Manager, Enrollment

BlueCross BlueShield of South Carolina•Columbia, SC

1d•Onsite

About The Position

Manages the provider enrollment unit ensuring the accurate and timely enrollment of providers, meeting all regulatory requirements, and maintains the national provider file database. Logistics: Palmetto GBA– one of BlueCross BlueShield's South Carolina subsidiary companies. This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. This role is located onsite at 17 Technology Circle, Columbia, SC, 29203. This position is not eligible for sponsorship now or in the future.

Requirements

Bachelors in a job-related field.
5 years of healthcare, Medicare, health insurance operations, or operations experience.
2 years of leadership experience (may be concurrent with the 5 years).
Excellent verbal and written communication, organizational, customer service skills.
Excellent presentation, analytical or critical thinking skills.
Excellent problem-solving skills.
Good judgment skills.
Proficiency in spelling, grammar, and punctuation skills.
Ability to persuade, negotiate, or influence others.
Ability to handle confidential or sensitive information with discretion.
Ability to listen effectively and respond quickly.
Microsoft Office.

Nice To Haves

Bachelor's degree-in Business Administration, Healthcare Administration or other job-related field.
7 years of healthcare program management or provider network experience.
4 of the 7 must be in supervisory experience OR 4 years of equivalent military experience in grade E4 or above.
Active RN licensure in state hired.

Responsibilities

Provides day-to-day management oversight of enrollment staff and activities ensuring the accurate and timely completion of all aspects of the provider enrollment process and claims administration.
Manages individual and unit performance to ensure productivity, quality, and timeliness standards are met.
Ensures compliance with all applicable laws and regulations and keeps abreast of new requirements.
Directs the efforts of the analyst staff to be vigilant in the awareness and identification of potential fraud situations, and in working with and following through on fraud investigations.
Interacts with management staff to define and revise goals, objectives and performance measures.
Develops and maintains quality assurance activities. analyzes reports and trends to identify areas to improve efforts through outreach and educational activities.
Maintains effective working relationships with other internal departments to implement process and system improvements and troubleshoot any issues.
Prepares and verifies reports as necessary.