Performance Audit Senior Consultant

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

Job summary

A leading health insurance organization is seeking a dedicated professional to ensure accurate operations management and customer interactions. Responsibilities include executing audit programs and leading initiatives for continuous improvement. The ideal candidate should have a Bachelor's degree and 5+ years of relevant experience. Strong analytical and communication skills are essential. This position offers a competitive salary range between $92,788 and $130,326 and is eligible for annual bonuses.

Qualifications

• 5+ years of related work experience required.
• Proven ability to adapt to changing priorities.
• Demonstrated communication skills, both oral and written.

Responsibilities

• Ensure accurate handling of customer interactions.
• Execute and validate audit programs.
• Present updates and recommendations.
• Create and improve departmental operating procedures.
• Lead the development of audit initiatives.

Skills

Ability to manage multiple priorities

Proficiency in Microsoft Office

Research and analytical skills

Presentation and communication skills

Knowledge of BlueCross Blue Shield programs

Education

Bachelor's Degree in a business related discipline

Job description

Overview

This posting provides salary range and pay practices. The range may be adjusted in the future, and the candidate’s position within the range may be based on competencies, education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. The job is eligible for annual bonus incentive pay. The statement below clarifies pay and bonuses are at the Company’s sole discretion and are not wages until earned, vested, and determinable.

The posting range for this position is: $92,788.00 - $130,326.32.

Responsibilities

• The 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.

• Responsible for overall Plan execution of the Operational Audit Programs, including 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 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 understand and properly execute operational and audit requirements in formal and informal settings on a scheduled or ad-hoc basis, including face-to-face training, webinars, Help Desk, one-on-one meetings, and collaboration 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.
• Proficiency in 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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