PE QC & Training Lead-2

ourhrconnect; Columbia (SC); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health benefits

401k with company match

Paid Time Off

On-site cafeterias

Job summary

BlueCross BlueShield of South Carolina is seeking a senior-level professional to improve provider data quality by auditing Enrollment Analysts and Senior Enrollment Analysts. You will develop reports that keep management informed of quality, and provide training to new analysts and ongoing development for the department.

The role is onsite in Columbia, SC with potential travel, and sponsorship is not offered for this position.

Qualifications

• Bachelor's degree required.
• 2 years provider network enrollment/certification experience.
• Experience auditing provider data and developing QA reports.

Responsibilities

• Audits provider data to ensure accuracy and develops reports on data quality trends.
• Trains new analysts on PIMS and department policies.
• Conducts training needs analyses and recommends training materials.
• Acts as a resource for analysts with difficult issues.

Skills

Data quality auditing

Training delivery

Quality control

Education

Bachelor's degree

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.

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 disabilitiesand 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 moreinformation.

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