PE QC & Training Lead-2

BlueCross BlueShield of South Carolina•Columbia, SC

2d•Onsite

About The Position

The PE QC & Training Lead is a senior-level position focused on improving provider data quality by auditing the work of Provider Enrollment Analysts and Senior Provider Enrollment Analysts. The role develops reports that keep management informed about quality control for Provider Information Management Systems (PIMS), assesses training needs based on issues identified through quality control, and recommends training courses. The lead trains new analysts and provides ongoing developmental training to the department. This is a full-time, onsite position at 4101 Percival Road, Columbia, South Carolina. The schedule is Monday through Friday, 40 hours per week, with an eight-hour shift scheduled during normal business hours of 7:00 a.m. to 5:00 p.m. Occasional overtime may be necessary, and travel between buildings may be required.

Requirements

Bachelor's degree, or an equivalent combination of job-related work experience: four years of job-related experience, or an associate's degree and two years of job-related experience.
Two years of provider network enrollment/certification experience.

Responsibilities

Review provider data to ensure accuracy.
Develop reporting tools to keep management informed of data error trends and issues.
Work with the supervisor to address individual errors.
Develop and maintain departmental quality control protocols and policy and procedure manuals, ensuring changes are properly communicated.
Train new analysts on PIMS and departmental policies and procedures.
Conduct training needs analyses based on quality control results.
Recommend training materials and subject matter to management.
Serve as a resource to analysts with difficult or escalated issues.