Provider Enrollment Quality & Training Lead - Palmetto GBA

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.

Description

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 PECOS 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.Work environment: Typical office environment. Travel between office buildings

To Qualify For This Position, You’ll Need

Bachelor’s degree in any major OR Four (4) years of job-related work experience.Two (2) years of provider network enrollment/certification experience. (Can be concurrent)

We Prefer That You Have

Medicare Part A/B experienceTraining experience

What Blue Can Do For You

Our comprehensive benefits package includes

401(k) retirement savings plan with company matchSubsidized health plans and free vision coverageLife insurancePaid annual leave — the longer you work here, the more you earn.Nine paid holidaysOn-site cafeterias and fitness centers in major locationsWellness programs and a healthy lifestyle premium discountTuition assistanceService recognition

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 be conducting 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.

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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 mycareer.help@bcbssc.com 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.