Director Provider Enrollment
Director Provider Enrollment
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Job Description
Summary
Why should you join the BlueCross BlueShield of South Carolina family of companies Other companies come and go but weve been part of the national landscape for more than seven decades with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina and much more. We are one of the nations leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy consider joining our team!
Position Purpose:
Directs the administration of Medicare provider enrollment including decision making that affects contract performance budget management and provider satisfaction. Provides direction/guidance for the completion of all tasks associated with the provider enrollment function while managing the resources to meet all Centers for Medicare and Medicaid Services (CMS) expectations.
Description
Logistics: Palmetto GBA one of BlueCross BlueShields South Carolina subsidiary companies.
Location: This position is fulltime 40hours/week) MondayFriday working ONSITE at our 17 Technology Circle Columbia SC location You will work an 8hour shift scheduled during our business hours of 8:00AM5:00PM.
What Youll Do:
Manages the provider enrollment workload within the approved budget and allocates resources as appropriate in order to meet or exceed CMS defined standards.
Interacts with internal/external functional areas to develop effective performance measures goals and objectives that support the provider enrollment area and are consistent with the needs of the division.
Analyzes provider enrollment trends to identify specific areas of provider concern.
Develops plans to mitigate issues while establishing procedures to prevent similar issues from occurring.
Encourages the staff to improve customer service and expand educational efforts.
Resolves problems through interaction with multiple areas and varied staff. Serves as point of contact for provider/supplier internal staff CMS and other contractors to handle all customer complaints.
Ensures the appropriate follow through on any possible allegations of fraud received.
To Qualify for This Position Youll Need the Following:
Required Education: Bachelors degree
Required Work Experience: 7 years of management experience in healthcare Medicare health insurance or operations OR 7 years of equivalent military experience in grade E4 or above.
We Prefer That You Have the Following:
Medicare provider enrollment experience strongly preferred
Familiar with PECOS and/or OnBase
Our comprehensive benefits package includes the following:
We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment.
Subsidized health plans dental and vision coverage
401k retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
Onsite cafeterias and fitness centers in major locations
Education Assistance
Service Recognition
National discounts to movies theaters zoos theme parks and more
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills advance their careers and contribute their unique abilities to the growth of our company.
What to Expect Next:
After submitting your application our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
Management will be conducting interviews with those candidates who are the most qualified with prioritization given to those candidates who demonstrate the required qualifications.
Equal Employment Opportunity Statement
BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age race color national origin sex religion veteran status disability weight sexual orientation gender identity genetic information or any other legally protected status. Additionally as a federal contractor the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal state and local laws and regulations.
We are committed to working with and providing reasonable accommodations to individuals with disabilities pregnant individuals individuals with pregnancyrelated conditions and individuals needing accommodations for sincerely held religious beliefs provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment please email or callext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a casebycase basis.
We participate in EVerify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Heres moreinformation.
Some states have required notifications. Heres more information.
Required Experience:
Director
Employment Type
Full-Time
