Position Purpose:

Leads multi divisional area needs regarding the planning and prioritization of Clinical systems and support related activities including projects process improvements develops and provides information to drive the clinical decision-making process for divisional projects and job processes and operational support. Also assists with directing IS divisional systems projects and responsible for overall successful execution and implementation of projects and the resolution of system issues through coordination with Client Advocates and/or IT professionals. Oversees area electronic security policies and procedures ensuring compliance through methods of testing maintenance revisions and auditing of system security related rules tables and databases. Provides direction and oversight of electronic processes ensuring compliance with applicable mandates regulations accreditations and audits. Provides management oversight of team members.

Location:

This position is full-time and could potentially operate on a hybrid work schedule (3 days in office 2 days ) located in Columbia SC. Please note this is subject to change based on employee performance and/or business need.

What Youll Do:

• Leads defining or designing of operational and systems business processes. Research corporate and internally produced technology opportunities as well as new clinical trends. Drives process improvements based on clinical knowledge system expertise and overall divisional/industry knowledge and strategic goals.

• Responsible for leading and managing assigned projects including defining developing and providing information to drive the decision-making process. With input of leadership and SMEs provides technical and administrative guidance for development of operational systems training approaches and business processes through various avenues of communications for assigned projects. Implements or completes identified strategic goals based on leadership direction of the assigned area including supervising staff assigned to projects.

• Manages Auditing team using systems and operational support knowledge workflow knowledge of LOB specific workflows audit training and data and systems security.

• Tests processing systems identifies and assists with system related issues and determines severity level develop solutions and communicate impacts/resolutions to impacted areas. Serves as liaison with all facets of the Information Systems (I/S) area to ensure timely/accurate implementation of required system modifications.

• Monitors security requests for data accuracy. Determines proper business justification and appropriateness of requests. Ensures compliance with associated security policies and procedures and provides security approvals as required. Reviews routine audits for compliance. Acts as lead security administrator for outside vendor and divisional supported applications.

• Conducts and manages internal departmental efforts and special projects as assigned by management. Motivates and increases morale of team with effective leadership and cooperation. Coaches and professionally develops team members. Performs administrative activities including performance reviews counseling progressive discipline coaching feedback and promoting team-based culture.

To Qualify for This Position Youll Need the Following:

Required Education:

• Bachelors

Degree Equivalency:

• Associates degree plus an extra 2 years job related work experience for a total of 9 years of required work experience (see required work experience)

OR

• 11 total years required work experience.

Required Work Experience:

• 7 years of job-related experience in project management systems support and/or clinical utilization management.

• 2 years of supervisory experience OR 2 years of equivalent military experience in grade E4 or above (may be concurrent).

Required Skills and Abilities:

• Thorough understanding of project management phases techniques and tools.

• Ability to recognize problems or situations that are new or without clear precedent and offer solutions.

• Strong presentation and negotiation skills.

• Advanced knowledge of business process engineering methodology.

• Demonstrated analytical and decision-making skills.

• Excellent and effective communication customer service and time management skills.

• Ability to communicate complex information to a variety of audiences who have different levels of experience and knowledge.

• Demonstrated aptitude for effective leadership of staff.

Required Software and Tools:

• Microsoft Office

We Prefer That You Have the Following

• Understanding of healthcare data governance and compliance requirements Medical Billing and Insurance Operations.

• Familiarity with workload planning quality control and resource allocation.

• Ability to interpret complex data and drive actionable insights.

• Ability to communicate technical concepts clearly to leadership and non-technical audiences.

Work Environment:

• Typical office environment. Some travel required.

• Must be able to work under pressure.

• Handles multiple projects simultaneously.

• Some weekend/after hours.

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)

• On-site 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.

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.

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