Business Operations Advisor, Provider Credentialing

Blue Cross and Blue Shield of North Carolina; North Carolina; Híbrido; USD 74.000 - 118.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, vision benefits

401k with company match

Paid time off

Descripción de la vacante

Blue Cross NC is seeking a Business Operations Advisor, Provider Credentialing to support Network Operations. The role involves business planning, project coordination, data analysis, and senior stakeholder collaboration to enhance credentialing processes and overall operations.

You will help track budgets, staffing plans, and KPIs while coordinating cross-functional initiatives and preparing executive communications. Hybrid-flex/work setup with opportunities across multiple states.

Formación

• Bachelor's degree is required or equivalent experience.
• 3+ years of experience in related field; 5+ years if no degree.
• Experience in provider credentialing and health insurance payor environments preferred.

Responsabilidades

• Facilitate departmental and divisional operational plans and events.
• Coordinate workforce planning, staffing models and headcount tracking.
• Lead data gathering, budget analysis and KPI reporting.
• Support vendor relationships and executive communications.
• Assist in change management and SOP adoption across the department.

Conocimientos

Budget Administration

Budgeting

Business Process Improvements

Operations Management

People Management

Process Improvements

Project Management

Stakeholder Management

Strategic Planning

Vendor Relationships

Educación

Bachelor's degree

5+ years of related experience in lieu of degree

Herramientas

Salesforce

Descripción del empleo

We’re hiring a Business Operations Advisor, Provider Credentialing to join the Network Operations Team! Provide department, divisional and/or segment focused business and operational support to include our credentialing committee, operational planning, workforce planning, reporting, data and/or budget analysis, internal/external marketing, and special projects.

What You’ll Do

Business Planning Facilitate planning of strategic goals and development of departmental/divisional operational plans. May produce segment business plans and analysis under guidance from Segment Lead. Coordinate, plan and facilitate various departmental/divisional events (i.e. Departmental Summits, All Hands Meetings, Leadership Planning Sessions, staff meetings) to make them more effective, purposeful and outcomes based. Assist with the overall workforce plan and staffing models, taking into account multiple and interrelated initiatives to either increase or decrease headcount, each with their own set of success criteria/outcomes, budget, and duration. Responsible for tracking employee hires by budget & competency, per the Strategic Plan and other key inputs. Aid in the adoption of standard operating procedures and processes for the department and assist with the communication and education of new SOPs outside of the department. Lead change management work to support business and process improvements and overall departmental/divisional effectiveness.

Project Coordination Handle special projects for the department/division/segment as assigned.

Possible duties could include:

• Assist in the evaluation of potential opportunities to reduce costs/improve efficiencies
• Lead the review and evaluation of best or next practice opportunities for potential adoption
• Review industry literature and ensure leadership is briefed on current and emerging issues of importance to the organization.
• Serve as lead on engagements with external entities (i.e. consultants) and coordinate data gathering and research efforts based on the direction of leadership.
• Track initiatives/projects for the department/division/segment and may create presentations of initiative/project progress for varied audiences, which may include ILT and Senior Leadership.

Data Analysis/Reporting Consolidate and standardize data analysis and reporting for relevant business operations. Perform departmental budget analysis, monitor budget forecasts and review progress against administrative cost reduction goals. Track goal progress, including data collection and analysis of key performance metrics (KPIs).

Business Partnerships Accompany leaders to internal and/or external partnership meetings, and capture discussions for follow-up. Prepare input for Annual Report, CEO/Board reports, and other marketing/communication opportunities with a focus on partnering to deliver communications that are relevant and oriented to specific business partnerships both internal and external. Provide support for leadership’s public speaking engagements and/or industry Board and Committee meetings. Lead in management of vendor relationships as required by business operations’ needs.

What You Bring

• Bachelor's degree or advanced degree (where required)
• 3+ years of experience in related field
• In lieu of degree, 5+ years of experience in related field

Bonus Points (Preferred qualifications)

• 5+ years of provider credentialing experience is highly preferred.
• Experience working for a health insurance payor/payer is highly preferred.
• Executive reporting and data analysis experience is highly preferred.
• Salesforce experience is preferred.

What You’ll Get

• The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community
• Work-life balance, flexibility, and the autonomy to do great work
• Medical, dental, and vision coverage along with numerous health and wellness programs
• Parental leave and support plus adoption and surrogacy assistance
• Career development programs and tuition reimbursement for continued education
• 401k match including an annual company contribution

Where You’ll Work

Our Hybrid Flex approach is built on presence with a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplace that’s flexible, connected, and future focused. In a Hybrid-Flex role, you’ll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you’ll work virtually, with a few in-office visits each year for meaningful moments that matter. Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance.

$73,698.00 - $117,917.00

Skills

• Budget Administration
• Budgeting
• Business Process Improvements
• Operations Management
• People Management
• Process Improvements
• Project Management
• Stakeholder Management
• Strategic Planning
• Vendor Relationships

About Us

It’s an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we’re leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care – in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well‑being of North Carolinians. Blue Cross NC is a fully taxed, not‑for‑profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all. Help us lead the charge for better health care by joining our award‑winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.

Authorization to Work in the United States

We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview for English or Visión General de E-Verify for Español.

Request Accommodations

Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application, hiring process, or have technical issues that prevent you from completing your application please notify HR at [e-mail].

Location Availability

Blue Cross NC is a Hybrid Flex company. Whether the role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any of our approved states: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming