Job Description
Full job description
This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. A candidate’s position within the hiring 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 annual bonus incentive pay.
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 many other benefits to eligible employees.
Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.
The posting range for this position is:
$92,788.00-$130,326.32
The role 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.
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.
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.
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