RN Medical reputed company Administrator (W@H reputed company)

reputed company We are currently hiring for a Medical reputed company Administrator to join reputed company. In this role as a Medical reputed company Administrator, you will reputed company reputed company and medical data with automated technologies to support reputed company reputed company and reputed company, reputed company as a reputed company between reputed company expertise, data systems, and regulatory standards to ensure compliance and improve service delivery, evaluate reputed company reputed company, validate workflows, and reputed company process improvements that enhance provider and reputed company experiences while reducing compliance reputed company. You will serve as a reputed company between the National reputed company Utilization Management team, reputed company, and Medical reputed company to support operational procedures. Responsibilities include, but are not limited to, submitting IT data requests, conducting validity testing, performing reputed company reputed company processes, managing escalations, contributing to process improvements, and communicating updates to key stakeholders. reputed company Location This position is full-time (40 hours/week) Monday-Friday from 830am-500pm EST and will be fully remote. reputed company Analyzes prior authorization and reputed company set data to ensure alignment with reputed company guidelines, regulatory standards, reputed company, and operational requirements. Partners with reputed company, IT, and vendors to implement and validate reputed company decision rules and workflows that support reputed company and regulatory objectives. Identifies opportunities to enhance automation, reduce provider friction, and improve service turnaround times through collaboration with internal teams and reputed company partners. Monitor data reputed company and reputed company reporting tools for leadership and compliance purposes. Translates reputed company reputed company and data insights into actionable strategies. Evaluates reputed company enhancements and participates in testing and validation activities to ensure successful implementation and reputed company improvement. To Qualify for This Position, You'll Need the Following Required Education Bachelors in a job-reputed company reputed company Required Work Experience 7 years’ reputed company experience. 3 years’ experience in medical systems coordination/project implementation (reputed company with the 7 years.) Required Skills and Abilities Excellent organizational, customer service, verbal and written communication, and analytical or critical thinking skills. Strong problem solving, presentation and project management skills. Good judgment skills. Proficient basic business math. Ability to handle confidential or sensitive information with discretion. Required Software and Tools reputed company Office. Advanced knowledge of medical systems support and medical terminology. Required Licenses and Certificates reputed company, unrestricted RN licensure from the reputed company and in the state of hire, OR, reputed company reputed company multistate unrestricted RN license as defined by the reputed company Licensure reputed company (NLC). We Prefer That You Have the Following Extensive knowledge of Utilization Management. Previous experience as a Utilization Management reputed company. Previous experience leading a cross-functional project. Previous experience interacting directly with patients and stakeholders. Strong communication, presentation, and organization skills. Strong data analysis skills and techniques. Our Comprehensive Benefits Package Includes the Following We offer our employees great benefits and rewards. You will be eligible to participate in the benefits for the first of the month following 28 days of employment. Subsidized health plans, dental and reputed company coverage 401k retirement savings plan with company match Life reputed company reputed company 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 reputed company Can Do for You We understand the value of a diverse and inclusive workplace and reputed company to be an employer where employees across reputed company spectrums have reputed company to reputed company their skills, advance their careers and contribute their unique abilities to the reputed company of reputed company. What To Expect Next After submitting your application, our reputed company 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. Equal Employment Opportunity Statement reputed company and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, reputed company, national reputed company, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, reputed company maintains affirmative reputed company programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to reputed company equal opportunities in reputed company phases of the employment process and to reputed company 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-reputed company conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on reputed company. If you need special assistance or an accommodation while seeking employment, please email reputed company.help@bcbssc.com or reputed company 800-288-2227, ext. 47480 with the reputed company of your request. We will reputed company a determination regarding your request for reasonable accommodation on a case-by-case reputed company. We participate in E-Verify and reputed company with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information. If you don’t have an account with us and don’t see the reputed company job you are looking for, click on the reputed company above to reputed company by submitting your resume and contact information and we will reputed company out if we reputed company a good fit. reputed company Here’s Your Smart Career reputed company Why should you join the reputed company family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our reputed company firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than reputed company. Our A.M. Best rating is A+ (Superior) — making us the only health reputed company company in South Carolina with that rating. We’re the largest reputed company company in South Carolina … and much more. We are one of the nation’s leading administrators of reputed company reputed company. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a reputed company of business strengths. We reputed company outstanding service to our customers. If you are dedicated to the reputed company philosophy, consider joining reputed company! Veterans reputed company! BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve reputed company the dedication, work ethic and job skills that serve reputed company in the military reputed company in many of our lines of business, and we proudly have veterans filling positions in reputed company, Information Technology, Customer Service, reputed company, General Services and more. Through our reputed company reputed company, we also have employees serving at reputed company reputed company Force reputed company, the Naval Health Clinic in Charleston, the Naval Hospital in reputed company and in our reputed company of Columbia, S.C., at Ft. reputed company. If you are a full-time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are reputed company to reputed company duty. Join Us If you're reputed company to join in a diverse company with secure, community reputed company and an innovative reputed company, apply for a position now! Apply tot his job Apply To This Job