Jobs at BlueCross BlueShield of Tennessee (Now Hiring) — 17 open
Risk Adjustment Medical Record Coder-2
Chattanooga, Tennessee, United States · Remote OK
Mid level
We are hiring a Risk Adjustment Medical Record Coder at BCBST! In this role, you will support accurate and compliant coding practices by performing first-pass reviews of member medical records to identify and capture act…
Skills: HCC Coding, ICD-10 Coding, Medical Record Review, Risk Adjustment, Medicare Advantage
CHOICES Care Coordinator- Memphis Area
Memphis, Tennessee, United States · Hybrid
Mid level
Are you a compassionate individual who enjoys helping others achieve their personal health and wellness goals? If so, a career as a CHOICES Care Coordinator might be perfect for you. As a Care Coordinator, you will make …
Skills: Clinical Assessment, Case Management, Time Management, Critical Thinking, Customer Service
Supervisor Case Management
Chattanooga, Tennessee, United States · Remote OK
Senior
Our Total Health Management team is looking for a new Supervisor of Case Management! We are seeking a results-driven and people-focused Clinical Supervisor for Women and Children’s Health who is committed to strengthenin…
Skills: Case Management, Clinical Supervision, Performance Management, Coaching, Quality Auditing
Intern - Provider Data Reporting
Chattanooga, Tennessee, United States · Remote OK
Entry level
BCBST’s BlueBridge Internship program is seeking an Intern for our Provider Network Team! About the Program: BCBST’s BlueBridge Internship Program offers hands-on experience, professional collaboration, and opportunities…
Skills: SQL Query Design, SSRS, Power BI, SSIS, Data Analysis
Legal Assistant
Chattanooga, Tennessee, United States · Hybrid
Mid level
We are seeking a dedicated and adaptable Legal Assistant to join our team in our corporate offices in Chattanooga, TN. This office‑based role requires a true team player—someone who works well with others, is willing to …
Skills: Microsoft Office, Legal Document Preparation, Contract Formatting, Scheduling, Communication
Behavioral Health Case Manager BlueCare Plus
Jackson, Tennessee, United States · Remote Solely
Mid level
The BlueCare team at BlueCross BlueShield of Tennessee (BCBST) is seeking a Behavioral Health Case Manager to support members enrolled in BlueCare Plus, a Fully Integrated Dual Eligible Special Needs Plan (FIDE SNP) desi…
Skills: Case Management, Care Coordination, Behavioral Health, Motivational Interviewing, Microsoft Office
Investigator II
Nashville, Tennessee, United States · Hybrid
Senior
BCBST is hiring an Investigator II Are you an experienced investigator with a strong eye for detail and a passion for protecting the integrity of healthcare? At BlueCross BlueShield of Tennessee, our Special Investigatio…
Skills: Fraud Investigation, Evidence Analysis, Interviewing, Case Documentation, Risk Assessment
Senior Technical Recruiter
Chattanooga, Tennessee, United States · Remote OK
Mid level
BlueCross BlueShield of Tennessee is hiring a Senior Technical Recruiter to support full-cycle recruitment across the enterprise. In this consultative role, you’ll serve as a trusted advisor to hiring managers and senior…
Skills: Full-Cycle Recruitment, Technical Sourcing, Stakeholder Management, Data-Driven Decision Making, Candidate Experience
Supervisor, Clinical Quallity Assurance
Chattanooga, Tennessee, United States · Remote OK
Senior
We are hiring a Supervisor for Clinical Quality Assurance here at BCBST to lead a high-performing team of nurses statewide. In this role, you will guide clinical reviews of medical records, partnering with provider offic…
Skills: Clinical Leadership, Quality Improvement, Project Management, Medical Record Review, HEDIS
Sr. Financial Systems Analyst
Chattanooga, Tennessee, United States · Remote OK
Senior
The Financial Accounting and Reporting division is looking to add a Sr. Financial Systems Analyst to our team. This role serves as a liaison between the Finance division and the IT organization to provide product and use…
Skills: Workday Financials, Cognos, Power BI, Financial Data Management, Business Process Configuration
Data Modeler
Chattanooga, Tennessee, United States · Remote OK
Mid level
BlueCross BlueShield of Tennessee is hiring a Data Modeler. In this fully-remote role, you’ll support data modeling tasks on multiple database technologies. In your day to day, you’ll design, deliver, and govern scalable…
Skills: Data Modeling, Erwin DM, Facets, OLTP, Data Warehousing
Clinical Review Manager
Chattanooga, Tennessee, United States · Remote OK
Mid level
The Commercial team is hiring a Clinical Review Manager to support the Commercial lines of business through BlueCross BlueShield of Tennessee. This role conducts comprehensive clinical reviews of medical service requests…
Skills: Clinical Review, Utilization Management, Medical Necessity Criteria, Care Coordination, Microsoft Office
Principal AI Workflow Engineer
Chattanooga, Tennessee, United States · Remote OK
Senior
At BlueCross BlueShield of Tennessee, we’re building the foundation for an AI‑enabled future—one where our teams work smarter, our operations move faster, and our 3.4 million members experience a more responsive, reliabl…
Skills: Generative AI, LLM Integration, Python, Workflow Orchestration, API Integration
RN Case Manager (Federal Employees Program)
Chattanooga, Tennessee, United States · Remote OK
Senior
BlueCross BlueShield of Tennessee (BCBST) is seeking a skilled and compassionate Medical Case Manager to join the FEP Population Health team. This role supports members with acute care needs and chronic health conditions…
Skills: Case Management, Telephonic Member Engagement, Empathetic Listening, Problem Solving, Utilization Management
Clinical Review Manager
Chattanooga, Tennessee, United States · Remote OK
Mid level
The Commercial team is hiring a Clinical Review Manager to support the Commercial lines of business through BlueCross BlueShield of Tennessee. This role conducts comprehensive clinical reviews of medical service requests…
Skills: Clinical Review, Utilization Management, Medical Necessity Criteria, Care Coordination, Case Management
Corporate Pharmacy Director
Memphis, Tennessee, United States · Remote OK
Senior+
Job Responsibilities Benefit Strategy Development: Utilize clinical and analytical data to evaluate product performance and develop strategic pharmacy benefit options tailored to customer needs.Pharmacy SME Support: Serv…
Skills: Pharmacy Benefit Design, Managed Care, Clinical Compliance, Regulatory Compliance, Client Relationship Management
Dual Special Needs Plan VP, BlueCare
Chattanooga, Tennessee, United States · Remote OK
Senior+
BCBST is hiring a Senior Executive Leader, BlueCare Plus D‑SNP. We’re looking for a proven leader who brings deep expertise in Medicare and Dual Special Needs Plans, along with a strong track record of driving financial …
Skills: P&L Management, Medicare Advantage, Dual Special Needs Plans, Regulatory Compliance, Strategic Planning