Logistics:

This is a full-time position working (40-hours/week) Monday-Friday 8:00am 5:00pm working on-site at 200 North Dozier Blvd. Florence SC 29501. Occasional travel may be required between PGBA locations in Florence Surfside and Columbia and minimal out of state travel may be requested.

What Youll Do:

• Accountable for directing the testing of standard systems release modifications and their interface with external systems. Provide technical assistance to internal staff and to contract/business associates. Evaluate and authorize implementation of systems modifications. Maintain contacts and effective relationships with external sources Prime Contractor government providers etc. Participate in systems workgroups as a company representative.
• Ensure internal systems files and tables are maintained according to regulations and claims processing procedures. Communicate changes to affected business units.
• Identify and propose solutions for problems or issues which involve complex systems analysis.
• Direct motivate and develop staff.
• Prepare and manage budget.

To Qualify for This Position Youll Need:

• 10 years of experience including 6 years of systems testing and analysis and either 4 years of management experience OR 4 years of equivalent military experience in grade E4 of above.
• Bachelors degree
• Excellent management communication analytical and human relations skills.
• Knowledge of provider reimbursement methodologies.
• Knowledge of budget planning preparation and monitoring.
• Strong presentation organization customer service and negotiation skills.
• Computer systems support knowledge.
• Ability to use complex mathematical calculations or statistical concepts.
• Standard office equipment.
• Based on contractual requirements this position may be classified as a Sensitivity Level 3C Security Risk according to the CMS core security requirements. Level 3C is the highest personnel security level and is subject to periodic criminal background re-investigation checks.

We Prefer That You Have:

Additional Preferred Experience would be helpful:

• TRICARE claims processing
• TRICARE customer service
• Transition and contract startup
• Communications with government and prime contractor representatives
• Change Order Management
• Testing
• Benefit Files
• Scripting Coordination
• Operational leadership of system changes
• Prioritization of system changes including cost benefit analysis

What We can Do for You:

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)
• On-site cafeterias and fitness centers in major locations
• Wellness program and healthy lifestyle premium discount
• Tuition assistance
• Service recognition
• Employee Assistance
• Discounts to movies theaters zoos theme parks and more

What to Expect Next:

After submitting your application our recruiting team members will review your resume to ensure your meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. If the qualifications required proof of semester hours please attach your transcript to your application.

Management will be conducting interviews with the most qualified candidates with prioritization give to those candidates who demonstrate the preferred 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 pregnancy-related 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 call ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Heres moreinformation.

Some states have required notifications. Heres more information.