Operations Manager-2

Southcarolinablues; Florence, Northern (SC, KY); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Subsidized health plans

Dental and vision coverage

401k retirement savings with company‑m

Life Insurance

Paid Time Off (PTO)

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina is seeking a responsible supervisor to manage daily activities in a multi‑functional claims/processing area in Florence, SC. You will monitor productivity, attendance, quality, and motivate associates to meet departmental goals.

The role is on‑site at 200 N Dozier Blvd, Florence, SC 29501, with 40 hours/week, Monday‑Friday 8:00am‑5:00pm. A Bachelor's degree and strong leadership are required to ensure contract compliance and quality results.

Qualifications

• Bachelor’s degree required.
• Strong management, organization, communication, decision‑making and analytical skills.
• Excellent customer service and presentation skills.
• Knowledge of applicable laws and regulations for business unit operations.
• Proficiency with Microsoft Office tools.

Responsibilities

• Direct and supervise claims/documents processing and support team to ensure timely, contract‑compliant processing.
• Prepare and analyze reports on pending/processed documents, claims, adjustments and quality audits.
• Administer and oversee quality control procedures and ensure compliance with guidelines.
• Select and maintain a well‑trained staff.
• Identify education and system issues and implement improvements.
• Maintain a high level of internal and external customer service.
• Lead projects on policy changes, quality improvements, and system changes.
• Assist in budget preparation and monitor related expenses.

Skills

Strong management

Organizational skills

Communication

Decision-making

Analytical skills

Customer service

Presentation skills

Business math

Knowledge of laws/regulations

Microsoft Office

Education

Bachelor’s degree

Tools

Microsoft Office

Job description

Summary

Manages the daily activities of a multi-functional area. Responsible for monitoring productivity, attendance and quality of work produced. Responsible for motivating associates to meet individual and departmental goals.

Why Join Us

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina ... and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Position Purpose

Manages the daily activities of a multi-functional area. Responsible for monitoring productivity, attendance and quality of work produced. Responsible for motivating associates to meet individual and departmental goals.

Logistics

PGBA - one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full‑time (40 hours/week) Monday‑Friday from 8:00am-5:00pm. This role is located on‑site at 200 N Dozier Blvd, Florence, SC 29501.

What You’ll Do

• Direct and supervise claims/documents processing and support team associates to ensure claims/documents are processed in a timely and efficient manner to maintain contract compliance standards.
• Prepare and analyze reports of pending and processed documents, claims, adjustments and reprocesses, and quality audits of claims/documents that measure level of performance of the team.
• Administer and oversee quality control procedures and ensure compliance of all corporate and contract required guidelines.
• Select and maintain a well‑trained staff.
• Identify potential education and system issues.
• Establish and maintain a high level of customer service with all internal and external customers.
• Direct and supervise the customer service associates to ensure that all correspondence and telephone inquiries are processed in a timely and efficient manner to maintain contract compliance standards.
• Select and maintain a well‑trained staff.
• Identify potential education and system issues.
• Participate as project leader on policy changes, quality improvements initiatives and system change efforts, while ensuring corporate, contractor, and department policies and procedures are administered timely, consistently and accurately.
• Identify system errors and process/quality improvement opportunities, initiate work requests, and serve as the customer project lead to ensure accurate implementation.
• Assist in budget preparation and monitor expenses related to the budget.

To Qualify for This Position

• Required Education: Bachelor’s
• Required Skills and Abilities: Strong management, organization, communication, decision‑making, and analytical skills.
• Excellent customer service skills.
• Strong presentation skills and basic business math proficiency.
• Knowledge of applicable laws and regulations pertaining to business unit operations.
• Required Software and Tools: Microsoft Office.

We Prefer That You Have the Following

• Preferred Work Experience: 3 years‑of related health or managed care industry work experience.
• 1 year‑of management experience OR 1 year of equivalent military experience in grade E4 or above.
• Preferred Skills and Abilities: Ability to use complex mathematical calculations.
• Knowledge of mathematical or statistical concepts.
• Preferred Software and Other Tools: Proficient in database software.
• Knowledge of Provider Data Management system.

Our Comprehensive Benefits Package Includes the Following

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment.

• Subsidized health plans
• dental and vision coverage
• 401k retirement savings plan with company match
• Life Insurance
• Paid Time Off (PTO)
• On‑site cafeterias and fitness centers in major locations
• Education Assistance
• Service Recognition
• National discounts to movies, theaters, zoos, theme parks and more

What We Can Do for You

We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy‑related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment, please email [e-mail] or call 800‑288‑2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case‑by‑case basis. We participate in E‑Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

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Welcome

Welcome Here’s Your Smart Career Move Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than ever. Our A.M. Best rating is A+ (Superior) - making us the only health insurance company in South Carolina with that rating. We’re the largest insurance company in South Carolina ... and more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Veterans Welcome!

BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve found the dedication, work ethic and job skills that serve well in the military excel in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more. Through our government contracts, we also have employees serving at Shaw Air Force Base, the Naval Health Clinic in Charleston, the Naval Hospital in Beaufort and in our hometown of Columbia, S.C., at Ft. Jackson. If you are a full‑time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are called to active duty.