Summary
 

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. 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 that allows 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!

Description
 

Position Purpose:

Oversees the testing/implementation of all system changes requested by external/internal customers. Investigates/identifies system problems and develops business requirements for corrections. Responsible for interpreting change requests/mandates, and ensuring accuracy of test matrixes/results, and production validation. Analyzes changes and prepares technical/cost responses resulting from the change. Ensures adequate staffing (selection, training, appraisal of associates). Ensures internal system files and tables are maintained according to regulations and claims processing procedures. Communicates changes to affected business units.

Logistics: This position is full-time (40 hours/week, 8 hours/day) Monday – Friday and is approved for a flexible work arrangement in Nashville, TN with the opportunity to work remotely 2 to 3 days a week.

What You'll Do:

• Ensures system changes are accurately interpreted/tested/implemented.

• Develops and maintains effective and efficient workflow to ensure accurate testing and implementation of systems changes, complex systems process analysis and compliance with all government program requirements. Serves as liaison with all facets of the information systems area to ensure timely and accurate implementation of required system modifications.

• Coordinates efforts with customers, government agencies, information systems personnel and project leaders and provides education/training on changes being implemented. Documents and communicates business requirements with business partners along with information systems areas and operations staff to facilitate systems enhancements and modifications.

• Analyzes changes and prepares technical/cost responses resulting from the change. Participates as project leader for contract changes. Ensures all corporate, contractor and government healthcare policies and procedures are administered timely, consistently and accurately. Identifies and initiates work requests for system changes or enhancements. Assists in budget preparation of projects and monitors expenses for budget compliance.

• Ensures adequate staffing (selection, training, appraisal of associates). Selects, trains, develops, and evaluates staff. Coaches and develops team members. assists employees daily on problems. Ensures quality and productivity of departmental work. Motivates and increases morale of team with effective leadership.

• Provides education and training regarding policies and procedures to customers via phone, conference calls, faxes, letters, emails, meetings, or presentations either in-house or offsite. develops/implements system testing procedures and improved techniques. Prepares written reports and analyses, as well as operational reports, providing interpretation of findings to management.

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

Required Education:

• A Bachelor's degree OR 4 years of job-related work experience OR

• An Associate’s degree AND 2 years of job-related work experience.

• Equivalency not applicable for the Celerian Group. A Bachelor's degree required.

Required Work Experience:

• Five years of job-related systems and/or operations experience including either 1 year of supervisory/team lead experience OR one year of equivalent military experience in grade E4 or above.

Skills and Abilities:

• Excellent verbal, written and interpersonal communication skills.

• Medicare knowledge.

• Strong attention to detail.

• DME knowledge.

• Good judgment.

• Able to manage a team of highly professional analytical and technical staff.

• Knowledge of Microsoft Office and Smart Sheets.

• Ability to persuade, negotiate or influence.

• Analytical or critical thinking skills.

Our comprehensive benefits package includes the following:

• 401(k) retirement savings plan with company match.

• Fantastic health plans and free vision coverage.

• Life insurance.

• Paid annual leave — the longer you work here, the more you earn.

• Nine paid holidays.

• On-site cafeterias and fitness centers in significant locations.

• Wellness programs and a healthy lifestyle premium discount.

• Tuition assistance.

• Service Recognition.

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.

Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.

 

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.

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

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 minorities, females, disabled individuals and 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 physical and mental disabilities.

If you need special assistance or an accommodation while seeking employment, please e-mail [email protected] or call 1-800-288-2227, 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.