BlueCross BlueShield of South Carolina jobs

We have a job opening for the position of Communications and Marketing Summer Student Intern Student Intern at Palmetto GBA, a subsidiary of BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The responsibilities vary and are based upon the needs of the area and the experience of the incumbent at the time of employment. The incumbent will work under direct supervision and will be responsible for performing entry-level tasks and for learning professional-level tasks relating to area operations. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. 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 variety of business strengths. We deliver outstanding service to our customers. If you are committed to the same philosophy, consider joining our team! Description Logistics: Palmetto GBA,- one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This is a full-time internship (40 hours/week) Monday-Friday (flexible schedule) working on-site at 17 Technology Circle, Columbia, SC 29203, in an office environment. SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). What You'll Do: Intern position utilized for training an active high school or college student towards an entry-role. Responsibilities vary and are based upon the needs of the area and the experience of the incumbent at the time of employment. This incumbent works under direct supervision and has responsibilities for performing entry-level tasks and for learning professional-level tasks relating to area operations. May assist with the implementation of various activities and programs for assigned business units within the organization. Participates in business unit/department training designed to help this position acquire applicable knowledge/skills in their area of study. Completes area tasks that are conducive to learning the departmental procedures and applying industry/field best practices. May communicate with other areas of the company. May conduct research and analysis of various reports (monthly, quarterly, annually). Perform tasks that help in learning the business area and which provide an overall view of company operations. Assist other staff members with everyday tasks to gain an understanding of business operations and workflow. Completes other assigned area related tasks. May identify areas of need improvement and communicates to management. To Qualify For This Position, You'll Need The Following: Required Education: High School Diploma or equivalent Required Specialized Training: Must have a minimum of 12 semester hours earned in the field(s) specified by the hiring area and must be currently enrolled in college and working towards obtaining at least a 4-year degree in the field(s) specified by the hiring area. (PLEASE UPLOAD A COPY OF YOUR UNOFFICIAL TRANSCRIPTS(S) WITH RESUME.) Required Work Experience: No previous work experience is required. Required Skills and Abilities: Strong oral and written communication skills. Strong organizational skills and attention to detail. Analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion. Good planning and multi-tasking skills. Strong listening skills and the ability to follow directions and ask questions to ensure a productive internship. Required Software and Tools: Microsoft Office. We Prefer That You Have The Following: Microsoft Office. 1 year-general work history/experience. Journalism, Communication, Marketing, and Advertising majors 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 disabilities and 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. Here's more information. Some states have required notifications. Here's more information.

**Resp & Qualifications** **PURPOSE:** The Broker Relations Manager's primary responsibility is to bring the value of CareFirst to the marketplace by engaging and working with CareFirst's distribution channel (brokers). This role combines strategic leadership with hands-on management to ensure brokers receive timely, accurate, and comprehensive assistance. The ideal candidate will foster a customer-centric culture while driving operational excellence and team development. **ESSENTIAL FUNCTIONS:** **Broker Relationship Management** + Serve as the primary escalation point for complex broker inquiries and issues, ensuring timely and satisfactory resolution. + Build and maintain strong relationships with key broker partners, full service producers and consultants, understanding their needs and business objectives. + Monitor broker satisfaction metrics and implement strategies to improve service delivery and partner experience. + Collaborate with sales and account management teams to support broker growth and retention initiatives. **Team Leadership & Development** + Lead, mentor, and develop a team of broker support representatives, fostering a collaborative and high-performance culture. + Conduct regular performance reviews, provide coaching, and identify training opportunities to enhance team capabilities. + Manage team scheduling, workload distribution, and resource allocation to ensure optimal coverage and efficiency. + Recruit, onboard, and train new team members in company policies, systems, and broker service best practices. Operational Excellence + Develop and implement broker service standards, workflows, and standard operating procedures to ensure consistent, high-quality support. + Monitor key performance indicators including response time, resolution time, ticket volume, quality and customer satisfaction scores. + Identify process improvement opportunities and implement solutions to enhance efficiency and service quality. + Manage and optimize the use of Broker360 and ticketing systems to track interactions, issues, and resolutions. + Ensure compliance with regulatory requirements, company policies, and industry standards. + Drive development and adoption of service dashboard(s) to track performance and progress, including broker-level dashboards. + Drive development and ongoing enhancement of broker portals to drive continued automation of broker work with CareFirst. + Support enhancements to Salesforce CRM to drive better data collection and reporting opportunities. **Communication & Collaboration** + Partner with Product, Underwriting, Operations, and IT departments to resolve systemic issues and improve broker experience. + Prepare and present regular reports on team performance, broker feedback, and service trends to senior leadership. + Communicate policy updates, system changes, and important information to the team and broker community. + Facilitate regular staff meetings to share updates, celebrate successes, and address challenges. + Attend and participate in business and community activities to promote CareFirst and identify new opportunities as needed. **SUPERVISORY RESPONSIBILITY:** This position manages people. **QUALIFICATIONS:** **Education Level** : Bachelor's Degree in marketing, business or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. **Experience:** + 5 years in sales, relationship management and/or marketing. + 1 year supervisory experience or demonstrated progressive leadership experience. **Licenses/Certifications:** + A current Health/Life License in Maryland, Virginia, and District of Columbia is required **Preferred Qualifications:** + Previous experience working directly with insurance brokers or agencies. + Lean Six Sigma or process improvement certification. + Experience implementing or managing CRM or customer service technology platforms. **Knowledge, Skills and Abilities (KSAs)** + Leadership & Team Development: Ability to inspire, motivate, and develop team members while maintaining accountability. + Problem-Solving: Strong analytical skills with ability to identify root causes and implement effective solutions. + Communication: Excellent written and verbal communication skills with ability to explain complex concepts clearly. + Relationship Building: Skilled at building trust and rapport with internal stakeholders and external partners. + Organization & Time Management: Ability to prioritize competing demands and manage multiple projects simultaneously. + Adaptability: Comfortable with ambiguity and able to adjust strategies in response to changing business needs. + Customer Focus: Unwavering commitment to understanding and exceeding broker and customer expectations. + Data-Driven Decision Making: Ability to interpret metrics and analytics to drive continuous improvement. Salary Range: $108,400 - $201,218 **Salary Range Disclaimer** The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Client Relationship Managers **Equal Employment Opportunity** CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. **Where To Apply** Please visit our website to apply: ************************* **Federal Disc/Physical Demand** Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. **Sponsorship in US** Must be eligible to work in the U.S. without Sponsorship. \#LI-KL1 REQNUMBER: 21520

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Location: Position is hybrid. Candidate must live in TX. Prefer candidate to live in/around Austin, San Antonio, or Dallas. Position Purpose: Establishes and fosters a healthy working relationship between large physician practices, IPAs and Centene. Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment. Provides education for HEDIS measures, appropriate medical record documentation and appropriate coding. Assists in resolving deficiencies impacting plan compliance to meet State and Federal standards for HEDIS and documentation standards. Acts as a resource for the health plan peers on HEDIS measures, appropriate medical record documentation and appropriate coding. Supports the development and implementation of quality improvement interventions and audits in relation to plan providers. Delivers, advises and educates provider practices and IPAs in appropriate HEDIS measures, medical record documentation guidelines and HEDIS ICD-9/10 CPT coding in accordance with state, federal, and NCQA requirements. Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on opportunities for provider improvement and gap closure. Collaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters). Identifies specific practice needs where Centene can provide support. Develops, enhances and maintains provider clinical relationship across product lines. Maintains Quality KPI and maintains good standing with HEDIS Abstraction accuracy rates as per corporate standards. Ability to travel up to 75% of time to provider offices. Performs other duties as assigned. Complies with all policies and standards. Education/Experience: Bachelor's Degree or equivalent required 3+ years in HEDIS record collection and risk adjustment (coding) required Licenses/Certifications: One of the following required: CCS, LPN, LCSW, LMHC, LMSW, LMFT, LVN, RN, APRN, HCQM, CHP, CPHQ, CPC, CPC-A or CBCS For Superior HealthPlan: license/certification is preferred Location: Position is hybrid. Candidate must live in TX. Prefer candidate to live in/around Austin, San Antonio, or Dallas. Pay Range: $26.50 - $47.59 per hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

**Resp & Qualifications** **PURPOSE:** The Senior Systems Administrator is responsible for assisting with the development and maintenance of unique software platforms. Assists the Manager with the administration, integration and maintenance of system platform. This position assesses internal business process for efficiency in leveraging the system's platform. Additionally, the Sr. Systems Administrator is responsible for data reporting, configuration, analytics, and dashboarding, resulting from the application. Coordinates and/or facilitates meetings that support projects related to the system (i.e. Kickoff, Business Requirements, Proof of Concept, Trainings, etc.) as well as the provision of specific guidance and direction to various internal business stakeholders. On an ongoing basis, the Sr. Systems Administrator will maintain content integrity of the system's software. **ESSENTIAL FUNCTIONS:** + Responsible for operational governance oversight. Provide advisory support in the identification of control improvement and governance opportunities. Maintain documentation for governance and re-performance ability by leveraging the system software solution. Coordinate and conduct internal operational/process level audits. Continuously analyze and align all functional area policies, procedures, SOPs, workflows and systems to ensure compliance and alignment with regulations, contractual commitments and mandates. Review complex business processes, identify, document, and elevate the presence of risks and controls, and/or management controls in each functional area to mitigate any risk or exposure. Assists in the diagnosis and resolution of problems and works with the system software vendor to implement solutions. Test/validate changes to correct or enhance systems. Work with Subject Matter Resources in interacting with customers, (internal & external). Elicit, review, analyze, interpret, and document requirements for business/system needs. Perform business and technical designer functions, including contributing to both the business and technical architecture components, supporting functional area business process specialists, architects, product and technology specialists. Extract data from the system software solution and develop front end presentation and dashboarding. Work with system vendor and internal stakeholders to isolate and solve design problems or data anomalies encountered during testing and implementation stages. Assist in the creation of test cases to validate changes made to correct or enhance the system software solution. Serve as Subject Matter Resources in customer interaction (internal & external). + Responsible for gaining the ability to navigate the system software application along with a full understanding of the objectives system software application and communicating those objectives and requirements. Assists in the analysis of existing workflows as well as the implementation of new workflows. Ensures the application?s solutions for compliance management are identified and understood, communicated and adopted corporate-wide. Responsible for developing and delivering ad-hoc reports with analysis on a regular basis, or as requested. Day to day maintenance of application content along with associated documentation. Develop training materials and provide guidance and direction to all associate users for general use of the application. + Performs as the day-to-day maintenance of the system software platform. Responsible for ongoing day to day routine maintenance of the system software application including but not limited to user assistance, training, assisting with testing, workflows, monitors user feedback and addresses user questions; navigating all aspects of the application; and proactively identifies future opportunities and enhancements to the application + Collaborates with the system vendor for initializing any subsequent software system upgrades or new application modules. Ensures appropriate product-related training and documentation are made available to end users. Communicates technical and business problems clearly and in a concise manner to achieve resolution. **SUPERVISORY RESPONSIBILITY:** Position does not have direct reports but is expected to assist in guiding and mentoring less experienced staff. May lead a team of matrixed resources. **QUALIFICATIONS:** **Education Level:** Bachelor's Degree in Computer Science, Business or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. **Experience:** 5 years' experience in a systems administration or closely related role. **Knowledge, Skills and Abilities (KSAs)** + Knowledge of system security and data backup/recovery. + Excellent communication skills both written and verbal. + Knowledge of various operating systems and platforms. + Ability to recognize, analyze, and solve a variety of problems. + Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging. **Salary Range:** $81,216 - $161,304 **Salary Range Disclaimer** The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Procurement & Vendor Management **Equal Employment Opportunity** CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. **Where To Apply** Please visit our website to apply: ************************* **Federal Disc/Physical Demand** Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. **Sponsorship in US** Must be eligible to work in the U.S. without Sponsorship \#LI-CB1 REQNUMBER: 21515

**Resp & Qualifications** _CANDIDATES MUST LIVE IN THE MD, DC, NORTHERN VIRGINIA AREA IN ORDER TO TRAVEL INTO THE OFFICES AND FOR CLIENT MEETINGS AND STAFF MEETINGS_ **PURPOSE:** This position is responsible for **new business development** within the **middle market customer** space. This role leads sales initiatives and strategies as well as relationship building with both our external partners and prospects as well internal constituents. The sales consultant position requires a level of knowledge and understanding for selling to fully and self-insured customers with complex benefit arrangements. **ESSENTIAL FUNCTIONS:** + Achieve sales goals and profitable growth for the organization. + Position and sell multiple lines of coverage, medical, stop loss, dental and vision. + Excellent written and presentation skills. + Strategize on proposals to ensure we are meeting the clients objectives and delivering our value proposition. + Be proactive, organized, responsive, detail oriented and track all sales data within the required platforms. + Develop long term relationships with both internal and external constituents. + Ability to strategize and organize a team of subject matter experts for finalist meetings. + Continuously meet with our consultant partners and keep them informed on new products, updates, and relevant information to their business. **SUPERVISORY RESPONSIBILITY:** Position does not have direct reports but does require working closely with internal constituents to develop strategies for selling and presenting to consultants and prospects. **QUALIFICATIONS:** **Education Level:** Bachelors degree in business, Insurance Industry, or related field OR in lieu of a bachelors degree, an additional 4 years of relevant work experience is required in addition to the required work experience. **Licenses/Certifications:** + Current health and life license for the jurisdictions of Maryland, DC, and Virginia Required. **Experience:** 5 years sales/healthcare in a similar sales position. **Preferred Qualifications:** + 5+ years experience in a similar sales position with a competitor or similar industry. **Knowledge, Skills, and Abilities (KSAs)** + Ability to recognize, analyze, and solve for prospects challenges. + Excellent communication skills both written and verbal. + Must be able to meet established deadlines for proposals and work closely with internal constituents. **Travel Requirements** **Estimate Amount:** 80% This position is expected to travel to see consultants and prospective clients within the DC metro area. **Salary Range:** $72,000 - $117,000 **Salary Range Disclaimer** The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** CMLG New Business MD **Equal Employment Opportunity** CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. **Where To Apply** Please visit our website to apply: ************************* **Federal Disc/Physical Demand** Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. **Sponsorship in US** Must be eligible to work in the U.S. without Sponsorship \#LI-KL1 REQNUMBER: 21368

As a Principal Product Manager, you will oversee product roadmaps, strategy, and vision for strategic product offerings across all business units and domains. In this capacity, you will collaborate with leadership to identify critical strategic business challenges and ensure that robust, scalable cross-domain solutions are developed, maintained, and presented to stakeholders. You will engage closely with business partners to prioritize product enhancements and overall development in alignment with evolving strategic objectives. Recognized as the subject matter expert in your products, you will play a key role in guiding the organization's vision for analytics self-service and advancing our capabilities in areas such as Generative AI. What You'll Do Identify high priority strategic business problems and product capabilities needed to solve Define product requirements based on competitive analysis and market research. Prepares projections, analyzes potential operations and identifies the steps necessary to manage/enhance multiple lines of business Conduct market research to define product direction and design, plan, and implement enhancements that align with strategic goals. Develops product policies. Provides input to overall project activities for major initiatives Works within a cross-functional work group to maintain the product within the market. Monitors and reports on product performance and takes appropriate corrective action when necessary. Supports the entire organization as the product experts Provides field and customer support for assigned products, including communication of market strategy, product and competitive information, pricing and promotions. Mentor / coach other product managers Facilitation of meetings and work sessions from the peer to executive level Partner with vendors to develop and implement cutting edge AI enablement for operational applications What You Bring Bachelor's degree or advanced degree (where required) 8+ years of experience in related field. In lieu of degree, 10+ years of experience in related field. Bonus Points Strong project management knowledge Artificial Intelligence (AI) technology knowledge Previous experience working in or developing Agile teams. Agile certification a plus Knowledge of Genesys IVR and Salesforce application preferred What You'll Get The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community. Work-life balance, flexibility, and the autonomy to do great work. Medical, dental, and vision coverage along with numerous health and wellness programs. Parental leave and support plus adoption and surrogacy assistance. Career development programs and tuition reimbursement for continued education. 401k match including an annual company contribution Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $130,560.00 - $208,896.00 Skills Artificial Intelligence (AI), Business Analytics, Business Needs Analysis, Collaborating, Competitive Intelligence (CI), Competitor Analysis, Innovation, Market Analysis, Marketing, Market Needs Analysis, Market Research, Market Strategy, New Product Development, Operations Analysis, Product Development, Product Development Research, Product Management, Product Requirements Analysis, Salesforce (Software), Strategic Analysis

We have a job opening for the Operations Summer Student Intern position with at BlueCross BlueShield of South Carolina. The Intern position is utilized for training an active high school or college student towards an entry level role. The responsibilities vary and are based upon the needs of the area and the experience of the incumbent at the time of employment. The incumbent will work under direct supervision and will be responsible for performing entry-level tasks and for learning professional-level tasks relating to area operations. Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we have been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allow us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are committed to the same philosophy, consider joining our team! Description Location: This is a part-time internship (20- 24 hours/week) Monday-Friday (flexible schedule) working on-site at 4101 Percival Road, Columbia, SC 29229 in an office environment. What You'll Do: Intern position utilized for training an active high school or college student towards an entry-role. Responsibilities vary and are based upon the needs of the area and the experience of the incumbent at the time of employment. This incumbent works under direct supervision and has responsibilities for performing entry-level tasks and for learning professional-level tasks relating to area operations. May assist with the implementation of various activities and programs for assigned business units within the organization. Participates in business unit/department training designed to help this position acquire applicable knowledge/skills in their area of study. Completes area tasks that are conducive to learning the departmental procedures and applying industry/field best practices. May communicate with other areas of the company. May conduct research and analysis of various reports (monthly, quarterly, annually). Perform tasks that help in learning the business area and which provide an overall view of company operations. Assist other staff members with everyday tasks to gain an understanding of business operations and workflow. Completes other assigned area related tasks. May identify areas of need improvement and communicates to management. To Qualify For This Position, You'll Need The Following: Required Education: High School Diploma or equivalent Required Specialized Training: Must have a minimum of 12 semester hours earned in the field(s) specified by the hiring area and must be currently enrolled in college and working towards obtaining at least a 4-year degree in the field(s) specified by the hiring area. (PLEASE UPLOAD A COPY OF YOUR UNOFFICIAL TRANSCRIPTS(S) WITH RESUME.) Required Work Experience: No previous work experience is required. Required Skills and Abilities: Strong oral and written communication skills. Strong organizational skills and attention to detail. Analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion. Good planning and multi-tasking skills. Strong listening skills and the ability to follow directions and ask questions to ensure a productive internship. Required Software and Tools: Microsoft Office. We Prefer That You Have The Following: Microsoft Office. 1 year-general work history/experience. 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: (Standard, unless otherwise directed) 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: (Standard, unless otherwise instructed during intake) 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 disabilities and 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. Here's more information. Some states have required notifications. Here's more information.

We are currently hiring for an RN Concierge Care Manager - Case Management to join BlueCross BlueShield of South Carolina. In this role as an RN Concierge Care Manager - Case Management, you will provide care management services to more than 2 million members in South Carolina and nationally, administer complex, high-touch concierge case management for members identified into specialized programs such as high-risk maternity, NICU, ESRD, Cancer, Palliative Care or Behavioral Health, identify risks and provides outreach services to facilitate the coordination of healthcare services and gap closure, and provide individualized care plans to ensure cost-effectiveness, overall care satisfaction, and improved quality of life. Description The position will be fully remote on a desktop computer to provide highly interactive case management to assigned members. Members will include those with chronic or high-risk conditions and those who are admitted to inpatient care. You will educate and guide members through prior authorizations and understanding the need to adhere to medications and the plan of care. Most interactions will be by phone and through our messaging system, perfect for those who love case management and improving the lives and medical outcomes of members while working in your own home office. To work from home, you must have high-speed (non-satellite) internet and a private, secure home office. Attach a copy of your current RN license report to your application, or Include your RN license number on your resume Candidates who live within 50 miles of the Columbia office (4101 Percival Rd Ste 120, Columbia, SC 29229) and reside in South Carolina will be required to come on-site for one day of orientation to receive their equipment. After orientation, the position will be fully remote. This requirement does not apply to candidates residing in other states. Location This position is full-time (40 hours/week) Monday-Friday from 8:00am-4:30pm EST or 8:30am-5:00pm EST and will be fully remote. To work from home, you must have high-speed (non-satellite) internet and a private, secure home office. What You'll Do: Directs day-to-day, high-touch member management to include implementation of program goals, coordination of treatment plans and benefit coordination for high-risk patient populations and/or those with complex conditions. Coordinates clinical services with external sources to include: providers, vendors, facilities, social workers/case managers and/or community services. Participates in team training and continuing medical education. Prepares for external audits and quality assurance efforts. To Qualify for This Position, You'll Need the Following: Required Education: Associate's degree in nursing OR Graduate of Accredited School of Nursing OR master's degree in social work, Psychology, or Counseling (Div. 75 and 6B) only. Required Work Experience: 5 years' case management experience as an RN OR 2 years' case manager experience as an RN in a health insurance environment. Required Skills and Abilities: Working knowledge of word processing software Knowledge of quality improvement processes and demonstrated ability with these activities Knowledge of contract language and application Ability to work independently, prioritize effectively, and make sound decisions Demonstrated customer service, organizational, and presentation skills Demonstrated proficiency in spelling, punctuation, and grammar skills Demonstrated oral and written communication skills Ability to persuade, negotiate, or influence others Analytical or creative thinking skills Ability to handle confidential or sensitive information with discretion Required Software and Tools: Microsoft Office Required Licenses and Certificates: Active, unrestricted RN licensure from the United States and in the state of hire; OR active, compact, multistate, unrestricted RN license as defined by the Nurse Licensure Compact (NLC); OR active licensure as a social worker, psychologist, or counselor in state of hire (Div. 75 only). Nationally recognized Case Management certification to be obtained within 2 years of hire as a Case Manager. We Prefer That You Have the Following: Preferred Education: Bachelor's degree in health-related field (Nursing, Healthcare Administration, Pharmacy, Sciences, Applied Health) Preferred Work Experience: 5 years' experience in case management in a sub-specialty area (i.e. ICU, Palliative Care, Hospice, or Home Health, Behavioral health, and Case Management.) Preferred Skills and Abilities: Strong communication and customer services skills Excellent analytical skills to problem solve and remedy issues immediately Ability to work in an autonomous environment or leadership capacity Preferred Software and Tools: Working knowledge of Microsoft Word, PowerPoint, Excel, or other spreadsheet/database software; TMCS, LiveOps, MDDS, and BlueVue. Preferred Licenses and Certificates: Case manager certification, clinical certification in specialty area. Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS) certification. 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 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. 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 disabilities and 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. Here's more information. Some states have required notifications. Here's more information.

Become a part of our caring community and help us put health first The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Program Delivery Professional - IHWA Interoperability plays a key role in driving seamless data integration and collaboration within the In-Home Health and Wellbeing Assessment (IHWA) team and across interoperability initiatives. Serving as a business subject matter expert (SME), this individual partners closely with internal and external stakeholders, as well as the Interoperability team, to advance program objectives. Key responsibilities include collaborating with leaders on implementation planning, reviewing and communicating program results, and contributing to the ongoing improvement of processes and automation. The role also begins to influence departmental strategy and requires independent decision-making on moderately complex to complex technical matters related to project components. Work is performed without direct supervision, with considerable latitude in determining objectives and approaches to assignments. The ideal candidate demonstrates a collaborative approach, a strong interest in technology solutions, and a commitment to continuous process improvement. Use your skills to make an impact Required Qualifications Minimum three, (3) years of IT project management or business process automation, experience in technology solutions. Excellent communication skills, both oral and written Proven experience in interoperability or data integration within a healthcare or technology setting. Strong problem-solving skills with demonstrated success in process improvement initiatives and process automation. Familiarity with various technology solutions and interest in exploring new innovations. Excellent collaboration, and stakeholder management abilities. Experience with managing and monitoring successful and impactful projects. Self-starter with the ability to work independently and as part of a team. Futuristic and broad thinker with attention to detail and downstream impacts. Preferred Qualifications Bachelor's degree in Information Technology, Computer Science, Information Systems, or a related field. Experience with EHR integration or usage. Experience with AI integration. Experience automating business processes. PMP certification a plus Knowledge and experience in health care environment/managed care Strong analytical skills Workstyle: Open for Hybrid or Remote Work at Home Location: U.S. Schedule: 8:00 AM - 5:00 PM Eastern Time Monday through Friday Travel: occasional onsite as business needs require. Work at Home Guidance To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. SSN Alert Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. Interview Format As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $86,300 - $118,700 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 01-08-2026 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

**Become a part of our caring community and help us put health first** The Senior Coding Educator identifies opportunities to improve provider documentation and creates an education plan tailored to each assigned provider. The Senior Coding Educator is responsible for creating and executing the risk adjustment strategy for each provider groups. + Analyzes data and reporting and provides educational sessions with providers aimed at quality of care, documentation and coding improvements. + Collaboration with relationship owners and HQRI + Research data and workflow processes and arranges educational sessions with providers aimed at quality of care and documentation improvements. + Monitor and develops strategy with Coding educator and leader, tailor's provider group webinars and discussions based on various Risk Adjustment topics. **Use your skills to make an impact** **Required Qualifications** + AAPC CPC (Certified Professional Coder) Certification + 2 or more years of medical record review knowledge + 2 or more years of risk adjustment provider education + Familiar with coding guidelines (i.e. ICD-9/ICD-10) + Comprehensive knowledge of MS Word, Excel and PowerPoint + Analyzing Data to drive process improvement + Experience with public speaking and presentation skills **Preferred Qualifications** + Bachelor's degree + Certified Risk Coder (CRC) + Experience interacting with healthcare providers + Ability to work independently + Medicare Risk Adjustment knowledge + Analyzing data to build unique education strategies in PowerBi **Additional Information** **Department Hours: 7am to 5pm EST** Work at home - with ability to travel (up to 25% to surrounding provider offices) **Additional Information** As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. **Work at Home Guidance** To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: + At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested + Satellite, cellular and microwave connection can be used only if approved by leadership + Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. + Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Internal- If you have additional questions regarding this role posting, please send them to the Ask A Recruiter persona by visiting go/vivaengage and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. \#LI-BB1 Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $71,100 - $97,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Become a part of our caring community and help us put health first The Associate Actuary, Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide accurate and timely information for strategic and operational decisions. Establishes metrics, provides data analyses, and works directly to support business intelligence. Evaluates industry, economic, financial, and market trends to forecast the organization's short, medium and long-term financial and competitive position. The Associate Actuary, Analytics/Forecasting work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. This a remote nationwide position The Associate Actuary, Analytics/Forecasting ensures data integrity by developing and executing necessary processes and controls around the flow of data. Collaborates with stakeholders to understand business needs/issues, troubleshoots problems, conducts root cause analysis, and develops cost effective resolutions for data anomalies. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments. Use your skills to make an impact Required Qualifications Bachelor's Degree Associate of Society of Actuaries (ASA) designation MAAA Strong communication skills Must be passionate about contributing to an organization focused on continuously improving consumer experiences Preferred Qualifications Prior Part D experience Strong SAS skills Prior Databricks experience Our Hiring Process As part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you. If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker. Alert: Humana values personal identity protection. Please be aware that applicants selected for leader review may be asked to provide a social security number, if it is not already on file. When required, an email will be sent from ******************** with instructions to add the information into the application at Humana's secure website. Humana is more than an equal opportunity employer, Humana's dedication to promoting diversity, multiculturalism, and inclusion is at the heart of what we do in all of our Humana roles. Diversity is more than a commitment to us, it is the foundation of what we do. We are fully focused on diversity of race, gender, sexual orientation, religion, ethnicity, national origin and all of the other fascinating characteristics that make us each uniquely wonderful. #LI-Remote Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $106,900 - $147,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 01-29-2026 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: Under general supervision, performs a variety of routine to complex clerical/accounting functions such as inventory balancing, reconciliations, generating refund request letters, processing disbursements and deposits, keying journal entries and logging items in accordance with standard procedures in one or more of the following areas: general accounting, accounts payable, accounts receivable or related financial area. Completes special projects and resolves routine problems. Logistics: Palmetto GBA - one of BlueCross BlueShield of South Carolina's subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift within the hours of 7:00AM-7:00PM. You will have the potential to W@h after a required training period. This role is located at 17 Technology Circle Columbia SC 29203. What You'll Do: Prepares various in-depth financial data associated with refunds, invoices, recoupments, adjustments, cash disbursements, deposits, check voids and reissues, disputes, correspondence, or other data in support of the finance or accounting function. Ensures data is complete, accurate, and organized for processing. Provides supervisor with daily, weekly, and/or monthly summary reports of accounting activities for the position. Completes moderately difficult to complex research using financial reporting systems, files, and other means to identify errors such as overpayments or misapplication of funds. Resolves most questions and problems, referring most complex issues to higher levels. Performs calculations on financial documents to ensure accuracy of bank deposits, receipts, disbursements, refunds, or other accounting-related items. Provides other support duties related to the accounting/finance function that may include monitoring financial systems, tracking funds, balancing accounts, maintaining inventory and receiving cash funds from customers, etc. Assists less experienced accounting clerks as needed. Prepares journal entries and account reconciliations. Responds to telephone and written inquiries from internal and external customers to ensure accurate billing, payments and/or collections. To Qualify For This Position, You'll Need The Following: Required Education: Bachelor's in a job-related field. Degree Equivalency: 4 years job related work experience or Associate's and 2 years job related work experience. Good oral and written communication and customer service skills. Excellent organization skills and attention to detail. Strong business math skills. Microsoft Office. We Prefer That You Have The Following: Proficiency in Microsoft Excel and Word. Accounting related or Banking experience; highly preferred. 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 disabilities and 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. Here's more information. Some states have required notifications. Here's more information.

Care management interventions focus on improving care coordination and reducing the fragmentation of the services the recipients of care often experience, especially when multiple health care providers and different care settings are involved. Taken collectively, care management interventions are intended to enhance client safety, well-being, and quality of life. These interventions carefully consider health care costs through the professional care manager's recommendations of cost-effective and efficient alternatives for care. Thus, effective care management directly and positively impacts the health care delivery system, especially in realizing the goals of the "Triple Aim," which include improving the health outcomes of individuals and populations, enhancing the experience of health care, and reducing the cost of care. The professional care manager performs the primary functions of assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy. Integral to these functions is collaboration and ongoing communication with the client, client's family or family caregiver, and other health care professionals involved in the client's care. Description Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: Care management interventions focus on improving care coordination and reducing the fragmentation of the services the recipients of care often experience, especially when multiple health care providers and different care settings are involved. Taken collectively, care management interventions are intended to enhance client safety, well-being, and quality of life. These interventions carefully consider health care costs through the professional care manager's recommendations of cost-effective and efficient alternatives for care. Thus, effective care management directly and positively impacts the health care delivery system, especially in realizing the goals of the "Triple Aim," which include improving the health outcomes of individuals and populations, enhancing the experience of health care, and reducing the cost of care. The professional care manager performs the primary functions of assessment, planning, facilitation, coordination, monitoring, evaluation, and advocacy. Integral to these functions is collaboration and ongoing communication with the client, client's family or family caregiver, and other health care professionals involved in the client's care. Location: This is a remote position from 8am - 5pm Monday through Friday. What You'll Do: Provides active care management, assesses service needs, develops and coordinates action plans in cooperation with members, monitors services and implements plans, to include member goals. Evaluates outcomes of plans, eligibility, level of benefits, place of service, length of stay, and medical necessity regarding requested services and benefit exceptions. Ensures accurate documentation of clinical information to support and determine medical necessity criteria and contract benefits. Provides telephonic support for members with chronic conditions, high-risk pregnancy or other at-risk conditions that consist of: intensive assessment/evaluation of condition, at-risk education based on members' identified needs, provides member-centered coaching utilizing motivational interviewing techniques in combination with reflective listening and readiness to change assessment to elicit behavior change and increase member program engagement. Participates in direct intervention/patient education with members and providers regarding health care delivery system, utilization on networks and benefit plans. May identify, initiate, and participate in on-site reviews. Serves as member advocate through continued communication and education. Promotes enrollment in care management programs and/or health and disease management programs. Provides appropriate communications (written, telephone) regarding requested services to both health care providers and members. Performs medical or behavioral review/authorization process. Ensures coverage for appropriate services within benefit and medical necessity guidelines. Utilizes allocated resources to back up review determinations. Identifies and makes referrals to appropriate staff (Medical Director, Case Manager, Preventive Services, Subrogation, Quality of care Referrals, etc.). Participates in data collection/input into system for clinical information flow and proper claims adjudication. Demonstrates compliance with all applicable legislation and guidelines for all regulatory bodies, which may include but isnot limited to ERISA, NCQA, URAC, DOI (State), and DOL (Federal). Maintains current knowledge of contracts and network status of all service providers and applies appropriately. Assists with claims information, discussion, and/or resolution and refers to appropriate internal support areas to ensure proper processing of authorized or unauthorized services. To Qualify For This Position, You'll Need The Following: Required Education: Associate's in a job related field. Degree Equivalency: Graduate of Accredited School of Nursing or 2 years job related work experience. Required Experience: 4 years recent clinical in defined specialty area. Specialty areas include: oncology, cardiology, neonatology, maternity, rehabilitation services, mental health/chemical dependency, orthopedic, general medicine/surgery. Or, 4 years utilization review/case management/clinical/or combination; 2 of the 4 years must be clinical. Required Skills and Abilities: Working knowledge of word processing software. Knowledge of quality improvement processes and demonstrated ability with these activities. Knowledge of contract language and application. Ability to work independently, prioritize effectively, and make sound decisions. Good judgment skills. Demonstrated customer service, organizational, and presentation skills. Demonstrated proficiency in spelling, punctuation, and grammar skills. Demonstrated oral and written communication skills. Ability to persuade, negotiate, or influence others. Analytical or critical thinking skills. Ability to handle confidential or sensitive information with discretion. Required Software and Tools: Microsoft Office. Required License/Certificate: An active, unrestricted RN license from the United States and in the state of hire OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) OR, active, unrestricted licensure as social worker from the United States and in the state of hire (in Div. 6B) OR, active, unrestricted licensure as counselor, or psychologist from the United States and in the state of hire (in Div. 75 only). For Div. 75 and Div. 6B, except for CC 426: URAC recognized Case Management Certification must be obtained within 4 years of hire as a Case Manager. We Prefer That You Have The Following: Preferred Education: Bachelor's degree- Nursing Preferred Work Experience: 3+ years Oncology experience is preferred. Preferred Skills and Abilities: Working knowledge of spreadsheet, database software. Thorough knowledge/understanding of claims/coding analysis, requirements, and processes. Preferred Licenses and Certificates: Case Manager certification, clinical certification in specialty area. 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 disabilities and 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. Here's more information. Some states have required notifications. Here's more information.

**Resp & Qualifications** **PURPOSE:** The Small Group Existing Business Sales Consultant serves as the primary strategist and revenue leader for a defined territory of small group brokers, and their associated employers. Unlike traditional account service roles, this position will not manage day-to-day broker service issues those are handled by the Broker Service Team. Instead, the consultant is responsible for retention strategy, renewal positioning, revenue optimization, and broker ecosystem engagement. This role mirrors the strategic expectations of our manager-level sales leadership: driving clarity, elevating performance, and ensuring our market voice is consistent, compelling, and effective. The consultant functions as the internal authority on the assigned relationships the person the broader organization turns to for insights on portfolio health, competitive threats, renewal decisions, and growth strategy. **ESSENTIAL FUNCTIONS:** **Relationship Ecosystem Management** + Organize brokers and employer groups into relationship ecosystems, identifying influence networks, key producing clusters, and regional patterns. + Lead relationship engagement across these ecosystems, ensuring brokers receive consistent, strategic messaging and renewal support, not just performing service work. + Act as the strategic face of CareFirst to broker partners, elevating our value proposition and shaping how we show up in the market. + Partner closely with the Broker Service Team, who owns service delivery and issue resolution, ensuring a seamless and coordinated experience. + Facilitate escalations appropriately through service teams while maintaining focus on higher-order strategy, messaging, and relationship management. **Renewal Excellence & Competitive Positioning** + Lead renewal strategy conversations with brokers and internal teams; articulate competitive positioning, product differences, and value drivers. + Prepare and deliver compelling renewal presentations, tailored narratives, and portfolio-level insights for brokers and employer decision-makers. + Partner with underwriting, product, operations, sales leadership, and market strategy to ensure renewals are timely, accurate, and aligned with enterprise goals. + Strengthen consistency and quality of renewal execution by identifying process gaps, improving handoffs, and proposing enhancements to cross-functional workflows. **Internal Influence, Communication & Thought Leadership** + Serve as the internal subject matter expert on the assigned relationships, serving as trusted partner to brokers for insights, risks, or needed actions. + Communicate market feedback, broker sentiment, competitor behavior, and emerging threats to sales leadership and cross-functional partners. + Support the creation of strategic sales messaging, broker communications, market-level talking points, and competitive counter-strategies. + Participate in staff meetings, pipeline reviews, strategic planning sessions, and quarterly business reviews to represent the voice of the existing book. + Contribute to a high-performance, accountable culture by modeling preparation, clarity, rigor, and professional presence. **QUALIFICATIONS:** **Education Level:** Bachelor's Degree in Business, Finance or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. **Licenses/Certifications Upon Hire Required:** + Current health and life license for the jurisdictions of Maryland, DC, and Virginia. **Experience:** 3 years sales/healthcare experience in a similar sales position. **Preferred Qualifications:** + Experience in a similar sales position with a competitor or another Blue Cross Blue Shield plan is preferred. **Knowledge, Skills and Abilities (KSAs)** + Knowledge and understanding of CRM, Salesforce, and other client management tools. + Strong customer service orientation. + Ability to recognize, analyze, and solve a variety of problems. + Excellent communication skills both written and verbal. + Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging. **Salary Range:** $60,800 - $98,800 **Salary Range Disclaimer** The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** SM SBU New Business **Equal Employment Opportunity** CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. **Where To Apply** Please visit our website to apply: ************************* **Federal Disc/Physical Demand** Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. **Sponsorship in US** Must be eligible to work in the U.S. without Sponsorship \#LI-KL1 REQNUMBER: 21583

Responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines. Description Logistics: Palmetto GBA- one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located onsite at 17 Technology Circle, Columbia, SC, 29203. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). As a Service Contract Act (SCA) employee, you are required to enroll in our health insurance, even if you already have other health insurance. Until your enrollment is complete, you will receive supplemental pay for health coverage. Your coverage begins on the first day of the month following 28 days of full-time employment. What You'll Do: May perform any or all of the following in the enrollment of providers: determines the acceptability of provider enrollment applications (which may be used for initial full application, reenrollment, reactivation, change of information); provides in-depth review and verification/validation of provider data; verifies provider data by use of information databases and various organizations/agencies to ensure authenticity; sets up/tests EFT accounts. Processes/enters/updates provider data information/applications into appropriate enrollment database used in evaluating/tracking the processing of the application and/or updating of provider directories. Provides quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone). Obtains information from internal department, providers, government and/or private agencies, etc. to resolve discrepancies/problems. Supplies enrollment applications and general information on the enrollment process to interested enrollees. Contributes to and participates on special projects related to provider files. Assists technical support staff with testing system changes related to provider files. Assists with process improvements related to Provider Enrollment. Assists with provider education and provider services training. To Qualify for This Position, You'll Need the Following: Required Education: Bachelor's degree equivalency: Four (4) years job-related work experience or associate's and two (2) years job related work experience. Required Skills and Abilities: Working knowledge of word processing, spreadsheet, and database software. Good judgment skills required. Effective customer service and organizational skills required. Demonstrated verbal and written communication skills. Demonstrated proficiency in spelling, punctuation, and grammar skills. Basic business math proficiency required. Analytical or critical thinking skills required. Ability to handle confidential or sensitive information with discretion. Required Software and Tools: Microsoft Office. We Prefer That You Have the Following: Preferred Education: Bachelor's degree in business administration or health administration. Preferred Skills and Abilities: In-depth knowledge of provider certification process, claims processing operations/systems, and pricing methodology and discount programs. In-depth knowledge of Medicare program instructions/regulations related to provider enrollment/issues. Effective presentation skills. 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 disabilities and 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. Here's more information. Some states have required notifications. Here's more information.

**Resp & Qualifications** **PURPOSE:** This role directly supports the **Underwriting teams** rating system by defining, designing, and developing system requirements. The position involves coordinating subsystem design, integrating total systems, and resolving program support deficiencies. The engineer will conduct independent technical investigations, perform engineering studies, and analyze system problems to develop effective implementation solutions. Responsibilities include designing, coding, testing, and documenting application programs, gathering requirements, and performing complex software analysis and development. The role also involves system integration, architecture design, and selection of appropriate technologies and tools, all in alignment with established project standards and processes. **Are you detail-oriented, energized by data, and thrive in fast-paced environments where every day brings a new challenge?** If you're someone who finds excitement in numbers, enjoys solving complex problems, and perhaps even built an app to help decide whats for lunchthen the Underwriting Systems team might be the perfect fit for you. Were looking for individuals who: + Embrace innovation and continuous learning + Are driven by curiosity and analytical thinking + Thrive in dynamic settings with evolving priorities + Want to contribute to impactful, data-driven decision-making If you're ready to apply your skills in a space where creativity meets precision, wed love to connect. **ESSENTIAL FUNCTIONS:** + Troubleshoot and maintain computer systems related to supported applications, ensuring optimal performance for end users. + Conduct software analysis including requirements gathering, use case development, and design. + Follow change management protocols to maintain data integrity in production environments. + Implement and document source code based on design specifications. + Perform application testing, including unit tests and structured test cases for end users. + Develop and analyze interface design documentation. + Ensure compliance with hardware and software standards and procedures. + Demonstrate experience with front-end and back-end programming, including API integration frameworks and tools. + Assist in estimating development timelines and application features. + Analyze, debug, and resolve software bugs and enhancement requests. + Update user and software documentation as needed. + Develop techniques to prevent system issues and support root cause analysis. + Write system design and application code documentation. + Gather, analyze, and compose technical information. + Enhance engineering knowledge through workshops, training, professional publications, and networking. + Participate in regular team meetings and peer reviews. + Stay current with technology trends and best practices. + Evaluate new systems through in-depth testing and end-user reviews. + Research software and related products to support recommendations and purchasing decisions. + Identify systems integration issues and develop performance tests and automation solutions. **QUALIFICATIONS:** **Education Level:** Bachelors Degree in Information Technology or Computer Science OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. **Experience:** 3 years software, hardware and/or systems engineering. **Preferred Licenses/Certifications** : ITIL Foundations v3 ( to be obtained within 180 days of starting). **Preferred Qualifications:** + Direct support of underwriting rating systems. + Familiarity with Stepwise Formula, Portal Designer, Facets, or CareFirst business processes. **Knowledge, Skills, and Abilities (KSAs)** + Strong data analysis and report writing capabilities. + Proficient in test case development and documentation. + Highly self-motivated with a proactive work ethic. + Exceptional critical thinking and problem-solving skills. + Ability to work independently and collaboratively in dynamic environments. + Proficiency in system engineering tools and programming languages (e.g., JavaScript, XML, .NET Framework, Python). + Experience with Power BI and Microsoft Office Suite, with a strong focus in Excel. + Exposure to database technologies (e.g., SQL, Oracle, MongoDB, MySQL, cloud platforms). + Understanding of SDLC and Agile methodologies. + Ability to communicate professionally with internal and external stakeholders, including those with challenging needs. Salary Range: $78,768 - $156,442 **Salary Range Disclaimer** The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). **Department** Underwriting Systems **Equal Employment Opportunity** CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. **Where To Apply** Please visit our website to apply: ************************* **Federal Disc/Physical Demand** Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. **Sponsorship in US** Must be eligible to work in the U.S. without Sponsorship. \#LI-KL1 REQNUMBER: 21432

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but we've been part of the national landscape for more than seven decades, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation's leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, allowing us to build on various business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: Responsible for entry level accounting activities relating to the maintenance of a complete and accurate general ledger and/or the resultant managerial reports and/or financial statements. Logistics: Planned Administrators Inc. (PAI) - one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. This role is located at 17 Technology Circle Columbia SC 29203 What You'll Do: Reconciles assigned accounts. Initiates and/or processes general ledger, and/or journal entries into various accounts. Prepare spreadsheets and/or ensures that entries are entered into the accounting system. Assist coworkers in preparation and/or/or review of daily activity, monthly, quarterly and/or annual filings as required by regulatory agencies and/or internal requirements, as well as entries made to various systems. Prepares reports for financial analysis, forecasting, budgeting, trending, and/or results analysis to ensure transactions in the ledger tie to statistical files and/or various financial reports. Performs analysis of financial data to identify problem areas and/or report to management. Maintains accurate general ledger (G/L) accounts. This includes performing monthly, weekly and/or daily reconciliations. May assist with special projects as assigned by the manager to include coordination between areas, allocation of resources, formulating solutions to problems, providing timely feedback to the manager and/or developing and/or implementing job procedures/controls in accordance with policies. To Qualify For This Position; You'll Need The Following: Required Education: Bachelor's in a job-related field with 24 semester hours in Accounting. (Anyone hired prior to August 1, 2008, in an Accounting position only requires 21 semester hours of Accounting.) Required Work Experience: Required Skills and Abilities: Knowledge of fundamental accounting concepts, practices and procedures. Good communication, organizational, customer service, and analytical skills. Ability to work independently. Ability to handle confidential or sensitive information with discretion. Required Software and Other Tools: Microsoft Office. Ability to use data retrieval applications. We Prefer That You Have The Following: 2 years-of accounting work experience. Accounts Payable experience, preferred. Proficiency in Microsoft Excel. SAGE 100 experience preferred. 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 disabilities and 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. Here's more information. Some states have required notifications. Here's more information.

**Become a part of our caring community and help us put health first** The Care Manager, Telephonic Behavioral Health 2 , in a telephonic environment, assesses and evaluates members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Care Manager, Telephonic Behavioral Health 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Care Manager, Telephonic Behavioral Health 2 is a **Licensed, Masters level, Social Worker** who functions as a Support Social Services associate (Support SS) in our Special Needs Plan (SNP) program and serves as part of an interdisciplinary care team member working with other disciplines, such as nurse care managers, dieticians, behavioral health, and pharmacists to help promote and support member health and well-being. This role requires the use of structured assessments along with critical thinking skills to determine appropriate interventions such as care coordination, health education, connection to community resources, full utilization of benefits and advocacy. This role requires effective and professional communication with providers, community resources, and other members of the interdisciplinary team to address member needs. The Support SSs daily job duties include making outbound call attempts to members with social determinants of health (SDOH) needs to assess and assist with coordinating care with available plan benefits and/or appropriate community resources in a telephonic, call center, work from home environment. This role does not carry a caseload but may require additional member follow-up to ensure that all needs have been assessed and addressed. The Support SS may also receive inbound calls from members needing additional assistance. This role is also responsible for assessing the member to determine if a referral to any other discipline is needed depending on member's individualized needs. Creating and updating member care plans may be required. Documentation in the member's record is required to ensure CMS compliance, and accurately reflect work with members, providers, and other members of the interdisciplinary care team. **Use your skills to make an impact** **Required Qualifications** + Master's degree in social work from an accredited university + Current, unincumbered, social work license; **LMSW, LCSW, LICSW** + Must have passed ASWB Exam (Master, Advance Generalist, or Clinical level) + Minimum 3 years of experience working as a social worker in a medical healthcare setting + Proficient in Microsoft applications including Word, Outlook, Excel + Capacity to manage multiple or competing priorities including use of multiple computer applications simultaneously + Must be willing to obtain/maintain social work licensure in multiple states, based on business need **Preferred Qualifications** + Experience working with geriatric, vulnerable, and/or low-income populations + Licensure in LA, MD, MI, MS, NV, NM, OK, VA + Bilingual English/Spanish + Bilingual English/Creole + Experience working with Medicare and Medicaid **Additional Information** **Work-At-Home Requirements:** To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. **Social Security Notification:** Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from ******************** with instructions on how to add the information into your official application on Humana's secure website. **HireVue Interview Process:** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. **Benefits Day 1:** Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security-both today and in the future, including: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities **START DATE after completion of background/onboarding-** *Projected start dates for these positions will be throughout Feb 2026 with all interviews being conducted Dec/Jan **Schedule:** + Hours for this position are Monday - Friday 9:30am - 6pm EST. + Hours for the first 2 weeks of training are M-F 8:30am-5pm EST Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $59,300 - $80,900 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 12-30-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Ensures that personal sales, retention and service targets are met for all National Alliance products. This includes traditional self-funded, national products, and new carrier administration. Identifies new market opportunities for growth on a national scale, works with the other departments to implement those opportunities, and then manages the relationships with those new partners. Description Location: This position is full-time (40-hours/week) Monday-Friday, you will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. You may be required to travel. This role is located at 4101 Percival Road, Columbia, SC 29229 however, we are open to hybrid or remote. What You Will Do: Communicates effectively with sales prospects (groups, brokers and carriers). Monitors marketplace regularly to identify trends in sales, competitors. Establishes and maintains distribution channel relations. Communicates regularly and effectively with management regarding information pertinent to successful achievement of goals. Monitors performance metrics and distributes to Management. Completes all reporting requirements as outlined by senior management within specified time periods. To Qualify for This Position, You'll Need the Following: Required Education: Bachelor's Required Work Experience: 6 years-sales experience or equivalent military experience in grade E4 or above. Required Skills and Abilities: Comprehensive knowledge of products, procedures, systems, marketing applicable to Third Party Administration -- both in terms of self-funded group administration and back-office carrier administration. Basic understanding of enrollment/underwriting guidelines. Working knowledge of word processing and spreadsheet software. Excellent verbal and written communication skills. Ability to work independently, prioritize effectively, and make sound decisions. Excellent judgment skills. Strong customer service, organizational, presentation skills with proven ability to manage projects/work teams. Proficiency in spelling, punctuation, and grammar skills. Analytical or critical thinking skills. Ability to persuade, negotiate, or influence others. Ability to handle confidential or sensitive information with discretion. Ability to direct, motivate, and assess performance of others. Required Software and Tools: Ability to use standard office equipment. Working knowledge of Microsoft Word, Excel, or other word processing/spreadsheet software. Required Licenses and Certificates: Current South Carolina Department of Insurance License or the ability to acquire within 4 months of date hired. We Prefer That You Have: Preferred Work Experience: Self-funded sales experience to include finalist presentations and consultant relationship management. Preferred Skills and Abilities: Previous budget experience. In-depth knowledge of competitor products and guidelines. Preferred Licenses and Certificates: CEBS, CLU, FLMI, or other applicable designation. 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 disabilities and 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. Here's more information. Some states have required notifications. Here's more information.