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.
#LI-Remote
The posted salary range 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
t
his
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
m
any 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.