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InterPlan Consultant Intern - Work U

Blue Cross of Idaho Health Service, Inc.
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InterPlan Relations is responsible for the overall relationships between Blue Cross of Idaho, the Blue Cross Blue Shield Association, the Consortium, and the Sister Blue Plans.  We ensure Blue Cross of Idaho is in compliance with all BCBSA and Consortium rules and regulations.  In addition to the rules and regulations, InterPlan is responsible for the negotiation of fees with other Blue Plans nationwide.  BlueCard Modernization is the newest addition to InterPlan Relations and is the first significant change to the BlueCard infrastructure since its inception in 1994; BlueCard Modernization will completely alter the way in which Blue Plans conduct business with members, providers, BCBSA and each other.  There are a number of capabilities that will be implemented over the coming months and years that will contribute to these architectural and infrastructural changes including: Clinical Data Exchange, Enhanced Data for Account Reporting, ITS SaaS, Provider Data Transformation, and Real-Time Messaging. Collectively, these capabilities will catapult the Blues into a new sphere allowing us to be far more nimble and meet the needs of our customers.       

        

Opportunity/Project Duties:

There are two areas in need of assistance, the creation of BlueCard Modernization documentation on these capabilities and meeting attendance as well as the building out of the InterPlan Relations SharePoint site which will allow users across the enterprise easy access to data they otherwise would have difficulty locating.      

Clinical Data Exchange – The establishment of a near real-time receipt of Admission Discharge Transfer data on BCI members nationwide as well as Care Coordination data allowing our Care and Case Managers a more holistic view of our members while also allowing a more precise development of the Risk Adjustment Factor for our Federal lines of business.

Enhanced Data for Account Reporting (EDAR) – A single site location allowing a subscription based “push’ versus “pull” of data that will automatically “land” data in a lake permitting consistent tableau type reporting for our clients. 

ITS SaaS – A complete infrastructural change to BlueCard that will move all elements of BlueCard to the cloud.  Due to the size and complexity of BlueCard, this will be completely incrementally and will not be completed until 2026.

Provider Data Transformation (PDT) – A complete change in the way Plans report and update and share their provider data.  This change will result in updates being completed daily rather than weekly ensuring members have the most current data available to them at the point in time they are reviewing providers’ network status. 

Real-Time Messaging (RTM) – As its name indicates, Real-Time Messaging provides the ability for Plans to exchange messages in a real-time capacity to review and resolve claims issues in real-time to allow Plans to get back to members and providers far more quickly than we have had the ability to do up until this point.  It brings the Blues into the 21st century! Into a world of more instant gratification as many in the Generation  

 

Qualifications: 

  • Attention to detail
  • Familiarity with SharePoint development (we have a site, it just has not been built out)

Skills You Will Develop: 

  • Understanding of national health insurance, rules and regulations governing insurers