Manager, GAP

BlueCross BlueShield of South Carolina•Columbia, SC

20h

About The Position

Summary Provides oversight/direction for all activities of a membership area/function to include any or all of the following: enrollment, application processing, billing, account administration and management (mailings, reconciliations, collections, etc.), commissions, corporate/company reporting, coordination of marketing material mailings, system testing for corporate/company projects, customer service/new group or renewal implementation, online administration, monitor functionality of policy/certificate issuing system. Description 40% Manages the administration, implementation, maintenance and day-to-day operations, procedures, and activities of assigned cost centers or areas. Provides communication and dissemination of information to staff members. Prepares, reviews, and submits various reports required by management. Prepares, monitors, and analyzes expenditures. Ensures overall operational compliance. 30% Works with marketing, underwriting, claims, fiscal services, medical review, and other internal/external customers to ensure appropriate group structure, status, benefits, billing, and commissions. Works with other major departments in the company to identify and further overall business goals. 20% Responds to more sensitive, complicated and/or escalated issues and inquiries from internal/external customers. 10% Selects, trains, develops, and guides staff and ensures excellent customer service is given to employees, customers, management, etc. Monitors department performance and productivity. Performs quality control functions for work performed. Makes recommendations on process improvements and identifies training needs of staff.

Requirements

Required Education: Bachelor's.
Degree Equivalency: 4 years job related work experience or Associate's and 2 years job related work experience (Equivalency not applicable for the Celerian Group. Bachelor's degree required.)
Required Work Experience: 5 years of experience in insurance, membership, billing, claims processing, or customer service, or combination of these. 2 of the 5 years listed must either have been in a supervisory role OR be 2 years of equivalent military experience in grade E4 or above.
Required Skills and Abilities: Knowledge and proven ability in a membership or billing system.
Ability to work independently, prioritize effectively, and make sound decisions.
good judgment skills.
Demonstrated customer service, organizational, and presentation skills.
Demonstrated verbal and written communication skills.
Ability to persuade, negotiate, or influence others.
analytical or critical thinking skills.
Basic business math proficiency.
Ability to handle confidential or sensitive information with discretion.
Ability to direct, motivate, and assess performance of others.
Required Software and Tools: Microsoft Office.

Nice To Haves

Preferred Education: Bachelor's degree-in Business Administration, Healthcare Administration or other job related field.
Preferred Work Experience: 5 years-of budget management and healthcare program management experience.
Preferred Skills and Abilities: Knowledge of underwriting guidelines, legislative law, benefit structures.
Knowledge of corporate contracts, marketing procedures, and procedural manuals.
Working knowledge of database software.
Understanding of compliance rules and regulations.
Knowledge of state insurance laws.
Knowledge/ability to use computer and reporting systems/files. Such systems/files are membership, billing, CES, AMMS, OPRS, PABS, TOTL, OPAS. additional systems/files are web, GCOM, PRO, Corbel, TSO.
Preferred Software and Other Tools: Working knowledge of Microsoft Access, Easytrieve, DB2.

Responsibilities

Manages the administration, implementation, maintenance and day-to-day operations, procedures, and activities of assigned cost centers or areas.
Provides communication and dissemination of information to staff members.
Prepares, reviews, and submits various reports required by management.
Prepares, monitors, and analyzes expenditures.
Ensures overall operational compliance.
Works with marketing, underwriting, claims, fiscal services, medical review, and other internal/external customers to ensure appropriate group structure, status, benefits, billing, and commissions.
Works with other major departments in the company to identify and further overall business goals.
Responds to more sensitive, complicated and/or escalated issues and inquiries from internal/external customers.
Selects, trains, develops, and guides staff and ensures excellent customer service is given to employees, customers, management, etc.
Monitors department performance and productivity.
Performs quality control functions for work performed.
Makes recommendations on process improvements and identifies training needs of staff.