to do what's right for the business; consistently guides, focuses, and energizes a group to accomplish the firm's objectives even under stressful or ambiguous situations.Manages time effectively so that the right time is allocated to the right activity.Has a structured approach to problem solving, demonstrates planning and analytical skills to deliver on organizational results.Ensures that goals are consistently being met in an effective and efficient manner.Understands the diverse needs and agendas of various clients and is able to balance multiple and sometimes conflicting interests in support the organization's longer-term effectiveness.Works cooperatively with others to accomplish team and contact center goals. Supports others and shares information and own learnings.Applies and improves extensive or in-depth specialization knowledge, skills and judegement to accomplish a result or to serve one's "customers" effectively.Education and/or Experience RN with 3-5 years acute care in good standing with management experience desirable.Must be licensed in the state of North Dakota.Variety of clinical experience. Equal Employment Opportunity Equal Employment Opportunity An Equal Opportunity/Affirmative Action EmployerHow To Apply If you are interested in this job opening and wish to complete an application, please apply onlinePlease note: All job openings require a completed application in order to be considered in the employment process. Contact Primary Employment Representative: Vicki BirkholzPhone Number: (701) 282-1425Email: Victoria.Birkholz@bcbsnd.com  

]]> Enterprise Security - Senior LevelJob ID:  13331 Position Objective This position is responsible for coordinating and ensuring computer/data security requirements within the IT Division and the corporation as a whole are being adhered to. The position will perform auditing, logging and monitoring on all systems and applications. Develop and assist in the development of departmental and corporate security policies and standards. Provide security guidance. Participate in security-related projects as needed. Perform security and risk assessments. Maintain a knowledge base of applicable regulations and disciplines, and ensure they are being met.This position is also responsible for assisting with corporate-wide (Noridian and all affiliated organizations) project planning and documentation of internal Enterprise Security projects and Enterprise Security Corporate Projects. These activities include researching and documenting federal and state regulatory requirements, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Health Information Technology for Economic and Clinical Health (HITECH) Act, the Centers for Medicare and Medicaid Services (CMS) requirements, and standards as outlined by the National Institute of Standards and Technology, and maintaining of documentation.Knowledge Advanced knowledge of Log analysis methodologies and techniques Working knowledge of information security principles and practices Advanced knowledge of security & risk assessment fundamentals Working Knowledge of auditing theories, techniques, and practices SQL query development Script development (Perl, shell, Python) General knowledge of the insurance industry Working understanding knowledge in Incident Handling techniques Working knowledge of Computer Forensics techniques Working Knowledge of Information Systems Development Principles, Secure Programming Concepts, and Systems Development Life Cycle Working Knowledge of HIPAA and HITECH requirements Working Knowledge of federal and state regulatory practices; including Federal Information Security Management Act Requirements and NIST Special Publications 800 series; Working knowledge of computer applications: Microsoft Office Suite Working understanding of security architecture and design principles including Security practices for operating systems, firewalls, networking, encryption, Intrusion Detection Systems, virtualization, webservers, databases, and applications. Information Security Best Practices & IT Security regulations (CMS, Sarbanes Oxley, FISMA, NIST)Abilities Information Security Skills Ability to adjust to change and be flexible; Ability to handle multiple tasks simultaneously; Analytical skills; Editorial skills for policy and procedure reviews; Excellent communication skills both written and verbal; Organization and prioritization skills; Research and investigative skills; Time management skills; Ability to travel if required. Facilitation and leadership skills; Effective Presentation skills; Coordination of project activities/planning Management SkillsEducation and/or ExperienceEEducation: Requires a four-year degree, preferably in the Information Systems field or two year degree preferably in information systems and additional two years experience in Information Systems, Information Security, and/or Information Technology Auditing.Experience: Minimum of five years of experience in Information Systems, Information Security, and/or Information Technology Auditing with a minimum two years experience in Information Technology and minimum of three years experience in Information Systems Security and/or Information Technology Auditing." CISSP, CISA, or equivalent certification preferred Other Information The wage and level of this position will be based on the applicant's relevant experience and certification. We have mid-level to experienced level position available.Equal Employment Opportunity An Equal Opportunity/Affirmative Action Employer Please note: All job openings require a completed application in order to be considered in the employment process. Contact Primary Employment Representative: Vicki BirkholzPhone Number: (701) 282-1425Email: Victoria.Birkholz@noridian.com

]]> IS Security Team LeaderJob ID: 001391Position Objective This position is responsible for supervising activities related to the IS security and privacy initiatives to ensure compliance with federal and state laws and regulations, such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA); the Centers for Medicare and Medicaid Services (CMS) requirements; and other regulatory and industry requirements.Knowledge Project management concepts Information systems Auditing theories Security & privacy initiatives HIPAA requirements CMS Business Partners Systems Security Manual requirements 1. Management theories and practices 2. Standards and procedures 3. Basic understanding of all major functional areas of department 4. Advanced knowlede in at least one of the major functional areas of department 5. System backup and recovery procedures 6. Disaster recovery planning concepts 7. System security concepts, policies and proceduresAbilities 1. Documentation skills 2. Excellent written/oral communication skills 3. Analytical skills 4. Organizational skills 5. Motivational skills 6. Interpersonal skills 7. Time management 8. Leadership skills 9. Mediation skills 10. Team work skills 11. Coordinate project activities and workload of staff 12. Presentation skillsEducation and/or Experience Minimum Two-year Technical degree or four-year degree degree in I.T. related field of study and 10 years experience, of which 4 years are security related.Equal Employment Opportunity An Equal Opportunity/Affirmative Action Employer How To Apply If you are interested in this job opening and wish to complete an application, please apply online.Please note: All job openings require a completed application in order to be considered in the employment process. Contact Primary Employment Representative: Vicki BirkholzPhone Number: (701) 282-1425Email: Victoria.Birkholz@noridian.com  

]]> Manager Coding Education & ReimbursementJob ID: 13322Position Objective The Manager of Coding Education &Reimbursement will be responsible to develop and manage the Plan's Reimbursement Programs. This position will be responsible to maintain consistent education to internal and external parties on appropriate billing and coding practices and policies. Coordinate the financial and clinical aspects of the development, implementation, control, and monitoring of reimbursement systems and strategies. In addition, the Manager Coding Education & Reimbursement will provide leadership, supervision, direction, and assistance to professional exempt and non-exempt staff within the teams of Education Consulting, Coding Analysis, and Reimbursement Analysis.Knowledge Health care reimbursement methods and strategies. Health insurance industry practices. Contract and benefit plan information. Claims processing systems and procedures. Personnel policies and /procedures. Medical terminology, CPT, HCPCS, and ICD coding. Budgeting. Management theories and practices.Abilities Analytics and problem solving skills. Ability to work independently to develop effective reimbursement strategy and tactical program/tools. Strong interpersonal skills to influence and negotiate complex decisions and be a strong positive advocate for communicating the mission, objectives and results of the Reimbursement Team with stakeholders and building cross-functional relationships. Organize and prioritize workload Confidentiality Teaching ability Listening skills Problem solving skills Decision making skills Oral and written communication skills Leadership/management skills Analytical skills Motivational skills Planning/strategy/goal settingEducation and/or Experience Bachelors Degree required, advanced degree preferred. 5 years experience working directly with managing reimbursement strategy and tactical execution including managing reimbursement support in the health care industry or reimbursement consulting. 10 years health insurance background desired.Equal Employment Opportunity An Equal Opportunity/Affirmative Action EmployerHow To Apply If you are interested in this job opening and wish to complete an application, please apply onlinePlease note: All job openings require a completed application in order to be considered in the employment process. Contact Primary Employment Representative: Vicki BirkholzPhone Number: (701) 282-1425Email: Victoria.Birkholz@bcbsnd.com  

]]> Medical Director - WellnessJob ID: 13292Position Objective The Medical Director Wellness is a member of the Health Network Innovation Medical Director team and serves as the Strategic Leader of Wellness programs and initiatives based upon provider guidance of evidence-based, proof-of-concept development and research. In partnership with the Marketing Division's Consultative Services, make recommendations to employer groups and members based on analysis of various utilization, clinical and pharmacy data. Provide direction for BCBSND's various clinical and wellness programs in partnership with Human Resources and Marketing and interfaces with internal partners and external partners departments to develop new programs and initiatives.Knowledge Expert-level business knowledge and skills (e.g., business processes and planning, capability road mapping, budget planning, metrics, etc.) Health care industry Population health management Disease management Wellness programs, procedures and general business principles. Medical practiceAbilitiesWillingly cooperates and works collaboratively towards solutions which generally benefit all involved parties; works cooperatively with others to accomplish company objectives; promotes collaboration and partnerships.Demonstrates a combination of listening, communication, problem solving, and facilitation skills to thoroughly understand and diagnose client issues; partners with clients to design and implement solutions that are seen as adding value and contributing to bottom-line results.Encourages and values creativity; expresses unique ideas whilst taking action that generates viable solutions.Displays the highest standards of personal and professional conduct. Supports organizational ethical standards and values.Consistently demonstrates the courage to do what's right for the business; consistently guides, focuses, and energizes a group to accomplish the firm's objectives even under stressful or ambiguous situations.Manages time effectively so that the right time is allocated to the right activity.Has a structured approach to problem solving, demonstrates planning and analytical skills to deliver on organizational results.Ensures that goals are consistently being met in an effective and efficient manner.Understands the diverse needs and agendas of various clients and is able to balance multiple and sometimes conflicting interests to support the organization's longer-term effectiveness.Works cooperatively with others to accomplish team and contact center goals. Supports others and shares information and own learnings.Applies and improves extensive or in-depth specialized knowledge, skills and judgment to accomplish a result or to serve one's customers effectively.Education and/or Experience Must possess a Doctor of Medicine Degree (M.D.) and a minimum of five years clinical experience. Experience as a physician leader in payer, integrated health system, or health care specialty setting. Demonstrated supervisory experience.Current North Dakota non-restricted licensed Medical Doctor. Board certified by ABMS in a primary medical specialty.Equal Employment Opportunity Equal Employment Opportunity An Equal Opportunity/Affirmative Action EmployerHow To Apply If you are interested in this job opening and wish to complete an application, please apply onlinePlease note: All job openings require a completed application in order to be considered in the employment process. Contact Primary Employment Representative: Vicki BirkholzPhone Number: (701) 282-1425Email: Victoria.Birkholz@bcbsnd.com  

]]> Reimbursement AnalystJob ID: 13343Position Objective Responsible for monitoring, developing, researching, and implementing BCBSND reimbursement programs and policies for hospitals, clinics, physicians, and other groups.Knowledge Statistical and analytical theories and practices; - Basic computer science with working knowledge of databases, commercial relational based languages (SQL), and statistical software; - Proven use of PCs and various software packages such as Access, Excel, Power Point, Word, etc.; - Knowledge of medical terminology, CPT-4, and ICD-9 diagnosis coding; - Familiarity with claims processing systems; - Broad knowledge of health care reimbursement methods; - Knowledge of research methods and data sources.Abilities - Perform independent statistical and analytical research; - Research, analyze, and interpret data/information to draw conclusions; - Excellent PC skills; - Excellent oral and written communication skills; - Excellent analytical abilities; - Effectively present technical, financial, or statistical analysis/ information to non-technical audiences; - Organizational and time management skills.Education and/or Experience- Bachelor's degree in Accounting, Finance, Business Administration, or related field with 1-3 years of experience in a health care related field. Equal Employment Opportunity An Equal Opportunity/Affirmative Action EmployerHow To Apply If you are interested in this job opening and wish to complete an application, please apply onlinePlease note: All job openings require a completed application in order to be considered in the employment process. Contact Primary Employment Representative: Vicki BirkholzPhone Number: (701) 282-1425Email: Victoria.Birkholz@bcbsnd.com  

]]> Software Application DeveloperJOB ID: 13320Position Objective This position is responsible for coding and testing major enhancements and small new applications on their own with direction from senior staff. They will also work under the guidance of senior staff for major projects. Accountable to follow all appropriate policies and procedures. This position also is responsible for timely and accurate support of production applications.Knowledge Application of software development life cycle to projects Object oriented programming concepts Relational databases Integrated Development Environment (IDE) including source code editor, compiler, build tools, and debuggers Testing methodologies and tools Source Control tools Knowledge of appropriate programming languages or 3rd party products as assigned to support the domainSpecific to this position:JSF HTML and XML Portlets Liferay Content Management Systems SQL JBoss Developer tools including Eclipse, SVN, TFS, GITAbilities Trouble-shooting and problem solving Analytical and design skills Effective Time Management Customer Service Skills Solid Written/Oral Communication Skills Teamwork Skills Interpersonal Relationship Skills Documentation Skills Organizational Skills Risk management/analysis and escalation Respond to after-hour Production ProblemsEducation and/or Experience Bachelors Degree in Computer Science, Management Information Systems or a related field with 2 years of professional experience. Or Masters Degree in Computer Science, Software Engineering or a related field. Or equivalent in related work experience and abilities.Equal Employment Opportunity An Equal Opportunity/Affirmative Action EmployerPlease note: All job openings require a completed application in order to be considered in the employment process. Contact Primary Employment Representative: Alison KruegerPhone Number: (701) 277-2408Email: Alison Krueger@noridian.com

]]> Team Leader-Utiliztn/Bene MgtJob ID: 13337Position Objective Responsible for selecting, motivating, supervising & training other nurse reviewers in the untilization management functions of the department to ensure high quality case review. Support the objectives of the department & provide assistance in developing, coordinating & monitoring Utilization activites to determine the most medically appropriate cost effective plan of treatment for members.Oversight of the multidisciplinary team in collaboration with other divisional Team Leaders.Knowledge a. Medical and nursing practices and theories b. Case management standards c. Benefit plan benefits d. ICD 9/ ICD10 e. Medical policies f. Institutional and professional claims processing g. Statistical analysis h. Management theories i. Medical Necessity CriteriaAbilities Leadership skills Communication (interpersonal, verbal, written) Organized & prioritize workload (self & others) Problem solving skills Analytical skills Decision making skills Respect confidentiality Travel as requested Be proficient in the English language Typing (alpha & numeric) Software (i.e. WORD, Excel, Access, Flow Charting)  Education and/or Experience a. Current, active, unrestricted North Dakota (ND) Registered Nurse (RN) license. b. Minimum 2-3 years equivalent direct clinical care experience in a variety of settings preferred. c. Case Management/Utilization Management experience preferred. d Supervisory experience desirable.Equal Employment Opportunity An Equal Opportunity/Affirmative Action EmployerHow To Apply If you are interested in this job opening and wish to complete an application, please apply onlinePlease note: All job openings require a completed application in order to be considered in the employment process. Contact Primary Employment Representative: Vicki BirkholzPhone Number: (701) 282-1425Email: Victoria.Birkholz@bcbsnd.com  

]]> Our Health Network Innovations Division is expanding. Come join a team that is focused on excellence, innovation and process improvement. We are seeking to fill the following leadership positions.Vice President Health Innovations and Practice TransformationThe position of Vice President Health Innovations and Practice Transformation will provide leadership, direction and motivation to management in developing and implementing strategies for the network and reimbursement teams. This position involves using detailed financial analysis, competitive intelligence, market research, and medical cost trends to advise and execute appropriate strategic priorities. The qualified application will have a Bachelors Degree in business or healthcare management, business or finance with 5 years of experience working in a managed care organization, health insurer, or as a consultant in a network management/contract management role including 3 years experience in data analysis, project management or project lead experience, training or experience in provider negotiations. For more information about the above position and to complete an online application, please go to our website at www.bcbsnd.com/jobs.An equal opportunity/affirmative action employer

]]>