Performance Audit Senior Consultant (Remote)

Blue Cross Blue Shield Association; Virginia (MN); Remote; USD 92,000 - 105,000; Full time

Job summary

A leading healthcare organization is seeking a professional to ensure efficient customer interactions and oversee operational audits. The ideal candidate will have a Bachelor's Degree, at least 5 years of experience, and strong analytical and communication skills. The position offers a salary range of $92,788.00–$105,000.00 and extensive benefits including medical insurance and a 401(k) plan.

Benefits

Paid time off

11 holidays

Medical/dental/vision insurance

Generous 401(k) matching

Lifestyle spending account

Qualifications

• 5+ years of related work experience.

Responsibilities

• Ensure Plans' operations handle customer interactions accurately and promptly.
• Responsible for overall Plan execution of the Operational Audit Programs.
• Analyze performance results and lead cross‑functional meetings.
• Develop and administer various audit initiatives/programs.
• Provide Plans education and support for operational and audit requirements.

Skills

Ability to manage and adapt to multiple, changing priorities

Demonstrated proficiency in Microsoft Office

Demonstrated research and analytical skills

Demonstrated presentation and communication skills

Knowledge of BlueCross Blue Shield and Inter‑Plan Programs

Education

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

Job description

The role will ensure 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. 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.

Salary

The posting range for this position is: $92,788.00–$105,000.00.

Qualifications

Education

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

Experience

• 5+ Years related work experience.

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.

#LI-Remote

Salary is an estimate that may vary. The posted salary range is the lowest to highest we believe we would pay at the time of posting. We may ultimately pay more or less than the hiring range and the range may be modified in the future. Candidate's position within the range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs. This job is also eligible for an annual bonus incentive payment.

We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and any other benefits to eligible employees.

Note: No amount of pay is considered wages or compensation until earned, vested, and determinable. Bonus, commission, or any other form of compensation remains at the Company's discretion until paid and may be modified at the Company's discretion, consistent with the law.