Health Insurance Careers

Our focus is providing knowledge for people to make better health care decisions. We can only do so through the incomparable dedicated individuals like you. Individuals who have the drive and ambition to make a difference.

Actuary Associate

The Regence Group Actuarial Division is responsible for proactively managing and retrospectively tracking and reporting on the financial and risk positions within the company, and supporting the strategic goals of the corporation. Within that context, the Associate Actuary performs technical, analytical, support, and leadership functions to help the division and the company meet its goals.

Accountant

Staff positions throughout various departments of the Finance Division. Responsibilities include preparing journal entries, supporting schedules, reconciliations and account analysis, and basic system maintenance and administration.

Claims Service Analyst

Provide claims processing. Investigate and apply contract benefits.

Clinical Pharmacist Consultant

Provides professional level of clinical pharmaceutical knowledge and interaction with the staff of Medical Affairs and Pharmacy Services to develop and recommend policies and procedures to ensure positive clinical outcomes in a cost-effective manner for prescription drug usage within Regence BlueCross BlueShield of Oregon and subsidiaries.

Advises and provides direction for the Medical Affairs and Pharmacy Services staff for case management, home health care, inpatient and outpatient hospital as each relates to prescription drug charges. Has frequent contact with other Medical Professionals (case managers, physicians, pharmacists, hospital administrators) involving complex medical information requiring negotiating skills.

Customer Service Specialist

Provide information, education and assistance to members, providers, other insurance companies, attorneys, agents/brokers or other member representatives on recorded phone lines regarding benefits, claims and eligibility.

The Customer Service Specialist is likely to be the primary contact between the corporation and members and providers. The manner in which a member or provider is treated during that contact is critical for retaining our members and to the overall success of the corporation.

Financial Analyst

Responsible for both specific and general financial activities or functions including assistance in the areas of profitability analysis, operating expense trends, business plan development, budgeting, cost accounting, project accounting and other areas relating to financial or managerial accounting and analysis. Involved in the direct support of operating department management by providing accurate and timely reports and analysis for influencing business decisions and the achievement of strategic goals. Will require an individual to apply a detailed understanding of financial concepts and principles to business operations.

Healthcare Informatics Analyst Associate

Our Actuarial Division is responsible for proactively managing and retrospectively tracking and reporting on the financial and risk positions within the company, and supporting the strategic goals of the corporation. Within that context, the Healthcare Informatics Analyst Associate performs technical, analytical, support, and leadership functions to help the division and the company meet its goals.

Medical Management Analyst

This position assists the department, professional staff, and their assigned teams in responding to the needs of the physicians, providers, members and various in-house personnel. The Medical Management Analyst makes determinations or recommendations and provides the analytical support necessary to meet Health Care Services and corporate objectives.

Based on the unit in Healthcare Services that the employee is hired for, they may perform in a role within one of the following areas:

• Utilization Management (pre-authorization, pre-certification and concurrent review)
• Condition Management (Disease Management, Maternity Management)
• Case Management
• Medical Operations (post service, pre- and post-pay claim review and audit, member appeals)

Medical Management Coordinator

Based on the unit in Healthcare Services that the employee is hired for, they may perform preauthorizations, medical care assessment, case management, medical/surgical review, medical audits, quality improvement activities, member health promotion and medical policy support when appropriate. The Medical Management Coordinator (MMC) performs prospective, concurrent, and retrospective evaluation of clinical information to establish medical necessity, appropriateness of services, cost effectiveness, and compliance with medical policy. The MMC performs all functions while maintaining compliance with member and provider contracts.

Membership Administrator

Establish and maintain eligibility, billing premium, reconcile cash, pursue aged accounts and provide eligibility and billing related customer service for Individual, Group, Government Programs, Cobra and Flexible Spending business.

Pharmacy Technician

The pharmacy technician is a corporate-wide technical support resource for pharmacy benefit, reimbursement, and other drug use issues which do not require clinical judgment. This function assists the Clinical Pharmacy Consultants and Pharmacy Services staff with formulary-related operations and other operational processes which require knowledge and experience with pharmaceuticals.

Java Developer

This position participates in a team environment for the delivery and maintenance of Java application systems under the direction or coaching of senior team members. Responsible for programming, debugging and testing of Java based internet applications in a Java development environment. Generally responsible for database design and system testing. This position provides technical, interpersonal and administrative skills in performing day to day work.

Expected deliverables include but are not limited to; program design, source code development, test case development, testing, and documentation.

In this position it is essential that IT departmental policies and procedures be adhered to. Those include, but not limited to; technical and architecture standards, production implementation standards, regular status reporting, regular participation in team, regular one on one meetings with supervisor, and providing work estimates and regular time tracking.

Systems Analyst

This position participates in a team environment for the development, maintenance and delivery of application systems under the direction or coaching of senior team members. This position provides business, analytical, design, interpersonal and administrative skills in performing day to day work.

This position participates in formal sessions and interviews to gather, translate and document business and system requirements to support transforming the requirements into effective technology solutions. This position additionally ensures correct business functionality and Regence Information Technology Services (RITS) standards are addressed within the computer applications; understands simple specification test cases enough to execute and verify results.

In this position it is essential that RITS departmental policies and procedures be adhered to. Those include, but not limited to regular status reporting, regular participation in team meetings, regular one on one meetings with supervisor and regular time tracking.