Job Description

Leads system development and the design for highly complex solutions that are efficient and cost effective, which support Wellmark’s business and Technology initiatives. Serves as a subject matter expert for other engineers to ensure the end product aligns with business expectations and development logic meets Wellmark standards and security requirements. Utilizes established relationships with Wellmark leaders and acts as a consultant on engineering and business process improvements and technology enhancements or capabilities.

Qualifications

Required:

• Bachelor’s degree in Computer Science, MIS, or related field of study and at least 5 years of development experience (ex. Angular, NodeJS, TypeScript, C++, .NET, Java, SQL) OR 9 years of related and applicable experience.
• Strong analytical problem-solving skills. Accuracy and high attention to detail. Previous experience troubleshooting and developing creative technical solutions. Ability to provide innovative solutions to complex issues.
• Demonstrated experience in software development lifecycle methodologies.
• Demonstrated ability to communicate with and coach/mentor team members, while setting an example in maintaining a positive attitude, staying calm under pressure, being approachable, and respectful and taking responsibility for failures.
• Big picture thinker with the ability to translate the value of the Wellmark as a Service (WaaS) strategy to company strategy when making design and development decisions.
• Demonstrated, strong ability to gather information, perform necessary research needed for root cause analysis, problem definition and formulation, recommend solution implementation, verification, and ongoing optimization, using data to support recommendations.
• Demonstrated ability to build relationships to reach outcomes that gain the support and acceptance of all parties. Ability to communicate key information in a timely manner to the appropriate stakeholder audience with the ability to adjust communication style that will best suit the audience.
• Ability to thrive in fast-paced environment with changing priorities. Excellent organizational skills. Strong time management skills with the ability to set and meet established timeframes with little direction, while assuring data and information integrity.
• Eagerness to learn and stay current on industry trends and have a continuous learning mindset.
• Ability to collaborate and work as a team to accomplish goals and/or solve problems. Ability to earn trust and respect from peers, leadership, and stakeholders. Ability to learn by actively listening and applying coaching feedback.
• Ability to lead, support and work within a diverse development team model including global staffing, crowd sourcing, etc.

Preferred:

• Bachelor’s degree
• Experience working within an Agile team environment
• Experience partnering with global staffing vendors to deliver projects.
• Experience with Test Driven Development
• Experience with AWS

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Job Description

This Enterprise Cloud Engineer role sits on our Engineering Practices team and plays an instrumental role in transforming and modernizing how Wellmark engineers develop software. You will share knowledge on best practices and drive technological advancements. You will focus on the support of designing and optimizing cloud-native solutions, IaC, CI/CD, DevOps Practices, and Microservices Architecture are all a part of the ecosystem you will be working to modernize and influence. You will be responsible for designing, developing, and maintaining our internal developer portal. You will serve as a technical resource for engineering staff and tasked with coaching and mentoring engineers.

Qualifications

Preferred: 

• Strong knowledge of cloud platforms – AWS, Azure.
• Strong experience with Backstage or similar developer portal frameworks.
• Expertise in Git, JavaScript, Python and unit testing frameworks such as Jest and PyTest.
• Proven track record of mentoring and coaching software engineers.
• Experience with Test Driven Development.
• Proficiency in Agile methodologies.

Required: 

• Bachelor's Degree or direct and applicable work experience 
• Minimum 5 years’ experience with system engineering/architecture with multiple platforms; including advanced scripting and coding experience. Leverage relationships with Engineers, Security and Application Design/Run teams to develop and champion system design standards and best practices.  Lead the transformation of design, build and delivery patterns for cloud services. Strong understanding of DevOps / CICD methodologies and tools 
• Advanced experience with multiple scripting tools and concepts and utilization of them into an enterprise environment 
• Proven experience with a variety of virtualization technologies in multi-tenant, private and hybrid cloud environments. Hands on experience creating reusable solutions (patterns) leveraging 'design for failure’ approaches 
• Demonstrated ability to collaborate across all technical and business teams in the process of defining IT Solution scope, business/system/non-functional requirements, and writing/executing test cases 

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Job Description

About the Opportunity:As an experienced M.D. or D.O. in adult acute care setting(s), you will use evidence-based decision making to perform inpatient case reviews that are timely and clinically appropriate. You will concisely, effectively, and consistently synthesize clinical information to document a clear summary of a medically necessary determination. While case reviews are this role's primary priority and function, you will have the opportunity to make recommendations on efficiencies and innovations to ensure our members are getting appropriate and timely care based on their health plan coverage. You will partner across the organization with other internal teams, such as Business Analytics, Claims, Operations, Actuarial, and BlueCard, to name a few. Join us on this continuous journey as we make health care better for our members! 

About You: You are decisive and have a strong ability to influence internally and externally by appropriately and effectively presenting evidence-based medicine to support a determination. Critical thinking, sound judgment, and decisiveness are key; however, you will be able to draw from your colleagues’ subject matter expertise from various departments, to help make evidence-based prior authorization decisions. You are collaborative by nature and are energized by the opportunity to work in a highly integrated and matrixed culture. Managed care experience in a large commercial organization, such as at another Blue Cross & Blue Shield plan, a plus. 

If this sounds like you, apply to our Medical Director-Inpatient Utilization Management opportunity today! 

Iowa or South Dakota-based candidates preferred but open to remote for the right candidate. 

This full-time position will also work a rotating on-call schedule for weekend and holiday reviews. 

Qualifications

Required Qualifications:

• Graduate of an accredited medical school; M.D. or D.O. degree is required.
• Active and unrestricted license to practice medicine in Iowa or Iowa Administrative Medical License is required within 3 months from date of hire AND must be licensed in the state in which you reside. While obtaining license, the incumbent will participate in training, provide operational guidance and advice, and participate in projects as assigned while licensure is pending approval.
• Current Board Certification in Emergency Medicine, Family Medicine, or Internal Medicine through the American Board of Medical Specialties (ABMS) or American Osteopathic Association (AOA).
• 3-5 years of adult inpatient clinical experience in an acute care hospital setting (e.g. inpatient unit or emergency department) sufficient to enable medical judgments regarding appropriateness of inpatient care, medical necessity, and post-acute care. 
• Ability to participate in rotating on call schedule for weekends and holiday reviews.
• Strong analytical and critical thinking skills; makes sound evidence-based decisions.
• Demonstrated commitment to service excellence (timeliness, accuracy, quality) and advocacy for member care.
• Strong consulting and interpersonal skills. Quickly builds rapport and establishes credibility.
• Excellent verbal and written communication skills. Ability to communicate effectively and with clarity with internal and external audiences, and clinical peers, even when conveying difficult decisions and complex information.
• Strong change management skills. Creates a clear view of future state and inspires others to advance the vision.
• Ability to mentor and guide others and work within the teams. This includes sharing accountability, influencing without direct authority, and effectively listening to others.
• Self-starter with strong organization and time management skills. Flexible with changing priorities.
• Works well independently and collaborates as a member of a cross-functional team; ability to navigate in a dynamic corporate environment.
• Strong technical acumen. Learns new systems and processes quickly (e.g. Microsoft Office, clinical platforms, etc.).

Preferred Qualifications:

• Previous administrative medical experience (e.g. clinical coordination, medical consulting, health plan, provider group, hospital group, etc.).

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