Performance Audit Senior Consultant

Blue Cross Blue Shield Association; Maine; Remote; USD 92,000 - 131,000; Full time

Job summary

A leading health insurance organization is seeking a qualified individual to manage Operational Audit Programs. The role requires 5+ years of related experience and a Bachelor's degree. Responsibilities include leading audits, analyzing performance results, and providing education and support to Plans. Candidates should have strong adaptability, research skills, and proficiency in Microsoft Office. This position is remote and offers competitive compensation.

Qualifications

• 5+ years of related work experience required.

Responsibilities

• Responsible for overall Plan execution of the Operational Audit Programs.
• Analyze performance results and lead cross-functional meetings.
• Administer various audit initiatives/programs.
• Provide Plans education and support.

Skills

Adaptability to changing priorities

Proficiency in Microsoft Office suite

Research and analytical skills

Presentation skills

Communication skills (oral and written)

Knowledge of BlueCross Blue Shield

Education

Bachelor's Degree in business or equivalent work experience

Job description

Overview

The posting range for this position is: $92,788.00-$130,326.32. This role ensures Plans' operations handle customer interactions accurately and promptly, leaving a positive brand impression. Execute audit programs and validate reported results. Present updates and recommendations at various events. Contribute to strategic planning by developing materials, presentations, and documentation. Create and improve standard operating procedures for departmental functions. Interact extensively with Plan staff at all levels, requiring diplomacy in difficult conversations. Influence local and national Plan operations.

Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.

Responsibilities

• Responsible for overall Plan execution of the Operational Audit Programs. This includes auditing Plans' local and inter-Plan claim processing, local customer service processing, and enrollment processing in accordance with applicable program.
• Analyze performance results and lead cross-functional meetings with Plan stakeholders in order to facilitate the development and completion of action plans for each performance program.
• Lead in the development and administration of various audit initiatives/programs that impact internal and external stakeholders.
• Provide Plans education and support by helping them to understand and properly execute operational and audit requirements in both formal and informal settings on a scheduled or ad-hoc basis. This includes providing face-to-face training, webinars, handling the Help Desk, one-on-one meetings, and collaborating with other BCBSA staff.

Qualifications

Education

• Required Bachelor's Degree in a business related discipline or equivalent work experience

Experience

• 5+ Years related work experience Required

Knowledge Skills and Abilities

• Ability to manage and adapt to multiple, changing priorities.
• Demonstrated proficiency in the Microsoft Office suite and Internet technologies.
• Demonstrated research and analytical skills (quantitative and qualitative).
• Demonstrated presentation and communication skills both oral and written.
• Knowledge of BlueCross Blue Shield and Inter-Plan Programs.

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