The Senior Workers' Compensation Claims Adjuster is responsible for the initial investigation, analysis of exposure, claim management, and file resolution. Job Description Ability to analyze data and reports for trends, pattern analysis and financial exposure. Knowledge of legal issues and liability related to workers' compensation injuries. High level of knowledge of the

Under minimal direction this role performs non routine tasks, with direction only at the highest level and minimal to no guidance on how to complete them. There is a high level of decision making authority impacting the whole company and a wide degree of financial ownership, including ROI projections. This role will serve as the voice of the customer and translate custome

Data Scientists are innovative, gifted, business outcome focused individuals who thrive in an environment with a vast array of data, technologies, and techniques in their daily work. Data Scientists work closely with business leaders, vendors, and other teams to create critical insights that can be used to add value to Blue KC business. Data Scientists need to be creative

The Provider Reimbursement and Content Analyst, Lead formulates and defines systems scope and objectives; and combines an understanding of applicable business systems and industry requirements. Must possess an in depth understanding of the provider reimbursement business functions/processes supported, and be viewed as a knowledgeable representative of that business functi

The Account Executive achieves specified retention goal on assigned territory while also supporting a Sales Consultant to achieve retention goals in a shared territory. Develops and executes strategies to maintain and manage a specific number of assigned accounts (complex to most complex) and to direct the management of these accounts in a manner that promotes an excellen

Responsible for configuration and product modeling within the Product System. Uses effective analytical reasoning to understand and document business requirements and business processes required to support the Product System. Demonstrates a basic knowledge of health insurance products and benefits, and uses this knowledge to evaluate requirements, anticipate implications

The Director, Contracting and Network Management is responsible for negotiation, execution, implementation, and administration of provider contracts with hospitals, physicians, and ancillary providers as assigned and all activities that support those efforts for all lines of business, including commercial and all Government Programs and related network management and expa

The Director, Government Programs Risk Adjustment & Audit assumes overall leadership of the risk adjusted revenue optimization strategy and oversight of Government Programs Risk Adjustment programs. Job Description Interface with Blue KC operational and clinical leadership to assist in identification of operational and coding best practices in chronic condition management