Search the 74 jobs at BlueCross BlueShield of South Carolina

As an IT Project Manager, you will coordinate project planning and execution, monitor progress, manage resources, and ensure compliance with project standards while leading multiple low complexity projects.

The Representative, Enrollment I is responsible for processing membership and enrollment applications, handling terminations and renewals, updating databases, and addressing customer inquiries. This role involves working with various operational areas, preparing contracts and ID cards, and participating in enrollment-related projects.

The Provider Contracting Manager is responsible for establishing and maintaining provider networks, managing contract negotiations, ensuring compliance with contract obligations, and conducting financial analyses of contract proposals. This role requires effective relationship management with providers and coordination with internal departments to improve operational processes and training programs.

The Provider Enrollment Analyst is responsible for reviewing, researching, analyzing, and processing provider enrollment applications, ensuring compliance and integrity of provider data. Key tasks include data entry, providing customer service, resolving discrepancies, and supporting process improvements and special projects.

The Strategic Account Executive is responsible for sales, service, and management of relationships with existing and prospective accounts, including analyzing data and market trends, mentoring team members, and managing new account sales strategies.

The Provider File Specialist I is responsible for maintaining healthcare provider files, ensuring accurate provider directories, claims adjudication, and billing processes. This role involves verifying information, preparing and managing provider data in relevant systems, and participating in special projects related to quality improvement and audits.

The Auditor III will conduct various operational, financial, and compliance audits, evaluate internal controls, identify business risks, prepare audit reports, and provide training to other auditors. Additionally, the role involves developing audit programs and maintaining data integrity in financial systems.

The Group Actuary Manager oversees actuaries, ensuring accurate actuarial reporting and analysis. They direct the preparation of reports, conduct profitability analysis, review rating bureau changes, and ensure compliance with regulatory submissions. They also manage hiring, coaching, and staff performance while supporting the development of actuarial models.

The Quality Assurance Analyst performs audits and monitoring of departmental operations to ensure quality standards. Responsibilities include identifying problems, analyzing causes, generating reports, coaching new hires, and recommending improvements. The role focuses on claims, customer service, and operational efficiency.

Supervise and manage SOX/MAR compliance activities across BCBSSC companies. Responsibilities include developing policies for compliance, conducting risk assessments, documenting key controls, and ensuring the effectiveness of the compliance program while providing leadership and guidance to staff.

The Mainframe Identity & Access Management Analyst will monitor and administer IT security policies, manage system access rules, provide technical support for customer access issues, conduct compliance audits, and enhance security features across systems. They will also analyze security reports and collaborate with project teams on data access issues.

The Senior Quality Assurance Analyst conducts quality control audits on departmental operations, identifies process weaknesses, and recommends improvements. Responsibilities include documenting findings, compiling data, training new employees, and proposing new systems to enhance operational efficiency.

As a Senior Provider Education Consultant, you will educate medical providers on Medicare coverage and related issues, conduct workshops, analyze reports, and assist in training the medical review associates. You will also target providers abusing the Medicare program and improve the accuracy of provider billing practices.

As a Provider Enrollment Analyst, you will review and process provider enrollment applications, ensuring data integrity and compliance with standards. You will also verify provider data, assist with special projects, and provide customer service related to the enrollment process.

As a Provider Enrollment Analyst, you will be responsible for reviewing, analyzing, and processing provider enrollment applications, ensuring compliance and integrity of provider files, and providing customer service throughout the enrollment process.

Responsible for establishing and maintaining healthcare provider files, verifying information, assigning providers to appropriate networks, and contributing to departmental projects. Requires High School Diploma, 1 year of administrative/clerical support or customer service experience, proficiency in Microsoft Office, and ability to learn DB2 and SQL.

The System Support Manager oversees the testing and implementation of system changes, investigates system problems, develops business requirements for corrections, and ensures compliance with regulations. They coordinate efforts with various stakeholders, prepare technical responses, manage staff, and provide training and documentation related to system enhancements.

Performs quality audits across various operations functions to ensure quality standards are met. Provides feedback, recommendations, and implements improvements. Trains new employees and assists in special projects.

The Digital Experience Design Manager is responsible for managing the development and enhancements of websites, overseeing web support teams, and ensuring effective communications. This role involves analyzing trends to guide the strategic direction of web initiatives, troubleshooting issues, and managing related business events.

Performs quality control audits across various operations functions to ensure quality standards are met. Develops and implements quality control programs and provides feedback on errors detected. Assists with special projects and training new employees.