Summary
Functions as the subject matter expert and work leader for a team of operations quality auditors by assigning, monitoring and auditing their work. Ensures audit, performance, and reporting deadlines are met. Promotes customer satisfaction, both internally and externally, through continuous quality assessments/improvements. Trains and guides staff, develops work instructions, and assumes managerial tasks in the absence of the supervisor.
Description
Location: Onsite in Columbia, SC with quarterly travel required.
Work Environment: Typical office environment.
What You'll Do:
Assigns/monitors/audits the work of the quality audit staff. Monitors workloads, generates work samples, analyzes the outputs for timeliness/quality, and ensures audit/performance/reporting deadlines are met. Serves as subject matter expert and primary point of contact for coordination of their particular work specialty. Represents quality assurance on workgroups/special teams and in meetings. Assumes managerial tasks as needed and acts in a back-up capacity. Develops work plans, objectives, priorities, methods and procedures to improve quality performance. Writes, updates and maintains all work instructions. Creates reporting methodologies to analyze and measure effectiveness of implemented improvements. Uses new or existing data to identify and implement qualitative and quantitative improvements focusing on prevention, planning, and quality control. Provides training for quality audit staff. Conducts quality targeted audits for all designated areas of responsibility as needed, to include those audits of a complex nature. Enters quality results and data into various databases and presents audit finding to customers. Negotiates errors/handles rebuttals. Completes monthly quality reporting for customers, trend analysis, etc. Maintains effective on-going communication with all departments and their management, including task forces for implementation of process improvements. Actively participates in calibration sessions, meetings, conference calls and training. Provides leadership and support for the quality management system by gathering, synthesizing, and presenting information to all levels of division management for the purpose of determining feasibility of proposed changes. To Qualify for This Position, You'll Need:
Bachelor's Degree Equivalency: 4 years job related work experience or Associate's and 2 years job related work experience Required Work Experience: 1 year of quality assurance experience. Required Software and Tools: Microsoft Office. Required Skills and Abilities:
Demonstrated leadership skills. Strong analytical, presentation, customer service, persuasion, and organization skills. Advanced business math proficiency. Able to document problems and assist in their resolution. Able to document processes and identify areas for improvement. Excellent written and verbal communication skills. Ability to produce written documentation and summarize for management level. We Prefer That You Have The Following:
ACA experience Medicare advantage experience Insurance sales experience Our comprehensive benefits package includes the following:
401(k) retirement savings plan with company match Fantastic health plans and free vision coverage Life insurance Paid annual leave — the longer you work here, the more you earn Nine paid holidays On-site cafeterias and fitness centers in significant locations Wellness programs and a healthy lifestyle premium discount Tuition assistance Service Recognition 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 conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.
We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.
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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 minorities, females, disabled individuals and 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 physical and mental disabilities.
If you need special assistance or an accommodation while seeking employment, please e-mail or call with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.
