Cobalt Benefits Group, LLC (DBA: Blue Benefit Administrators, CBA Blue & EBPA)

Account Executive

• Act as the primary executive-facing contact for national account clients and their brokers
• Build and maintain trusted relationships with senior HR, finance, and benefits leaders
• Lead quarterly and/or annual plan performance meetings, presenting plan performance metrics, claim trends, and strategic recommendations
• Represent Cobalt at executive-level client meetings, industry conferences, and client-sponsored events as needed
• Provide proactive insights on emerging industry trends, compliance updates, and healthcare cost drivers
• Evaluate benefit plan performance and identify opportunities for cost savings and employee health improvements
• Collaborate with Sales and Underwriting to drive renewals, upsell opportunities, and revenue growth
• Partner with the National Accounts Account Manager to ensure seamless day-to-day service execution
• Monitor and oversee escalations and resolve complex client issues quickly and transparently
• Serve as the executive escalation point for high-visibility issues impacting client satisfaction
• Partner with the Health Plan Performance/Analytics Consulting team to deliver customized data reporting
• Translate analytics into executive-level insights and communicate actionable recommendations
• Prepare clients with data-driven strategies for renewal and performance planning
• Drive accountability across internal stakeholders to ensure National Account standards are met
• Participate in the National Accounts Leadership Council and contribute to continuous improvement and best practices

Senior Account Executive

Account Manager

• Serve as the primary day-to-day contact for national account clients and brokers
• Acknowledge client and broker emails within one business day and provide clear updates on resolution timelines
• Partner with the National Account Executive to maintain strategic client relationships
• Provide proactive outreach on operational updates, claims activity, and service trends
• Monitor and manage claim escalations, appeals, and high-touch service issues with internal claims teams
• Lead root cause analysis and ensure closure of recurring issues with full documentation
• Identify trends in claims or service activity and escalate patterns to leadership
• Monitor centralized service channels and ensure inquiries are routed and resolved with accountability
• Partner cross-functionally with Finance, Claim Operations, Curated Solutions, Reporting, and Stop-Loss
• Collaborate with the HPAC team to provide accurate data and insights for plan performance meetings
• Review and quality-check service materials, claims documentation, and client deliverables
• Ensure compliance with service standards, regulatory requirements, and internal SLAs
• Maintain Salesforce records tracking service activity, escalations, and client communications

National Account Manager, Self-Funded TPA

Procurement

• Implement, configure, and maintain client-specific provider contracts, reimbursement methodologies, pricing arrangements, and related system records
• Validate contract configuration against approved client requirements, source documentation, fee schedules, and reimbursement methodologies
• Develop, document, and execute contract testing scenarios to ensure accurate pricing, reimbursement, and claims processing outcomes
• Coordinate contract implementation and maintenance activities with internal departments, network partners, clients, and other stakeholders
• Maintain organized and accurate documentation related to provider networks, contracts, pricing arrangements, affiliations, tiering structures, and implementation decisions
• Support provider network tiering setup, validation, testing, and ongoing maintenance activities
• Monitor medical and dental network changes to ensure updates are implemented accurately, consistently, and in a timely manner
• Perform provider contract and pricing maintenance, including identifying and resolving configuration discrepancies
• Import and analyze 835 and 837 electronic claim files to support contract validation, reimbursement analysis, and provider maintenance activities
• Respond to provider, network, and contract-related requests within established service standards
• Support audits, quality reviews, issue resolution, and continuous improvement initiatives related to provider data, contract configuration, network maintenance, and reimbursement accuracy

Healthcare Provider Network – Contract Management Specialist

Security Analyst

• Monitor managed detection and response, endpoint, identity, email, network, cloud, and security analytics platforms for suspicious activity
• Triage and investigate alerts; document findings; coordinate containment, remediation, recovery, and post-incident follow-up
• Analyze event, identity, endpoint, cloud, application, and network logs
• Maintain incident response plans, investigation procedures, escalation paths, and case documentation
• Assess and improve security across public cloud subscriptions, storage, workloads, applications, and hybrid connectivity
• Administer identity and access controls, including MFA, conditional access, role-based access, privileged access, service identities, access reviews, and joiner-mover-leaver processes
• Support Zero Trust and secure access services for private applications
• Design secure access for cloud data platforms, application hosting, and AI-enabled services with administrators and engineers
• Operate data security posture management capabilities and administer data loss prevention controls
• Support data discovery, classification, information protection, retention, encryption, and remediation workflows
• Administer security awareness training, phishing simulations, targeted education, completion tracking, and human-risk reporting
• Support endpoint detection and response, device security, mobile device management, application control, browser protection, and workstation security baselines
• Coordinate vulnerability and exposure management and prioritize remediation through patching
• Assess application and infrastructure changes for secure configuration, logging, access, data protection, and resilience
• Monitor firewalls and intrusion detection systems for security incidents
• Collaborate on operating system, application, firmware, and security patching; validate remediation and document accepted exceptions
• Support backup, recovery, immutable storage, business continuity, and disaster recovery security requirements
• Maintain policies, standards, procedures, diagrams, and inventories
• Contribute to automation and repeatable analysis using scripting, query languages, and workflow integrations
• Evaluate emerging security requirements for cloud, SaaS, and AI agents
• Establish AI governance, security controls, and risk management practices
• Support the AI Risk Management Framework program through inventory management, risk assessments, control validations, policy development, monitoring, and governance reviews

Information Security Analyst

General

• Manage the initial intake and data entry of clinical information required for utilization review processes
• Verify patient information
• Prepare and submit authorization requests to nursing staff or external UR vendor AHH
• Support daily Utilization Review department operations and assist the Lead Utilization Review Intake Coordinator
• Enter clinical and intake information into the appropriate platform and route it to the appropriate vendor
• Maintain current knowledge of utilization review processes and timelines
• Conduct outreach calls, collect data according to scripts, tools, and protocols, and meet productivity and performance expectations
• Process incoming and outgoing correspondence and faxes according to standards and timeliness guidelines
• Refer cases to appropriate staff and clinical team members according to workflow
• Perform urgent scanning, document retrieval, and other clerical responsibilities routed to Utilization Review
• Communicate professionally and accurately regarding agreed-upon resolutions
• Adhere to standard operating procedures and maintain knowledge of member benefits, rights, and responsibilities
• Interpret plan language and apply it to intake tasks
• Perform other related duties and projects as assigned

Healthcare Utilization Review Coordinator

• Prepare and coordinate reviews of group renewal information as needed at each group’s renewal time and upon special request.
• Review claims submitted to UR Queues for medical necessity and on-file/not-on-file authorizations.
• Make determinations for claims processing based upon coding.
• Interpret medical data and coordinate utilization review processes.
• Collaborate with clinical and administrative teams to support effective utilization management.
• Support daily Utilization Review department operations by assisting the Senior Utilization Review Specialist.
• Maintain current knowledge of UR processes and timelines.
• Conduct outreach calls, collect data according to scripts, tools, and protocols, and refer to appropriate staff when indicated by workflow.
• Process incoming and outgoing correspondence and faxes according to standards and timeliness guidelines.
• Perform urgent scanning and document retrieval for claims routed to UR.
• Interpret plan language and apply it to specialist tasks.
• Process claims within BCBS Association standards.

Healthcare Utilization Review Specialist

QA Engineer

• Perform daily pre-pay and post-pay audits of medical claims
• Validate benefit application, including deductibles, copays, coinsurance, eligibility, and plan provisions
• Audit provider network tiering and reimbursement accuracy
• Verify claims are processed according to provider contracts, fee schedules, and client plan designs
• Identify, document, and communicate claim processing errors and trends
• Conduct production, system configuration, and operational quality audits
• Complete LDLA (Licensee Desk Level Audit) and MTM (Member Touchpoint Measurement) reviews
• Support external client, regulatory, and internal audit activities
• Participate in new client, renewal, and plan change testing efforts
• Produce audit reports and recommend corrective actions and process improvements
• Collaborate with Claims, Provider Maintenance, Customer Service, Configuration, and Implementation teams to resolve quality issues