Sinclair Virtual Job Fair

September

12-18

2016

Capital BlueCross
 
Capital BlueCross

About the Company

In the rapidly evolving health care industry, Capital BlueCross stands at the forefront, leading the change to enhance the health and well-being of our customers and the communities we serve.

Headquartered in Harrisburg, Pa., and a partner in the community’s health for nearly 80 years, Capital BlueCross is the leading health solutions and insurance company in central Pennsylvania and the Lehigh Valley. More than a health insurer, the company delivers innovative solutions through a family of diversified businesses that is creating a healthier future and lowering health care costs. Among these solutions are patient-focused care models, leading-edge data analytics, and digital health technologies. Additionally, Capital BlueCross is growing a network of Capital Blue stores that provide in-person service and inspiration to help people reach their health goals.

The success of everything we do is directly related to the efforts of our dedicated and talented workforce. We are one of our area’s largest employers with more than 1,800 employees. We offer an excellent employee benefits package as well as an award-winning employee wellness program. Our accolades include recognition by the American Heart Association as a Platinum-Level Fit-Friendly Worksite and we have been ranked No. 3 among the top 125 training programs globally by Training Magazine.

Capital BlueCross is an independent licensee of the BlueCross BlueShield Association.

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JOBS

DIRECTOR, PROFESSIONAL PROVIDER CONTRACTING

Position Summary:

This specialized professional has the right background in health system provider contracting to lead the development and execution of our professional network strategy and associated details surrounding contract structures, reimbursement methodologies, product design/network configurations, and competitive intelligence gathering for professional providers. You will manage hospital/ancillary provider portfolios; lead negotiations; oversee contract terms, regulatory requirements and financial impact analysis; and represent Provider Network Engagement in a variety of internal projects.

We’re looking for a passionate leader who has significant knowledge of the evolving health insurance industry and sees the landscape impacting health plan operations and how participating provider agreements impact groups and individual members. This Director, working in a team environment, will further develop our provider network strategies to strengthen partnerships with health systems using Value Based programs; and presents reimbursement strategy to CEOs and other principals, outlining details which guarantee that our network integrity and reimbursement levels optimize cost competitiveness for our market segments.

Candidates will have a minimum Bachelor’s degree and 7-10 years of related experience that includes 5+ years of direct hospital/health system negotiation-related experience. Requires 3-5 years’ experience in a management role. Experience with building/supporting value-based relationships for Medicare Advantage and/or Medicaid products is highly preferred. Must have a valid driver’s license and willingness to travel frequently within the service area.

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INTERN / RETAIL STORE

Position Summary:

Engage customers as a greeter for retail services in an effort to expand knowledge of brand opportunities. Responsible for facilitating and enhancing Capital BlueCross’ reputation in the community through identification and execution of branding and programs/initiatives; may be accomplished by providing recommendations in conjunction with advertising, public relations, and communications areas.

The position serves as contact for external customers, and working with other unit staff members. Executes special projects including, but not limited to customer/employee opportunities and special projects/events. Supports development and execution of integrated communications programs in support of CBC customers or CBC advertising and branding campaigns. Supports and coordinates all retail brand strategy initiatives as requested. Engage in community health events in the retail model in an effort to expand knowledge of Health Care. The position also engages community resources to understand how our community views exercise, good nutrition, and positive psychology and the way we adapt/change their pre-conceived notions of the former.

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MEDICARE COMPLIANCE ADMINSTRATOR

Position Summary:

The position will carry out the activities of the Medicare Compliance Department, under direction of the Medicare Compliance Officer, in order to support the oversight and monitoring of Capital BlueCross’s, and its affiliates (Capital), Centers for Medicare and Medicaid Services (CMS) contracted Medicare Advantage Prescription Drug (MA-PD) and Prescription Drug Plan (PDP) programs. The position is responsible for performing all activities in a manner that fosters employees’ confidence in the Compliance Program and inspires trust in the Medicare Compliance Department.

Ideal candidate will have a Bachelor’s degree with 3+ years’ experience in a Medicare or Compliance role within the health care insurance industry. Requires knowledge of the CMS Managed Care Manual, Prescription Drug Benefit Manual and citations supporting these manuals; familiarity with the federal and state legal systems/regulations; sound decision making skills; and the ability to use discretion, sensitivity and clarity when communicating Medicare compliance information to employees. Must have proficiency in Access, Excel, Powerpoint and Sharepoint.

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SR. MEDICARE PRODUCT CONSULTANT

Position Summary:

This senior level position will manage the overall success of the Government Programs Division individual and group Medicare product portfolio.  This involves assessing pricing/ changes/strategy/launch of new and existing Medicare Advantage, Medicare Prescription Drug Plans (PDP) and Medicare Supplement products.  You will take a strategic look at operational and cross-functional work flow and develop Medical business strategy/products that meet expectations of external (regulators, providers, members, vendors) and internal customers.  You will ultimately find new market opportunities in the Medicare product portfolio based on demographic/membership changes; develop multi-year product strategies; and support sales, marketing, clinical, operational and other subject matters experts that support membership growth and profitability. 

This business strategist and leader will have 7+ years of experience managing products, benefits, pricing and operational processes in the health insurance industry.  Excellent analytical, project management and presentation skills are essential.  Must be able to build successful collaborative business relationships and effectively solve problems/make decisions/recommend improvements so that specific business processes are improved to champion our Medicare Advantage, Prescription Drug and Supplement products.  CMS compliance/regulatory experience is needed, along with knowledge of PBMs and operational requirements.  EOC, ANOC and Medicare Advantage experience is highly preferred.

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TAX ACCOUNTANT

Position Summary:

Capital Blue Cross is looking for a Tax Accountant to join its Corporate Tax Team. The Tax Team is responsible for the tax compliance, tax reporting, and tax planning of Capital BlueCross and its insurance and non-insurance family of companies. As part of the Tax Team, the Tax Accountant prepares tax returns and tax provisions as well as provides support for other department projects.
 
This position requires a Bachelor’s degree in Accounting or Finance, knowledge of accounting and tax principles, at least one year of tax experience in a corporate or public accounting setting, and solid PC skills including a working knowledge of Microsoft Office. The candidate should possess strong written and verbal communication skills, be able to work independently as well as within a team structure, and be able to manage multiple projects and assignments while meeting deadlines. CPA and/or Master’s Degree in tax is a plus as well as knowledge of GAAP tax accounting, knowledge of statutory accounting, state tax experience, and working knowledge of OneSource and/or Oracle Business.

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