Business Operations Advisor, Provider Credentialing

Blue Cross and Blue Shield of North Carolina; United States; Hybrid; USD 74,000 - 118,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Parental leave and adoption/surrogacy‑

401k match

Tuition reimbursement

Paid Time Off (PTO)

Annual Incentive Bonus

Job summary

Blue Cross NC is hiring a Business Operations Advisor, Provider Credentialing to support the Network Operations Team with credentialing committee work, planning, reporting, and special projects.

The role combines data analysis, budgeting, stakeholder engagement, and process improvements within a Hybrid-Flex work model, with opportunities to contribute to organizational goals.

Applicants should have a Bachelor’s degree (or 5+ years of related experience in lieu) and 3+ years in a related field.

Qualifications

• Bachelor’s degree or advanced degree required/preferred.
• 3+ years of experience in related field; in lieu of degree, 5+ years of experience.
• Executive reporting or data analysis experience is a plus.

Responsibilities

• Facilitate planning of strategic goals and development of departmental/divisional operational plans.
• Coordinate, plan and facilitate department events to improve effectiveness and outcomes.
• Assist with workforce planning and staffing models, tracking hires by budget and competency.
• Lead change management work to support business and process improvements.
• Consolidate and standardize data analysis and reporting for operations.
• Lead vendor relationship management as required by business operations.

Skills

Budget Administration

Budgeting

Business Process Improvements

Operations Management

People Management

Process Improvements

Project Management

Stakeholder Management

Strategic Planning

Vendor Relationships

Education

Bachelor’s degree

Advanced degree

Tools

Salesforce

Job description

Job Description

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.

WhatYoullGet

• 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
• Learn more

WhereYoullWork

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

_____________________________________________________________________

JOB ALERT FRAUD:

We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: [e-mail].