PE QC & Training Lead-2

001 BlueCross and BlueShield of South Carolina; Columbia (SC); On-site; USD 85,000 - 110,000; Full time

Benefits offered by this job

Subsidized health plans

401k with company match

Life Insurance

Paid Time Off

On-site cafeterias and fitness centers

Education Assistance

Service Recognition

National discounts

Job summary

BlueCross BlueShield of South Carolina seeks a senior professional to improve provider data quality by auditing the work of Provider Enrollment Analysts and Senior Provider Enrollment Analysts. You will develop reports to inform management about data quality across the Provider Information Management System (PIMS).

You will conduct training needs assessments and deliver training to new analysts, supporting ongoing development within a large, mission-driven health plan.

Qualifications

• Bachelor's degree equivalency: 4 years related work experience or an Associate's and 2 years related experience.
• 2 years of provider network enrollment/certification experience.

Responsibilities

• Audit provider data accuracy and quality.
• Develop reporting tools to highlight data error trends.
• Collaborate with supervisor to address individual errors.
• Maintain quality control protocols and policy manuals.
• Train new analysts on PIMS and department procedures.
• Perform training needs analysis and recommend materials.

Skills

Data quality auditing

Provider enrollment

Reporting tools

Training delivery

Education

Bachelor's Degree equivalency

Tools

PIMS

Job description

Summary Senior level position focused on improving provider data quality by auditing the work of Provider Enrollment Analysts and Senior Provider Enrollment Analysts. Develops reports to keep management informed of the overall quality control of Provider Information Management Systems (PIMS). Performs training needs assessments and recommends training courses based on issues found during the quality control process. Provides training to new analysts and ongoing developmental training to the department. 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! Sponsorship: This position is not eligible for sponsorship now or in the future.

Sponsorship: This position is not eligible for sponsorship now or in the future.

Description Logistics:

BlueCross BlueShield of South Carolina - About Us | BlueCross BlueShield of South Carolina Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 7:00AM - 5:00PM. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located onsite at 4101 Percival Road Columbia, SC 29229.

What You’ll Do:

• Reviews provider data to ensure accuracy.
• Develops reporting tools to keep management abreast of any data error trends or issues.
• Works with the supervisor to address individual errors.
• Develops and maintains departmental quality control protocol and policy and procedure manuals ensuring any changes are properly communicated.
• Trains new analysts on PIMS and departmental policies and procedures.
• Conducts training needs analysis based on quality control results.
• Recommends training materials and subject matter to management.
• Serves as a resource to analysts with difficult or escalated issues.

To Qualify for This Position, You’ll Need the Following:

• Required Education: Bachelor's Degree equivalency: 4 years job related work experience or Associate's and 2 years job related work experience
• Required Work Experience: 2 years of provider network enrollment/certification experience..

Our Comprehensive Benefits Package Includes The Following:

We offer our employees great benefits and rewards. You will be eligible to participate in the benefits 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.

What to Expect Next:

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.

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. Here's more information. Some states have required notifications. Here's more information.

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 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 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 Beauport 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.

Join Us

If you're ready to join in a diverse company with secure, community roots and an innovative future.