Medicare Audit & Appeals Operations Manager

Blue Cross Blue Shield of Alabama; Birmingham (AL); Híbrido; USD 90.000 - 125.000; Jornada completa

Descripción de la vacante

Blue Cross Blue Shield of Alabama is seeking an experienced CSA Operations Manager to oversee audit and data analysis across subsidiary contracts. The role requires directing a diverse team of statisticians, auditors, and analysts, and designing projects across contract lines.

You will guide training and quality assurance initiatives while ensuring timely, budget-conscious execution of directives. The candidate should bring leadership experience, strong regulatory knowledge, and proven ability

Formación

• Bachelor degree and five years of supervisory or leadership experience.
• Knowledge of Medicare or other agency regulations and guidelines.
• Experience using statistical methods and data analysis techniques.
• Experience in leadership, team building and performance management.

Responsabilidades

• Ensure data analysis, audit and appeal requirements across contracts are completed timely and within budget.
• Provide clear information and education regarding utilization of agency services to internal and external customers.
• Manage staff including statisticians, auditors and analysts, and design multiple projects across contract lines.
• Provide training and mentorship, and develop policies to improve workflow and quality assurance.

Conocimientos

Statistical analysis

Leadership

Regulatory knowledge

Project management

Educación

Bachelor degree in statistics, nursing, health care, business, accounting or related field

Herramientas

Database management systems

Descripción del empleo

Blue Cross Blue Shield of Alabama is seeking an experienced CSA Operations Manager to oversee audit and data analysis across subsidiary contracts. The role requires directing a diverse team of statisticians, auditors, and analysts, and designing projects across contract lines.

You will guide training and quality assurance initiatives while ensuring timely, budget-conscious execution of directives. The candidate should bring leadership experience, strong regulatory knowledge, and proven ability