Qureos Mentor

Wellmark Blue Cross and Blue Shield

<div>Company Description 
Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we&rsquo;ve built our reputation on over 80 years&rsquo; worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors&ndash;our members. If you&rsquo;re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!
Learn more about our unique benefit offerings here.
Want to know more? You can learn about life at Wellmark here. 
Job Description 
Use Your Strengths at Wellmark as a Designer!
Working as a part of our Marketing Creative Services team, the Designer supports print and web production efforts across the organization. You will collaborate with internal stakeholders from a variety of business units to understand requirements and translate those into technically sound documents that align with the Wellmark brand.
Ideal candidates have a demonstrated history of developing strong relationships within an organization. You thrive in a high-volume, fast-paced environment, and incorporate successful time management and prioritization methods to deliver within tight timelines. You enjoy contributing creative ideas and leveraging your design expertise to elevate projects while working within established processes and brand standards. Working in the weeds does not deter you, and you are eager to perform work that allows you to ideate, conceptualize, and execute (you appreciate a role that runs the gamut!). If this sounds like you, apply today! 
Qualifications 
Required:<ul><li>
Associate degree in Graphic Design, or related degree, or direct and applicable work experience.</li><li>
Portfolio of work required for consideration.</li><li>
Experience with using Adobe Creative Cloud.</li><li>
Organizational skills with the ability to prioritize workload as well as have a willingness to assist team members and multi-task to accommodate short timelines.</li><li>
Strong verbal and written communication skills. Must articulate information accurately to internal and external stakeholders, as well as represent Wellmark&rsquo;s brand with professionalism. Demonstrates sound judgment, critical thinking, and poise in all situations.</li><li>
Ability to complete projects both independently and in partnership with other designers.</li><li>
Self-starter and someone who thrives in a high-energy, fast-paced, ever-changing, collaborative environment with a curious mindset who seeks to constantly grow and learn marketing &amp; creative skillsets.</li><li>
Ability to receive feedback in a constructive manner and to support cooperation and collaboration across teams.</li></ul>
Preferred:
<ul><li>Associate degree in Graphic Design.</li></ul> 
Additional Information 
a. Create aesthetically pleasing and technically sound layouts, using Adobe Creative software and working with large amounts of information.
b. Package files for primarily for print but may work with digital static banner ad lay out, and work with partners for timely production.
c. Seen as the front-line face of the team, work with internal partners to understand needs and update documents accordingly.
d. Use data to inform and support creative decisions.
e. Create and update designs and templates.
f. Use project tracking software to log and track projects.
g. Perform administrative duties associated with storing of files.
h. Collaborate with others to ensure all creative meets the highest level possible of accessibility and upholds Wellmark brand standards.
i. Other duties as assigned.<div></div>
An Equal Opportunity Employer
The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.
Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com

Please inform us if you meet the definition of a &quot;Covered DoD official&quot;.

At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources:Nonimmigrant Workers and Green Card for Employment-Based Immigrants

Wellmark supports and expects the responsible use of AI for our workforce! We welcome the responsible use of these tools by job seekers as well and are interested in learning from you; you will have an opportunity in the application process to share which tools you used and how you applied them.</div>

Production Designer

<div>Company Description 
Why Wellmark Technology? Wellmark is building innovative, modern solutions using cutting edge technology. We are driving organizational transformation and business strategy by empowering our technology team to innovate new and elegant solutions to enhance the customer experience. Together, we are leaning into the future, owning the outcome, and driving organizational change to transform how we work. 
Job Description 
As a Sr. Scrum Master supporting the CRM Platform, you will enable and coach three Agile teams to deliver high-quality customer relationship management solutions that drive business value and enhance customer experiences. This role is committed to building high-performing, self-organizing teams by increasing efficiencies, fostering accountability, and ensuring successful delivery of team commitments. You will serve as a servant leader, facilitating Agile ceremonies, removing impediments, and promoting continuous improvement across teams. Working closely with Product Owners, business stakeholders, and technology partners, you will help align priorities, manage dependencies, and drive execution of complex initiatives that support the organization's CRM strategy and roadmap. 
Qualifications 
Preferred:<ul><li>
Formal Scrum Master experience.</li><li>
Certified Scrum Master (CSM) or Professional Scrum Master (PSM).</li><li>
Servant Leadership Training.</li></ul>
Required:<ul><li>
Bachelor's degree or direct and applicable work experience.</li><li>
Minimum 4 years of experience to include a combination of experience as a Scrum Master and/or Project Manager. Experience in Agile, which includes:</li><li>
Experience with estimating.</li><li>
Developing sprint planning and plan iterations. Leading scrum activities and meetings/stand-ups.</li><li>
Conducting sprint reviews and demos as well as retrospective meetings.</li><li>
Leading the team through change with effective communication, influence, and a proactive approach. Leading teams through to successful delivery.</li><li>
Experience with agile business analysis, including documentation of user stories and test requirements, process documentation. Experience working with Agile tools and/or project management software (i.e., Azure Dev Ops, etc.).</li><li>
Agile/lean mindset of adding value and eliminating waste.</li><li>
Ability to work well in a team environment and be capable of building and maintaining positive relationships with other staff, departments, and customers.</li><li>
Ability to identify approaches, risks, mitigation strategies to meet requirements.</li><li>
Consulting skills required with excellent communication, collaboration, and interpersonal skills. Proficient Microsoft Excel, Visio, PowerPoint, Project skills, SharePoint.</li></ul> 

Additional Information 
a. Lead all scrum events, sprint planning, daily scrum, sprint review and sprint retrospective. Responsible for ensuring scrum is understood and the team adheres to scrum theory, practice and guidelines; supports the Product Owner in product backlog management.
b. Ensure everyone has a voice, inviting participation from all. Seek to understand the root causes of issues and tackle them, rather than just the symptoms. Initiate open and honest coaching conversations at all levels and move easily between big picture thinking and managing relevant detail.
c. Responsible for getting teams to a high performing level by recognizing areas of strength and improvement and employing appropriate coaching/development techniques. Work with team to resolve team impediments. Work with other teams, stakeholders, and other Scrum Masters to grow within the role
d. Contribute to the advancement and improvement of agile practices within the organization. Work with other Scrum Masters to increase the effectiveness of the application of scrum in the organization.
e. Work with the Product Manager, Product Owner, and other stakeholders to provide feedback and escalate team impediments, assisting with resource activities (e.g., infrastructure support, licensing, etc.) and team growth.
f. Assist with internal communications (to other teams, stakeholders, governance, and leadership) and external communications (including vendors) to provide transparency. Collaborate with other teams, stakeholders, managers and vendors on planning and delivery alignment as needed.
g. Exemplify and promote agile values and principles. Coach teams in self-organization and cross-functional skillset and domain knowledge.
h. Other duties as assigned.
All your information will be kept confidential according to EEO guidelines.<div></div>
An Equal Opportunity Employer
The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.
Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com

Please inform us if you meet the definition of a &quot;Covered DoD official&quot;.

At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources:Nonimmigrant Workers and Green Card for Employment-Based Immigrants

Wellmark supports and expects the responsible use of AI for our workforce! We welcome the responsible use of these tools by job seekers as well and are interested in learning from you; you will have an opportunity in the application process to share which tools you used and how you applied them.</div>

Sr. Scrum Master - CRM Platform

<div>
 
 Why Wellmark
 
 : We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we&rsquo;ve built our reputation on over 80 years&rsquo; worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors&ndash;our members. If you&rsquo;re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation, consider applying today!
 
 
 Learn more about our unique benefit offerings here.
 
 
 
 Job Description
 
 
 
 As a Health Services Coding Analyst, you will provide clinical leadership and subject-matter expertise to support the analysis, configuration, and administration of complex medical policy content within claims processing systems, including Plan General Exclusion (PGE) rules and FACETS table maintenance. You will ensure the accurate implementation of medical policies, review criteria, and authorization requirements, while maintaining the integrity of system infrastructure and serving as a key liaison between business and technical teams. To do this, you will research and analyze system and business issues, develop high-level requirements, test and implementsolutions, and audit and document outcomes. The Health Services Coding Analyst also serves as an expert resource for medical policy configuration and PGE coding, mentoring and training Coding Specialists, and providing policy-related training and support to operational partners such as customer and provider services.
 
 
 
 Must be willing to work core business hours of 8 AM - 5 PM Central Time.
 
 
 
 
 Candidates located in Iowa or South Dakota preferred. This role is remote eligible and will require candidates to provide high-speed internet at their work location.
 
 
 
 
 Qualifications
 
 
 
 
 Preferred Qualifications - Great to have:
 
 
 
 <ul>
 <li>
 Prior health plan experience.
 
 
 </li>
 </ul>
 
 Required Qualifications - Must have:
 
 
 
 <ul>
 <li>
 Associate degree or direct and applicable work experience preferred.
 </li>
 <li>
 Certified Professional Coder (CPC) required.
 </li>
 <li>
 Clinical background which may include either formal education or training in a clinical or health-related discipline (such as nursing, medical assisting, surgical technology, health information management, or a related field) and/or direct work experience in a clinical or healthcare setting.
 </li>
 <li>
 7+ years&rsquo; or related health care experience in provider payment, claims, medical coding, or similar.
 </li>
 <li>
 Demonstrated expertise and knowledge of medical coding and terminology.
 </li>
 <li>
 Demonstrated strong attention to detail with the ability to multitask.
 </li>
 <li>
 Strong interpersonal skills including clear and concise written and verbal communication.
 </li>
 <li>
 Inquisitive nature, enthusiastic about developing and enacting new processes.
 </li>
 <li>
 Strong workflow management skills with sense of ownership, drive and initiative to continuously improve outcomes.
 </li>
 <li>
 Ability to communicate concepts clearly and concisely to individuals and groups and motivate others to achieve success with an eye toward promoting a culture of collegiality and excellence.
 </li>
 <li>
 Demonstrated ability to obtain relevant information by relating and comparing data from different sources.
 </li>
 <li>
 Proficiency in Microsoft Office applications including experience with spreadsheets, process mapping, presentation and word processing.
 </li>
 <li>
 Ability to adhere to quality and production metrics.
 </li>
 <li>
 Some experience with and continued interest in coaching and mentoring others.
 </li>
 <li>
 Demonstrated ability to consistently meet department work schedule.
 
 
 </li>
 </ul>
 
 Additional Information
 
 
 
 
 What you will do:
 
 
 
 <ul>
 <li>
 Leadership in Coding Analysis: Lead the analysis of the most complex Wellmark medical policy content and implementation of system edits to support its intent. Medical policy coding requirements are implemented, tested, documented and audited to assure compliance.
 </li>
 <li>
 Maintain the claims processing system infrastructure to ensure compliance with regulatory and accreditation bodies and vendor supported technical requirements and ensure accurate claims adjudication.
 </li>
 <li>
 Translate complex medical policy language into precise, actionable coding criteria for integration into claims systems and configuration platforms.
 </li>
 <li>
 Serve as coding subject matter expert for complex or escalated utilization management.
 </li>
 <li>
 Collaborate with Utilization Management nurses, medical directors, and claims teams to resolve coding-related denials, overrides, and policy interpretation questions.
 </li>
 <li>
 Contribute to the full lifecycle of medical policy creation, revision and interim review, including drafting coding sections, researching emerging procedures/devices, and ensuring policies reflect current coding conventions (AMA CPT, ICD10, HCPCS).
 </li>
 <li>
 Conduct impact analyses of proposed policy changes on coding, reimbursement, and operational workflows.
 </li>
 <li>
 Work directly with Health Services leadership, Medical Review staff, leadership within Claims and Customer/Provider Services and Network Engagement, Medical Directors to provide medical coding expertise and PGE rule knowledge to resolve complex claims and/or customer and provider issues.
 </li>
 <li>
 Maintain coding integrity by monitoring utilization trends to identify and resolve system configuration issues.
 </li>
 <li>
 Work with Medical Policy Leadership in the development and optimization of coding configuration standards and best practices.
 </li>
 <li>
 Work with payment integrity, business support, and data analytics teams to edit, develop, and implement Optum, Cotiviti, and Cognizant edits.
 </li>
 <li>
 Contribute to the achievement of corporate and UM Product Team objectives by independently serving as primary points of contact and UM Product Team Subject Matter Expert/Guest Star to provide expertise to support the various claims processing systems, including but not limited to PGE rules and table maintenance (FACETS and STAR). This will include attendance to various virtual cross-functional team meetings, as well as in-person attendance and participation in quarterly Iteration Planning meeting.
 </li>
 <li>
 Update coding files as required by code set revisions, HIPAA-AS, medical policy development and implementation, regulatory requirements, FEP and Blue Card guidelines, or as needed to support other internal processes.
 </li>
 <li>
 Participate in cross functional meetings or initiatives to support the goal of managing medical benefit expense.
 </li>
 <li>
 Provide expertise in the areas of medical coding PGE rule knowledge and medical policy configuration rules to support projects and broad organization initiatives. Consult with leadership as business decisions are made and retain and archive documentation of decisions made. Comply with regulatory standards, accreditation standards and internal guidelines; remain current and consistent with the standards pertinent to the Medical Policy team.
 </li>
 <li>
 Mentor and train Coding Specialist as well as provide specific topic training related to medical policy administration/PGE rules to other operational areas such as customer and provider service as needed.
 </li>
 <li>
 Other duties as assigned.
 
 
 </li>
 </ul>
 
 Remote Eligible:
 
 You will have the flexibility to work where you are most productive. This position is eligible to work fully remote. Depending on your location, you may still have the option to come into a Wellmark office if you wish to. Your leader may ask you to come into the office occasionally for specific meetings or other &lsquo;moments that matter&rsquo; as well.
 
 
 
 
 An Equal Opportunity Employer
 
 
 
 
 
 The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.
 
 
 
 
 Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com
 
 
 
 
 Please inform us if you meet the definition of a "Covered DoD official".
 
 
 
 At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources:Nonimmigrant Workers and Green Card for Employment-Based Immigrants
 
 
 Wellmark supports and expects the responsible use of AI for our workforce! We welcome the responsible use of these tools by job seekers as well and are interested in learning from you; you will have an opportunity in the application process to share which tools you used and how you applied them.
</div>

Health Services Coding Analyst (CPC Required)

Join Wellmark Blue Cross and Blue Shield and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Wellmark Blue Cross and Blue Shield

About Company

Production Designer

Sr. Scrum Master - CRM Platform

Health Services Coding Analyst (CPC Required)