Operations Manager

Internal Reference Number: R1047745

Manages the daily activities of a multi-functional area. Responsible for monitoring productivity, attendance and quality of work produced. Responsible for motivating associates to meet individual and departmental goals.

PGBA - one of Blue Cross Blue Shield's South Carolina subsidiary companies

This position is full-time (40 hours/week) Monday-Friday from 8:00am-5:00pm. This role is located on-site at 200 N Dozier Blvd, Florence, SC 29501.

This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.

• Direct and supervise claims/documents processing and support team associates to ensure claims/documents are processed in a timely and efficient manner to maintain contract compliance standards. Prepare and analyze reports of pending and processed documents, claims, adjustments and reprocesses, and quality audits of claims/documents that measure level of performance of the team. Administer and oversee quality control procedures and ensure compliance of all corporate and contract required guidelines.
  
  Select and maintain a well‑trained staff. Identify potential education and system issues.
• Establish and maintain a high level of customer service with all internal and external customers. Direct and supervise the customer service associates to ensure that all correspondence and telephone inquiries are processed in a timely and efficient manner to maintain contract compliance standards. Select and maintain a well‑trained staff. Identify potential education and system issues.
• Participate as project leader on policy changes, quality improvements initiatives and system change efforts, while ensuring corporate, contractor, and department policies and procedures are administered timely, consistently and accurately. Identify system errors and process/quality improvement opportunities, initiate work requests, and serve as the customer project lead to ensure accurate implementation.
• Assist in budget preparation and monitor expenses related to the budget.

• Required
  
  Education:
  
  Bachelor's
• Required
  
  Work Experience:
  
  3 years of job related work experience, including either 1 year of supervisory experience OR 1 year equivalent military experience in grade E4 or above.
• Required
  
  Skills and Abilities:
  
  
  • Strong management, organization, communication, decision‑making, and analytical skills.
  • Excellent customer service skills.
  • Strong presentation skills and basic business math proficiency.
  • Knowledge of applicable laws and regulations pertaining to business unit operations.
• Required Software and Tools: Microsoft Office.

• Preferred
  
  Work Experience:
  
  
  • 3 years‑of related health or managed care industry work experience.
  • 1 year‑of management experience OR 1 year of equivalent military experience in grade E4 or above.
  • Tricare Experience.
• Preferred
  
  Skills and Abilities:
  
  
  • Strong time management skills.
  • Good communication skills.
• Preferred Software and Other Tools: Proficient database software skills.

• 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

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.

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.

Blue Cross Blue Shield of South Carolina and our subsidiary companies maintain a…