Schedule service calls to field service technicians throughout the US based upon priority level and location in a timely fashion.
Create service tickets and route them to various service agencies
Act as liaison between clients and field technicians
Respond service order requests via phone and email
Fulfillment of any additional requirement set forth by Senior Management and deemed necessary within the scope of the job function
Provide excellent customer service to both internal and external customers, whether via direct contact, over the phone, or online services.
Qualifications:
Dispatch and/or Call Center experience, preferred
Must be able to communicate clearly and professionally, both verbally and in writing
Must have working knowledge of computers
Must be able to prioritize and communicate priorities effectively
Ability to handle multiple projects simultaneously and autonomously
Must be flexible to adjust to changes within the Company, either of procedural or organizational nature
$30k-38k yearly est. Auto-Apply 10d ago
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Supervisor, Customer Service
CGS Administrators 4.7
CGS Administrators job in Nashville, TN
Logistics - CGS 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. This role is located on-site at 26 Century Blvd Suite ST610 Nashville, TN 37214.
What You'll Do:
Responsible for recruiting and hiring, coaching and mentoring, monitoring and evaluation, and addressing all disciplinary issues in a timely manner. Encourage staff in creating and maintaining a work environment with high morale and employee satisfaction through support of professional development, training, career growth, and rewarding high performance.
Review departmental and/or contract standards to ensure compliance. Follow procedures to ensure business and customer needs are met systematically and correctly. Supervise and motivate staff to ensure prompt and accurate response to calls, e-mail, web, handwritten inquiries.
Monitor calls, service and workload. Track any service complaints and analyze problems in order to provide solutions or develop proper training of staff.
Represent department on projects and process improvements. Provide assistance and training to other operational areas of the company as needed.
To Qualify For This Position, You'll Need The Following:
Required Education: Bachelor's
Degree Equivalency: 4 years claims, customer service and/or call center experience or a combination of education and job-related work experience
Required Work Experience: 1 year-claims, customer service, and/or call center experience.
Required Skills and Abilities: Strong oral and written communication skills. Strong decision making, analytical, problem solving, and time management skills. Ability to handle confidential or sensitive information with discretion.
Required Software and Other Tools: Microsoft Office.
We Prefer You Have:
Preferred Education: Bachelor's Degree-Business Administration, Healthcare or related field
Preferred Work Experience: 1 year-leadership experience including scheduling or coordinating work of others, developing work procedures and training for others, and/or leading group project initiatives.
Preferred Skills and Abilities: Ability to persuade, negotiate, or influence. Strong organizational skills. Strong spelling, punctuation, and grammar 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.
$43k-60k yearly est. Auto-Apply 10d ago
Digital Sales Manager
Connectwise 4.2
Remote job
ConnectWise is an industry and Global leading software company
with over 3,000 colleagues in North America, EMEA and APAC. As a community-driven software company dedicated to the success of technology solution providers, our suite helps
over 45,000 of our partners manage their businesses better, sell more efficiently, automate service delivery, and remotely control technology so they can consistently deliver amazing customer experiences.
Our company is powered by our connections, our colleagues, and our community. And, we accept all kinds.
Game-changers, innovators, culture-lovers-and humankind.
We invite discovery and debate. We recognize key moments as milestones.
We see you and value you for your unique contributions. Our inclusive, positive culture lays the foundation to ensure every colleague is valued for their perspectives and skills, giving you the choice of how YOU make a difference.
Curious? Read this opportunity to learn how YOU can make a difference at ConnectWise!
Digital Sales Manager -
General Summary:
The Digital Sales Manager is responsible for the entire sales cycle for Remote Support & Privilege Access products targeting Managed Service Providers and Internal IT markets. This role focusses on acquiring new customers through consultative, value driven sales motions. You will be responsible for prospecting, discovery, demos and pipeline management to drive acquisition and upsell for ConnectWise to surpass monthly targets. With your consent, reference checks will be conducted prior to receiving an offer.
Essential Duties & Responsibilities:
• Ability to run repeatable GTM campaigns to prospect into new accounts to establish relationships with buyer personas within our Ideal Customer Profile and target markets
• Consultative selling by qualifying prospective accounts and solving pain points to build and maintain a pipeline
• Excellent presentation and communication skills including webinars, written presentation and event attendance to mature pipeline
• Strong sales fundamentals; discovery, buyer management, ROI storytelling, objection handling
• Ability to manage multiple stakeholders through sales cycles whilst protecting margin
• Follows the sales forecast process to manage pipeline and exceed monthly and annual sales targets
Knowledge, Skills, and/or Abilities Required:
• 3+ years of software sales experience with track record in over-achieving sales targets
• Results driven and personable who can roll up sleeves to build relationships externally and internally
• Proven in applying Sales frameworks (we use MEDDIC & BANT)
• Problem-solving skills, ability to use data to manage pipeline
• Strong attention to detail in negotiating and protecting margin whilst balancing customer needs
• Knowledge of Remote Support or Privilege Access markets are a plus
ConnectWise is an Equal Opportunity Employer, dedicated to building a diverse and inclusive workforce and providing a workplace free from discrimination and harassment. ConnectWise provides equal employment opportunities to all employees and applicants without regard to race, ethnicity, color, religion, age, sex (including pregnancy), sexual orientation, gender,
gender identity or expression, ancestry, national origin, citizenship status, physical or mental disability, genetic information, military/veteran status, marital status, familial or parental status, or any other characteristic or status protected by applicable federal, state and local laws.
The statements above are intended to describe the general nature and level of work being performed by individuals assigned to this job. Other duties may be assigned as needed. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job and/or to receive other benefits and privileges of employment. If you need a reasonable accommodation for any part of the application and hiring process, please contact us at ********************************* or **************.
$78k-135k yearly est. Auto-Apply 4d ago
Senior Product Designer
HCL International 4.4
Remote or Palo Alto, CA job
About Us: We are a forward -thinking team dedicated to pushing the boundaries of digital product design. We focus on creating exceptional user experiences across web and mobile platforms, emphasizing innovation, collaboration, and a user -centered approach. If you thrive in a creative environment and are passionate about delivering impactful designs, we want to hear from you!
Role Overview
As a Senior Product Designer, you will play a key role in shaping the user experience of our digital products from conception through to launch. You'll collaborate closely with multidisciplinary teams, bringing design excellence to every stage of the process. This position is ideal for someone who enjoys transforming complex ideas into intuitive, beautiful designs and is motivated by the opportunity to influence the product's evolution.
Key Responsibilities
Lead Design Projects: Drive the design process from research and ideation to final launch, ensuring a seamless user experience throughout.
Design Process Engagement: Participate in all aspects of design, including research, brainstorming, prototyping, user testing, and iteration.
User -Centered Design: Create personas, journey maps, user flows, wireframes, and prototypes to communicate design concepts effectively.
Workshops & Collaboration: Organize and lead workshops, design reviews, and user interviews to gather feedback and refine design solutions.
Advocate for Design Excellence: Champion best practices and high standards in design, collaborating closely with cross -functional teams.
Design System Maintenance: Maintain and evolve design systems, toolkits, and brand collateral to ensure consistency across all products.
Team Contribution: Contribute to the overall growth, culture, and productivity of the design team, sharing insights and learnings.
What We're Looking For
Experience: 5+ years of experience in product design for web and mobile applications.
Design Expertise: Strong understanding of design thinking, user -centered design principles, and familiarity with leading design tools and methodologies.
Creative Problem -Solver: Ability to build user empathy and translate complex requirements into intuitive, engaging designs.
Data -Driven Approach: Ability to back up design decisions with user research, data analysis, and a deep understanding of design principles.
Visual Communication: Skilled in translating complex data and user processes into clear, elegant visualizations and interfaces.
Core Design Skills: Expertise in layout, typography, iconography, and information architecture.
Continuous Learning: Passion for exploring new design trends, tools, methods, and emerging technologies.
Portfolio: A strong portfolio showcasing case studies and the thought process behind your design solutions.
Preferred Skills (Nice to Have)
Interest in Emerging Technologies: Experience or enthusiasm for digital assets, Web3 technologies, and blockchain.
Community Involvement: Active participation in the design community through speaking, writing, or hosting events.
Technical Knowledge: Familiarity with front -end development languages such as HTML, CSS, JavaScript, React, etc.
Design Systems: Experience in building and managing UI libraries and design systems.
Why Join Us?
Innovative Culture: Be part of a team that values creativity, experimentation, and continuous growth.
Career Development: Opportunities for personal and professional growth as you contribute to meaningful projects.
Collaborative Environment: Work with a talented and diverse team of professionals who share a passion for design and innovation.
Flexibility: Enjoy a remote work setup that supports work -life balance while allowing you to focus on delivering your best.
$86k-121k yearly est. 60d+ ago
Backend Engineer
HCL International 4.4
Remote or New York, NY job
100% remote optional. Or work in NYC offices. $140k - $200k + equity
Backend Developer with experience in Node.js, Django and Rails to join fast expanding NY FinTech. This company is accelerating its growth after receiving significant funding from a number of VC firms.
They require a backend developer with a minimum 3yrs commercial experience. Someone who has the tenacity and desire to produce top apps!
Job Functions include:
Technical collaboration with internal team
Build out web frameworks using Ruby on Rails, Django, ASP/ ASP.Net
SQL Server / AWS and other cloud architecture
Implementation of frontend & backend systems
Quality assurance and code reviews of existing codebases
Participation in release management including testing, security and reliability
Requirements
Min 3 years experience in full -stack application development (Node.js, Django, Ruby on Rails…)
Node.js, Django
Experience with systems programming
Cloud architecture
SQL, queries, data modelling
Any experience in financial application build a bonus. E.g banking, fintech, payment. But not essential.
Your tech stack experience might include:
Django
Express
Git/Github
HTML
JavaScript
jQuery
MongoDB
Node.js
Python
ASP
.NET
AWS / GCP
React
SQL
React Native
Xamarin
BenefitsSeed equity
$140k-200k yearly 60d+ ago
Consultant, Sr Provider Education
CGS Administrators 4.7
CGS Administrators job in Tennessee or remote
Logistics: CGS (cgsadmin.com)- one of BlueCross BlueShield's South Carolina subsidiary companies.
Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
Location: This a remote position. You will work an 8-hour shift scheduled during our normal business hours of 8:00 a.m.-5:00 p.m. Monday - Friday.
What You'll Do:
Communicates/educates providers on issues such as Medicare coverage, utilization statistics, documentation and medical review by use of written advisories, reports, letters, and telephone contacts.
Documents all provider contacts/communications in provider tracking system.
Conducts formal conference calls and/or in-person educational visits with providers that are consistently over utilizing services, on progressive corrective action, or have unacceptable denial rates and/or error rates under the medical review program.
Conducts coverage and documentation workshops for provider staff (Medicare providers and physicians' staff).
Researches, composes, and coordinates the preparation of all regulatory based provider education materials.
Performs analysis of effective reports to determine actions to be taken regarding medical reviewed its/audits.
Determines what providers are over-utilizing services and what services are being over-utilized.
Works with medical review department and provides input regarding actions taken in response to provider billing practices.
Targets providers where greatest abuse of Medicare program has occurred.
Participates in the medical review process and inter reviewer reliability (IRR) studies.
Assists in training of medical review associates regarding coverage and medical review process.
To Qualify for This Position, You'll Need the Following:
Required Education: If LPN, graduate of accredited School of Licensed Practical Nursing; if LVN, graduate of accredited School of Licensed Vocational Nursing; if RN, graduate of approved School of Nursing.
Required Experience: If LPN or LVN, 7 years of clinical experience or equivalent combination of clinical and educator experience. If RN, 5 years of clinical experience or equivalent combination of clinical and educator experience.
Required Software and tools: Microsoft Office.
Required Skills and Abilities: Knowledge of medical terminology and disease processes. Demonstrated proficiency in word processing and spreadsheet software. Good judgment skills. Effective customer service, organizational, and presentation skills. Demonstrated proficiency in spelling, punctuation, and grammar. Analytical or critical thinking skills. Basic business math proficiency. Knowledge of mathematical or statistical concepts. Ability to persuade, negotiate, or influence.
Required Licenses and Certificates: Active LPN or LVN licensure in state hired, OR active compact multistate LPN license as defined by the Nurse Licensure Compact (NLC), OR active RN licensure in state hired OR active compact multistate RN license as defined by the Nurse Licensure Compact (NLC) others. Ability to handle confidential or sensitive information with discretion.
We Prefer That You Have the Following:
Preferred Work Experience: 3 years of provider relations and Medicare experience.
Preferred Skills and Abilities: Knowledge of claims processing software. In-depth knowledge of Medicare program, guidelines, regulations governing coverage.
Preferred Software and Other Tools: Working knowledge of Microsoft Access or other database software.
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.
$55k-72k yearly est. Auto-Apply 28d ago
Technician, Data Preparation Senior
CGS Administrators 4.7
CGS Administrators job in Nashville, TN
Performs advanced, varied clerical duties in accordance with standard procedures. This includes clerical duties such as photocopying, compiling records, filing, tabulating, posting information, and distributing mail. Applies knowledge of department policies and procedures, and utilizes a general understanding of other departments' functions to resolve most issues. Maintains records, prepares forms, verifies information and resolves routine problems. May orient, train, assign and check the work of lower level employees and be designated as lead worker.
Description
Logistics: CGS (cgsadmin.com) - one of BlueCross BlueShield's South Carolina subsidiary companies.
Location: This position offers a hybrid schedule after training is completed, with work hours starting between 6:00 AM and 7:30 AM Central Time You will work an 8-hour shift schedule. It may be necessary, given the business need to work occasional overtime. This role is located at 26 Century Blvd, Suite ST610 Nashville, TN 37214 United States of America.
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:
Performs advanced, varied clerical duties in accordance with standard procedures. Completes scanning, indexing, imaging and quality control for the area's documentation and records. Verifies accuracy of data and corrects errors discovered during review or research of documents. Reviews varied and complex incoming documentation or work requests to determine handling and routing. Compares related data components and combines documentation for appropriate distribution and assignment. Handles requests for information, files, or research and may liaison frequently with other areas.
Coordinates and schedules departmental activities (projects, meetings, testing, visitors, etc.). Provides coverage or support for other staff members during departmental projects and/or periods of understaffing. May provide training and guidance to entry-level clerks.
Maintains departmental logs, spreadsheets or databases. Prepares basic reports/statistics for management on work received for production and workload assessment.
Prepares correspondence or packages for internal/external mailing. Tracks correspondence and/or packages and follows up as needed. Orders supplies and maintains departmental supply inventory.
To Qualify For This Position, You'll Need The Following:
Required Education: High School Diploma or equivalent
Required Experience: 5 years of clerical or office support experience.
Required Software and tools: Microsoft Office.
Required Skills and Abilities: Good communication and organizational skills. Detail oriented. Basic business math, computer 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.
$51k-70k yearly est. Auto-Apply 42d ago
Training Specialist I
CGS Administrators 4.7
CGS Administrators job in Nashville, TN
Logistics: (cgsadmin.com), one of BlueCross BlueShield's South Carolina subsidiary companies.
Location: This position is full-time (40-hours/week) Monday-Friday with a hybrid work schedule. You will work an 8-hour shift scheduled during our normal business hours hybrid work schedule and the work hours are Monday - Friday 8:00AM - 5:00PM Central. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. 26 Century Blvd Suite ST610 Nashville, TN 37214 2922
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). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.
What You'll Do:
Facilitates varying levels of technical and non-technical training for both new hire and existing staff and/or teams. Effectively manages the training environment to ensure compliance to organizational policies while delivering new employee orientation, job-specific, company-specific, e-learning, and other training solutions. Evaluates learner performance and effectiveness through the administration of varying testing methodologies. Communicates effectively with the applicable customer and/or manager related to both learner and course progression towards meeting expected outcomes.
Conduct assessments to identify the performance, skills, knowledge and information required for a desired training program. Design and develop training solutions and materials that meet the intended need and learning outcome(s) for each targeted audience. Enhance and evaluate training effectiveness through the redesign and revision of existing training courses, curricula and materials in order to fill learning gaps identified through various feedback methods. Demonstrate effective communication and collaboration to partner with Subject Matter Experts (SMEs), trainer peers and others to achieve high-quality instructional materials.
Provide support to training support areas to include processing work to maintain subject matter knowledge, attend Operations team and Workgroup meetings, partner with areas to identify performance gaps and proactively develop training plan objectives.
Maintain/Verify Training Systems access and other administrative functions.
To Qualify for This Position, You'll Need:
Required Education: Bachelor's degree
Degree Equivalency: Two year degree plus 3 years related training, insurance, or related work experience OR Five years training, insurance, or related work experience.
Required Work Experience: One year training, insurance, and/or related work experience required
Required Software and Tools: Microsoft Office and standard classroom and office equipment. (PC skills are needed to support the development of training programs and materials). Strong project management skills. Ability to learn corporate and other required systems.
Required Licenses and Certificates: Ability to complete area required training certification programs within 1 year and/or ability to receive internal competency verification on area specific curriculum within 1 year (area specific).
Required Skills and Abilities:
Strong verbal and written communication and human relations skills.
Ability to develop strong research, planning and data gathering skills.
Ability to design and develop to create outputs in various methods.
Strong organizational skills necessary to schedule, prioritize, and complete work assignments.
Ability to become an SME for multiple lines of business and job functions.
Able to acquire an understanding of the complex technical environment of the organization.
Understand Adult learning principles and appropriate learning development methodologies.
Ability to deliver training classes to 1 to 50 plus individuals.
Dependable, responsible and has the ability to work independently with little to no management intervention.
Required Licenses and Certificates:
Ability to complete area required training certification programs within 1 year and/or ability to receive internal competency verification on area specific curriculum within 1 year (area specific).
Preferred Qualifications:
Medicare J15 (A, B, HHH) experience
Familiar with Criterion-Referenced Instruction (CRI) and Instructional Module Design (IMD) principles and methodologies
Practical understanding of Lean tools and principles - Root Cause Analysis (RCA), Define, Measure, Analyze, Improve, Control (DMAIC), etc.
Working knowledge of or the ability to develop highly proficient personal computer skills (PC skills are needed to facilitate training activities and support training curriculum maintenance).
Strong time management and organizational skills.
Deep understanding of Medicare regulations and guidelines.
Our comprehensive benefits package includes the following:
401(k) retirement savings plan with company match
Fantastic health plans and free vision coverage
Life insurance
Paid annual leave - the longer you work here, the more you earn
Nine paid holidays
On-site cafeterias and fitness centers in significant locations
Wellness programs and a healthy lifestyle premium discount
Tuition assistance
Service Recognition
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What to Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.
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.
$44k-67k yearly est. Auto-Apply 8d ago
Program Manager - IT Nation
Connectwise 4.2
Remote job
ConnectWise is an industry and Global leading software company
with over 3,000 colleagues in North America, EMEA and APAC. As a community-driven software company dedicated to the success of technology solution providers, our suite helps
over 45,000 of our partners manage their businesses better, sell more efficiently, automate service delivery, and remotely control technology so they can consistently deliver amazing customer experiences.
Our company is powered by our connections, our colleagues, and our community. And, we accept all kinds.
Game-changers, innovators, culture-lovers-and humankind.
We invite discovery and debate. We recognize key moments as milestones.
We see you and value you for your unique contributions. Our inclusive, positive culture lays the foundation to ensure every colleague is valued for their perspectives and skills, giving you the choice of how YOU make a difference.
Curious? Read this opportunity to learn how YOU can make a difference at ConnectWise!
IT Nation Program Manager -
General Summary:
The IT Nation Program Manager is responsible for creating and cultivating a positive experience for partners and other groups attending the IT Nation program. This role works in partnership with the cross-functional teams to design and improve the experience and take aways for partners attending IT Nation events. With your consent, reference checks will be conducted prior to receiving an offer.
Essential Duties and Responsibilities:
Provides support to the IT Nation team, with a high attention to detail
Researches, analyzes, and documents findings
May coach and review the work of other team members
Designs and implements IT Nation Evolve programs, driving focus on vital behaviors and improving business performance
Identifies, recruits, coaches, and trains facilitators for IT Nation groups
Develops group level accountability practices and tracking
Utilizes knowledge of partners and information gathered to provide feedback for future IT Nation Programs
Knowledge, Skills, and/or Abilities Required:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Ability to manage projects and processes independently with limited supervision
Advanced knowledge of applicable work area
Ability to situationally adapt and understand new technology/processes as per business requirements
Knowledgeable in the organization and Managed Service Provider (MSP) industry
Ability to define and execute processes
Skills in talent and team development
Leadership skills and ability to influence other through reciprocal efforts
Educational/Vocational/Previous Experience Recommendations:
Bachelor's degree in related field or equivalent business experience
4+ years of related experience
Working Conditions:
Remote
0-10% travel may be required
ConnectWise is an Equal Opportunity Employer, dedicated to building a diverse and inclusive workforce and providing a workplace free from discrimination and harassment. ConnectWise provides equal employment opportunities to all employees and applicants without regard to race, ethnicity, color, religion, age, sex (including pregnancy), sexual orientation, gender,
gender identity or expression, ancestry, national origin, citizenship status, physical or mental disability, genetic information, military/veteran status, marital status, familial or parental status, or any other characteristic or status protected by applicable federal, state and local laws.
The statements above are intended to describe the general nature and level of work being performed by individuals assigned to this job. Other duties may be assigned as needed. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job and/or to receive other benefits and privileges of employment. If you need a reasonable accommodation for any part of the application and hiring process, please contact us at ********************************* or **************.
$81k-121k yearly est. Auto-Apply 4d ago
Senior Solutions Partner Manager
Connectwise 4.2
Remote job
ConnectWise is an industry and Global leading software company
with over 3,000 colleagues in North America, EMEA and APAC. As a community-driven software company dedicated to the success of technology solution providers, our suite helps
over 45,000 of our partners manage their businesses better, sell more efficiently, automate service delivery, and remotely control technology so they can consistently deliver amazing customer experiences.
Our company is powered by our connections, our colleagues, and our community. And, we accept all kinds.
Game-changers, innovators, culture-lovers-and humankind.
We invite discovery and debate. We recognize key moments as milestones.
We see you and value you for your unique contributions. Our inclusive, positive culture lays the foundation to ensure every colleague is valued for their perspectives and skills, giving you the choice of how YOU make a difference.
Curious? Read this opportunity to learn how YOU can make a difference at ConnectWise!
Senior Solutions Partner Manager -
General Summary:
The Senior Solutions Partner Manager is responsible for the overall strategy, execution, and profitability of our vendor partners. This role works in partnership with the Ecosystem and Vendor Management to manage relationships, develop strategic initiatives, and execute corporate strategy. With your consent, reference checks will be conducted prior to receiving an offer.
Essential Duties & Responsibilities:
Provides support cross-functionally, with a high attention to detail
Researches, analyzes, and documents findings
May coach, review, and/or delegate work to other team members
Develops an effective strategy and marketing plan with vendors around their products and objectives
Manages and presents strategic plans to key stakeholders both internal and external
Responsible for onboarding and launching a new resold vendor partner
Leads Quarterly Business Review meetings as it pertains to achievement against goals
Prepares and alters presentation content to target specific markets, opportunities, and audiences
Understands and communicates how partners utilize integrations to be more efficient
Assists with financial analysis that would be of strategic assistance to a contract, pricing structure, promotion or rebate
Conducts trainings cross-functionally for the advancement of the vendor
Assists the Invent team qualifying and evaluating new technology
Coordinates with Invent team and vendor, on integration plan and timeline
Owns SKU creation for resold vendor partners
Assists cross-functional teams with provisioning and management processes for resold vendors
Develops efficient processes for overage or usage charges with each respective vendor
Keeps stakeholders informed of vendor sales progress once on-boarded and take necessary actions as needed
Collaborates cross-functionally to plan, coordinate, and develop strategies to achieve team goals
Maintains a positive, professional "total customer service" attitude
Supports the implementation of the sales strategy based on direction from senior management
Forecasts for strategic initiatives and revenue
Conducts effective meetings with a clear goal, time limit, and follow up communication
Knowledge, Skills and/or Abilities Required:
Ability to manage large projects and processes independently with limited supervision
Recognized subject matter expert of applicable work area
Ability to situationally adapt and understand new technology/processes as per partner requirement
Strong knowledge of IT Service Providers or VARs and how these partners utilize both the organizations and vendor partner products
Strong ability to manage vendor relationships at different levels of engagement within the organization's ecosystem
Organized and detail-oriented
Strong technological skills
Proven success exceeding quotas
Strong negotiation skills
Knowledge of department strategies and services, resolve conflicts, and influence outcomes on non - routine matters for the division with some management assistance
Strong ability to prioritize, assign, monitor, and control the activities of vendor partnerships
Knowledge of IT Channels and Channel Ecosystem
Ability to work within a Channel Partner Ecosystem
Strong technological skills
Ability to effectively communicate through phone and email
Ability to liaise with partners, vendors, and with colleagues at all levels
Preferred: Knowledge of the IT, Professional Services, RMM, CRM, or ERP markets and various security solutions
Educational/Vocational/Previous Experience Recommendations:
Bachelor's degree in related field or equivalent business experience
6+ years of relevant experience
Preferred: 2+ years of inside sales or product management position with proven results
Working Conditions:
Onsite/Hybrid/Remote depending on location
25-40% travel may be required
ConnectWise is an Equal Opportunity Employer, dedicated to building a diverse and inclusive workforce and providing a workplace free from discrimination and harassment. ConnectWise provides equal employment opportunities to all employees and applicants without regard to race, ethnicity, color, religion, age, sex (including pregnancy), sexual orientation, gender,
gender identity or expression, ancestry, national origin, citizenship status, physical or mental disability, genetic information, military/veteran status, marital status, familial or parental status, or any other characteristic or status protected by applicable federal, state and local laws.
The statements above are intended to describe the general nature and level of work being performed by individuals assigned to this job. Other duties may be assigned as needed. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job and/or to receive other benefits and privileges of employment. If you need a reasonable accommodation for any part of the application and hiring process, please contact us at ********************************* or **************.
$112k-159k yearly est. Auto-Apply 2d ago
Provider Enrollment Analyst
CGS Administrators 4.7
CGS Administrators job in Nashville, TN
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: CGS (cgsadmin.com)- 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 at 26 Century Boulevard, Nashville, TN, 37214.
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: 4 years job related work experience or Associate's and 2 years job related work experience.
Required Software and tools: Microsoft Office.
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.
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.
$37k-52k yearly est. Auto-Apply 5d ago
Manager, Data Engineering
Connectwise 4.2
Remote job
ConnectWise is an industry and Global leading software company
with over 3,000 colleagues in North America, EMEA and APAC. As a community-driven software company dedicated to the success of technology solution providers, our suite helps
over 45,000 of our partners manage their businesses better, sell more efficiently, automate service delivery, and remotely control technology so they can consistently deliver amazing customer experiences.
Our company is powered by our connections, our colleagues, and our community. And, we accept all kinds.
Game-changers, innovators, culture-lovers-and humankind.
We invite discovery and debate. We recognize key moments as milestones.
We see you and value you for your unique contributions. Our inclusive, positive culture lays the foundation to ensure every colleague is valued for their perspectives and skills, giving you the choice of how YOU make a difference.
Curious? Read this opportunity to learn how YOU can make a difference at ConnectWise!
General Summary:
The Manager of Data Engineering will lead a team responsible for designing, building, and maintaining scalable data infrastructure and pipelines. This role involves collaborating with cross-functional teams to ensure data availability, integrity, and security, enabling data-driven decision-making across the organization.
With your consent, reference checks will be conducted prior to receiving an offer.
Essential Duties and Responsibilities:
- Lead and mentor a team of data engineers, fostering a culture of innovation and continuous improvement.
- Design, implement, and optimize data pipelines and ETL processes to support business needs.
- Collaborate with data scientists, analysts, and other stakeholders to understand data requirements and deliver solutions.
- Ensure data quality, governance, and compliance with industry standards and best practices.
- Evaluate and integrate new technologies and tools to enhance data processing capabilities.
Qualifications:
- Proven experience in data engineering, with a strong understanding of data architecture and ETL processes.
- Proficiency in programming languages such as Python, Java, or Scala.
- Experience with cloud platforms (e.g., AWS, Azure, Google Cloud) and big data technologies (e.g., Hadoop, Spark).
- Strong leadership and communication skills, with the ability to manage and motivate a team.
ConnectWise is an Equal Opportunity Employer, dedicated to building a diverse and inclusive workforce and providing a workplace free from discrimination and harassment. ConnectWise provides equal employment opportunities to all employees and applicants without regard to race, ethnicity, color, religion, age, sex (including pregnancy), sexual orientation, gender,
gender identity or expression, ancestry, national origin, citizenship status, physical or mental disability, genetic information, military/veteran status, marital status, familial or parental status, or any other characteristic or status protected by applicable federal, state and local laws.
The statements above are intended to describe the general nature and level of work being performed by individuals assigned to this job. Other duties may be assigned as needed. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the job and/or to receive other benefits and privileges of employment. If you need a reasonable accommodation for any part of the application and hiring process, please contact us at ********************************* or **************.
$104k-144k yearly est. Auto-Apply 44d ago
IT Process Assurance Auditor (CMMI Standards)- CGS Administrators, LLC
CGS Administrators 4.7
CGS Administrators job in Nashville, TN
Working at CGS Administrators CGS Administrators provides a variety of services, under contracts with the Centers for Medicare and Medicaid Services (CMS) for beneficiaries, health care providers, and medical equipment suppliers in 33 states, supporting the needs of more than 20 million Medicare beneficiaries nationwide.
We are seeking a passionate, collaborative and experienced IT Process Assurance Auditor to join our enterprise project management office team. This is an on-site position in Nashville, TN. This role operates as a Capability Maturity Model Integration (CMMI) champion coordinating internal and external audits and appraisals. If you're enthusiastic about technology, continuous improvement and have a passion for quality then look no further and join CGS Administrators, LLC!
Description
Logistics: CGS -one of BlueCross BlueShield's South Carolina subsidiary companies.
Work Environment:
Typical office environment.
What you'll do
Responsible for examining, evaluating and analyzing I/S processes, technical standards and management procedures to ensure they are working effectively to improve the overall performance of the organization. Conduct less complex audits against established standards to ensure compliance. Provide recommendations of process improvements. Participate in Governance sub-committees. Assist IT staff by providing education and guidance to I/S staff regarding IT methodology, processes and standards. Ensure the quality of data maintained by the Quality Assurance area.
Perform periodic audits (weekly, monthly, quarterly and annual). Conduct trend analysis and provide recommendations of process improvements. Provide reports to management on compliance with adapted IT standards.
Under the guidance of senior auditor, develop new or enhanced audits, of internal I/S areas and processes to assess compliance with adapted processes, standards and regulations. Document findings and prepare detail and summary audit reports relating to the standard being validated.
Provide administrative support for the I/S systems which document authorized software/hardware, Product/Service offerings and/or systematic data archival.
Develop knowledge of internal and external standards, regulations and regulatory bodies. Serve as a liaison to I/S Governance organization on applicable I/S sub-committees. Identify and communicate compliance issues and risks promptly so that they are understood.
To Qualify for This Position, You'll Need:
Required Education:
Bachelor's in a job-related field
Degree Equivalency:
Associates degree plus an extra 2 years job-related experience for a total of 6 years of required work experience (see "required work experience")
OR
8 total years required work experience.
Required Work Experience:
4 years of job-related experience including 2 years of IT system auditing, data security administration, contingency planning, quality assurance, systems development, or IT business system analysis.
Required Skills and Abilities:
Intermediate knowledge of systems development concepts.
Fully understands acceptable internal standards and methodologies.
Understand the interaction and relationship of business operations and information systems. Understand the interaction and relationship of network processes.
Demonstrated ability to analyze best-in-class processes.
Ability to identify problems and recommend solutions.
Ability to provide guidance in developing and implementing validation processes for all development and enhancement projects.
Excellent oral and written communication skills.
Required Software and Other Tools:
Microsoft Office and standard office equipment.
We Prefer That You Have:
Direct or indirect experience as a Capability Maturity Model Integration (CMMI) Appraisal Team Member and/or have provided support to an appraisal.
Completed CMMI Foundations of Capability and Building Development Excellence Course work.
Demonstrated collaboration with internal and external audit teams.
Conducted performance, improvement, and benefit analysis.
Developed and provided staff education.
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 access and opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
Our comprehensive benefits package includes:
Subsidized health plans, dental and vision coverage
401K retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
Nine paid holidays
On-site cafeterias and fitness centers in major locations
Wellness program and healthy lifestyle premium discount
Tuition assistance
Service recognition
Employee Assistance
Discounts to movies, theaters, zoos, theme parks and more
What to Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with those candidates who qualify with prioritization given to those candidates who demonstrate the preferred qualifications.
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.
$61k-79k yearly est. Auto-Apply 60d ago
IT Business Systems Analyst II (Medicare/Medicaid)- CGS Administrators, LLC
CGS Administrators 4.7
CGS Administrators job in Nashville, TN
Working at CGS Administrators CGS Administrators, LLC (CGS) is part of BCBSSCâ„¢'s Celerian Group of companies and provides a variety of services for Medicare beneficiaries, healthcare providers, and medical equipment suppliers in 38 states, supporting the needs of over 8.7 million Medicare beneficiaries and 103,000 healthcare professionals nationwide.
This is an onsite full-time position located at 26 Century Blvd., Ste. ST610 Nashville, TN 37214-3685. If you have IT Business Analysis Healthcare experience and leadership capabilities, this could be the perfect role for you. Join a mission-driven organization making a national impact in healthcare. Be part of a collaborative, forward-thinking team where your work truly matters. Apply now and help shape the future of Medicare services.
Position Purpose:
Defines customer needs in technical and business contexts. Ensure the proposed technical and business solutions meet the customer's objectives for the work effort. Provide guidance with planning and prioritization of business support-related activities.
Description
Logistics: CGS -one of BlueCross BlueShield's South Carolina subsidiary companies.
Sponsorship: This position is not eligible for sponsorship now or in the future.
Work Environment:
Fast-paced, high demand environment.
Work is frequently performed against mandated deadlines.
Knowledge of when and what to delegate is essential in order to balance multiple high-priority tasks.
Fast paced, multi-platformed environment which may require action and response 24X7 to support the technical business needs of the customer.
What you'll do :
Elicit and document user requirements to meet a business objective. Identify and validate requirements and organize the information into a logical document that is understood by the customer and Information Systems.
Guide both technical and customer departments in the development of the systems that support the business solution.
Facilitate the transfer of knowledge about the direction of the business units to others who support them.
Ensure the accurate deployment of solutions through review of problem logs, assisting with test plans and test matrices, and other analysis activities.
Provide input on the business direction for system changes.
Validate the business need for solutions to business problems and process improvements.
Assist in the development and documentation of training materials. Mentor or train less experienced staff.
To Qualify for This Position, You'll Need:
Required Education:
Bachelor's degree
Degree Equivalency:
Associates degree plus an extra 2 years job-related experience for a total of 6 years of required work experience (see "required work experience")
OR
8 total years required work experience.
Required Work Experience:
4 years of IT business analysis experience.
Required Skills and Abilities:
Demonstrated understanding of concepts of the supported business unit.
Basic knowledge of standard industry practices.
Demonstrated knowledge of procedures for the business unit.
Able to communicate effectively with technical and non-technical audiences, including the ability to express complex technical and business concepts to all management levels, peers, and the business units.
Strong teamwork and interpersonal skills.
Understands how IT affects an organization and is able to link it to business processes.
Excellent analytical skills.
Good conceptual skills.
Able to read and comment on test plans and test matrices, project plans, and scope and design documents.
Required Software and Other Tools:
Microsoft Office.
We Prefer That You Have:
Proficiency in Visio and Excel.
Agile and Waterfall methodology experience.
IT Business Analysis Healthcare experience.
Preferred Licenses and Certificates:
SAFe Scaled Agile Certification.
CBAP and/or demonstrated continuous learning in the Business Analysis profession.
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 access and opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
Our comprehensive benefits package includes:
Subsidized health plans, dental and vision coverage
401K retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
Nine paid holidays
On-site cafeterias and fitness centers in major locations
Wellness program and healthy lifestyle premium discount
Tuition assistance
Service recognition
Employee Assistance
Discounts to movies, theaters, zoos, theme parks and more
What to Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with those candidates who qualify with prioritization given to those candidates who demonstrate the preferred qualifications.
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.
$58k-78k yearly est. Auto-Apply 4d ago
Medical Review Director - CGS Administrators, LLC
CGS Administrators 4.7
CGS Administrators job in Nashville, TN
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've 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 dedicated to the same philosophy, consider joining our team!
Position Purpose:
The Medical Review Director directs and oversees operations in the medical review, clinical pricing, and re-determination areas ensuring performance expectations, compliance standards, and budgetary limits are maintained. In this role, you will supervise and motivate area employees.
Description
Logistics: CGS Administrators, LLC - one of BlueCross BlueShield of South Carolina's subsidiary companies.
Location: This position is full-time (40-hours/week) Monday-Friday ONSITE 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 can be physically located in Nashville, TN, Columbia, SC, or Springfield, IL. There are no options for remote or hybrid work schedules.
Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
What You'll Do:
Oversees operations of assigned areas. Coordinates tactical team activities.
Ensures area review decisions are accurate and all associates are well informed and trained on contract process work instructions.
Reviews and analyzes data and creates departmental strategy and error rate reduction plans based on the findings.
Provides guidance on the analysis, identification, and corrective actions of services and/or providers with suspected abuse of the program.
Works closely with the Provider Service Center and other internal departments, providing necessary assistance and resources, to ensure consistency and achieve the integrated goals of reducing the claims payment error rate and procurement of additional contracts.
Develops and monitors budget for all assigned areas.
To Qualify For This Position, You'll Need The Following:
Required Education: Bachelor's in a job related field.
Required Experience:
5 years healthcare program management, utilization/case management, or medical review management.
3 years of supervisory/management experience or equivalent military experience in grade E4 or above.
Required Software and tools:
Microsoft Office.
Knowledge of medical systems software.
Required Skills and Abilities:
Excellent verbal and written communication skills.
Excellent organizational, customer service, analytical or critical thinking skills.
Excellent presentation skills.
Good judgment skills.
Ability to persuade, negotiate, or influence others.
We Prefer That You Have The Following:
Bachelor's degree - Nursing
Graduate of Accredited School of Nursing
Experience working with CMS and/or Medicare.
Working knowledge of Medicare claims processes and the Medicare program.
Strong understanding of using data to make business decision.
Knowledge/understanding of utilization review guidelines, managed care delivery systems.
Ability to work independently, prioritize effectively, make sound decisions.
Demonstrated presentation skills in order to work effectively with both internal and external customers.
Ability to handle confidential or sensitive information with discretion.
Ability to direct, motivate, and assess performance of others.
Preferred Licenses and Certificates: Active RN licensure in state hired.
Work Environment: Typical office environment frequent. Travel between office buildings. Some out of town travel.
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.
Pay Range Information:
Range Minimum $76,546.00
Range Midpoint $113,900.50
Range Maximum $151,255.00
Pay Transparency Statement:
Please note that this range represents the pay range for this and other positions that fall into this pay grade. Compensation decisions within the range will be dependent upon a variety of factors, including experience, geographic location, and internal equity.
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.
$76.5k-151.3k yearly Auto-Apply 42d ago
Senior Provider Enrollment Analyst
CGS Administrators 4.7
CGS Administrators job in Nashville, TN
Acts as a Team Lead by providing guidance/direction/training to Provider Enrollment Analysts and/or other Provider Enrollment area staff. Responsible for the processing of difficult enrollment applications and/or complex inquiries. Description
Logistics: CGS (cgsadmin.com)- 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 26 Century Boulevard, Nashville, TN, 37214.
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:
Functions as Team Leader/senior-level Enrollment Analyst.
Provides leadership/guidance/direction/training to staff.
Distributes work and is available to answer questions from staff.
Acts as a resource for staff regarding any escalating issues.
Keeps manager informed of any problems/issues that need resolving.
Conducts quality reviews of completed work.
Ensures that all audits are completed, verified, and closed.
Performs analysis of audits to determine areas for training, development, and education.
Ensures that quality work instructions/forms/documents are developed/revised as needed.
Provides quality service and communicates effectively with external/internal customers in response to inquiries (correspondence, telephone).
Obtains information from internal departments, providers, government and/or private agencies, etc. to resolve discrepancies/problems.
Interprets various guidelines and provides input to required procedures.
Generates and analyzes various provider reports to management.
Participates in testing system changes related to provider files.
Contributes/participates/completes special projects as assigned.
To Qualify for This Position, You'll Need the Following:
Required Education: Bachelor's degree equivalency: 4 years job-related work experience or an associate's degree and 2 years job related work experience.
Required Work Experience: 2 years of provider network enrollment/certification experience.
Required Skills and Abilities: Working knowledge of word processing, spreadsheet, and database software. Working knowledge of provider certification process and claims processing operations/systems. Good judgment skills required. Effective customer service, organizational, and presentation 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. In-depth knowledge of pricing methodology and discount programs. In-depth knowledge of Medicare program instructions/regulations related to provider enrollment/issues.
Required Software and Tools: Microsoft Office.
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.
$68k-93k yearly est. Auto-Apply 28d ago
Senior Provider Relations Representative - CGS
CGS Administrators 4.7
CGS Administrators job in Tennessee or remote
As a member of the DMEPOS (Durable Medical Equipment Prosthetics, Orthotics and Supplies) team you will provide education and training for network providers, staff, suppliers, physicians, beneficiaries, and referral agents as necessary. You will develop and produce all training and educational materials for virtual and onsite training classes.
Description
Logistics: CGS (cgsadmin.com)- one of BlueCross BlueShield's South Carolina subsidiary companies.
Location: This is a full-time remote position (Tennessee, North Carolina, South Carolina, Georgia, Kentucky). You will work an 8-hour shift scheduled during our normal business hours of 8:00 a.m. - 5:00 p.m. Some overnight and weekend travel will be required for in-person conferences and presentations.
Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
What You'll Do:
Develops/prepares/reviews/updates all provider education materials. These may include: web-based training, computer-based training, ACT (ask the contractor) calls, outreach presentations/proposals, listserv articles, new highlights, calendar of events, job aids, resource tools, and web page content.
Conducts/facilitates meetings, workshops, training classes, teleconferences with providers, provider groups, staff, suppliers, physicians, beneficiaries, referral agents.
Develops relationships with providers, provider groups, staff, suppliers, physicians, beneficiaries, referral agents, state/local medical/professional associations.
Responds to educational needs. Acts as liaison between division/above mentioned groups and appropriate state/federal agencies to ensure training needs are met.
Responds to/resolves problems/issues identified through meetings, workshops, correspondence, etc.
Performs administrative functions in support of education and training.
Produces/generates various reports to management and provides feedback on activities to management.
Contributes/participates/completes special projects as assigned.
To Qualify For This Position, You'll Need the Following:
Required Education: Bachelor's degree equivalency: 4 years job related work experience or an Associate's and 2 years job related work experience.
Required Skills and Abilities: Demonstrated skills related to training materials development. Demonstrated skills related to classroom presentations to large groups. Working knowledge/understanding of government healthcare programs, HIPAA policies, procedures. Demonstrated proficiency in word processing, spreadsheet, database software. Good judgment skills. Demonstrated proficiency in spelling, punctuation, grammar skills. Demonstrated verbal and written communication skills. Analytical and critical thinking skills. Basic business math proficiency. Ability to persuade, negotiate, or influence others. Ability to handle confidential or sensitive information with discretion. Ability to identify learning objectives. Strong course design skills to include use of media/other instructional methods. Ability to evaluate progress in addition to actual delivery of training sessions.
Required Software and Tools: Microsoft Office.
We Prefer That You Have the Following:
Preferred Skills and Abilities: Experience developing virtual and onsite training classes. Medicare knowledge and experience. DMEPOS (Durable Medical Equipment Prosthetics, Orthotics and Supplies) 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:
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.
$33k-43k yearly est. Auto-Apply 42d ago
Software Engineer
HCL International 4.4
Remote or New York, NY job
Senior / Lead Full Stack Engineer Compensation: Competitive base salary + equity
About the Role
The Senior / Lead Full Stack Engineer will play a key role in developing and scaling the company's core platform. You will work across the full stack, designing and delivering high -quality software that drives real business impact. This position involves collaborating with cross -functional teams to architect new features, improve performance, and ensure reliability in a growing distributed system.
Responsibilities
Design, develop, and maintain scalable web applications and APIs.
Lead and contribute to product architecture, infrastructure, and integrations.
Write clean, efficient, and well -tested code using modern JavaScript/TypeScript frameworks.
Collaborate with product and design teams to deliver user -focused solutions.
Improve developer workflows, observability, and deployment processes.
Mentor other engineers and promote best practices in software development.
Requirements
Several years of professional experience as a full stack or backend engineer.
Strong knowledge of JavaScript/TypeScript and modern frameworks.
Proven experience with scalable systems, distributed services, and cloud environments.
Understanding of API design, data modeling, and CI/CD pipelines.
Strong communication skills and ability to thrive in a remote, fast -paced startup.
Passion for building reliable and user -centered products.
Benefits
Competitive compensation and meaningful equity.
Fully remote role (U.S. -based).
Opportunity to shape the technical direction of a growing company.
Collaborative, transparent, and flexible work culture.
$77k-101k yearly est. 60d+ ago
Consultant, Sr Provider Education
CGS Administrators 4.7
CGS Administrators job in Tennessee
Logistics: CGS (cgsadmin.com)- one of BlueCross BlueShield's South Carolina subsidiary companies.
Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen.
Location: This a hybrid position. Onsite work will be performed at 26 Century Blvd. Nashville, TN 37214. You will work an 8-hour shift scheduled during our normal business hours of 8:00 a.m.-5:00 p.m. Monday - Friday.
What You'll Do:
Communicates/educates providers on issues such as Medicare coverage, utilization statistics, documentation and medical review by use of written advisories, reports, letters, and telephone contacts.
Documents all provider contacts/communications in provider tracking system.
Conducts formal conference calls and/or in-person educational visits with providers that are consistently over utilizing services, on progressive corrective action, or have unacceptable denial rates and/or error rates under the medical review program.
Conducts coverage and documentation workshops for provider staff (Medicare providers and physicians' staff).
Researches, composes, and coordinates the preparation of all regulatory based provider education materials.
Performs analysis of effective reports to determine actions to be taken regarding medical reviewed its/audits.
Determines what providers are over-utilizing services and what services are being over-utilized.
Works with medical review department and provides input regarding actions taken in response to provider billing practices.
Targets providers where greatest abuse of Medicare program has occurred.
Participates in the medical review process and inter reviewer reliability (IRR) studies.
Assists in training of medical review associates regarding coverage and medical review process.
To Qualify for This Position, You'll Need the Following:
Required Education: If LPN, graduate of accredited School of Licensed Practical Nursing; if LVN, graduate of accredited School of Licensed Vocational Nursing; if RN, graduate of approved School of Nursing.
Required Experience: If LPN or LVN, 7 years of clinical experience or equivalent combination of clinical and educator experience. If RN, 5 years of clinical experience or equivalent combination of clinical and educator experience.
Required Software and tools: Microsoft Office.
Required Skills and Abilities: Knowledge of medical terminology and disease processes. Demonstrated proficiency in word processing and spreadsheet software. Good judgment skills. Effective customer service, organizational, and presentation skills. Demonstrated proficiency in spelling, punctuation, and grammar. Analytical or critical thinking skills. Basic business math proficiency. Knowledge of mathematical or statistical concepts. Ability to persuade, negotiate, or influence.
Required Licenses and Certificates: Active LPN or LVN licensure in state hired, OR active compact multistate LPN license as defined by the Nurse Licensure Compact (NLC), OR active RN licensure in state hired OR active compact multistate RN license as defined by the Nurse Licensure Compact (NLC) others. Ability to handle confidential or sensitive information with discretion.
We Prefer That You Have the Following:
Preferred Work Experience: 3 years of provider relations and Medicare experience.
Preferred Skills and Abilities: Knowledge of claims processing software. In-depth knowledge of Medicare program, guidelines, regulations governing coverage.
Preferred Software and Other Tools: Working knowledge of Microsoft Access or other database software.
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.
$55k-72k yearly est. Auto-Apply 3d ago
Specialist, Training I
CGS Administrators 4.7
CGS Administrators job in Nashville, TN
Provides blended learning solutions and the use of innovative technology and tools to meet business goals. Responsible for training, developing and coaching activities in various areas. This includes the analysis, design, delivery, evaluation and maintenance required to manage the on-going execution of training programs and expected outcomes.
Description
Logistics: (cgsadmin.com), one of BlueCross BlueShield's South Carolina subsidiary companies.
Location: This position is full-time (40-hours/week) Monday-Friday with a hybrid work schedule. You will work an 8-hour shift scheduled during our normal business hours hybrid work schedule and the work hours are Monday - Friday 8:00AM - 5:00PM Central. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. 26 Century Blvd Suite ST610 Nashville, TN 37214 2922
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). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days after the hire date.
What You'll Do:
Facilitates varying levels of technical and non-technical training for both new hire and existing staff and/or teams. Effectively manages the training environment to ensure compliance to organizational policies while delivering new employee orientation, job-specific, company-specific, e-learning, and other training solutions. Evaluates learner performance and effectiveness through the administration of varying testing methodologies. Communicates effectively with the applicable customer and/or manager related to both learner and course progression towards meeting expected outcomes.
Conduct assessments to identify the performance, skills, knowledge and information required for a desired training program. Design and develop training solutions and materials that meet the intended need and learning outcome(s) for each targeted audience. Enhance and evaluate training effectiveness through the redesign and revision of existing training courses, curricula and materials in order to fill learning gaps identified through various feedback methods. Demonstrate effective communication and collaboration to partner with Subject Matter Experts (SMEs), trainer peers and others to achieve high-quality instructional materials.
Provide support to training support areas to include processing work to maintain subject matter knowledge, attend Operations team and Workgroup meetings, partner with areas to identify performance gaps and proactively develop training plan objectives.
Maintain/Verify Training Systems access and other administrative functions.
To Qualify for This Position, You'll Need:
Required Education: Bachelor's degree
Degree Equivalency: Two year degree plus 3 years related training, insurance, or related work experience OR Five years training, insurance, or related work experience.
Required Work Experience: One year training, insurance, and/or related work experience required
Required Software and Tools: Microsoft Office and standard classroom and office equipment. (PC skills are needed to support the development of training programs and materials). Strong project management skills. Ability to learn corporate and other required systems.
Required Licenses and Certificates: Ability to complete area required training certification programs within 1 year and/or ability to receive internal competency verification on area specific curriculum within 1 year (area specific).
Required Skills and Abilities:
Strong verbal and written communication and human relations skills.
Ability to develop strong research, planning and data gathering skills.
Ability to design and develop to create outputs in various methods.
Strong organizational skills necessary to schedule, prioritize, and complete work assignments.
Ability to become an SME for multiple lines of business and job functions.
Able to acquire an understanding of the complex technical environment of the organization.
Understand Adult learning principles and appropriate learning development methodologies.
Ability to deliver training classes to 1 to 50 plus individuals.
Dependable, responsible and has the ability to work independently with little to no management intervention.
Required Licenses and Certificates:
Ability to complete area required training certification programs within 1 year and/or ability to receive internal competency verification on area specific curriculum within 1 year (area specific).
Preferred Qualifications:
Medicare J15 (A, B, HHH) experience
Familiar with Criterion-Referenced Instruction (CRI) and Instructional Module Design (IMD) principles and methodologies
Practical understanding of Lean tools and principles - Root Cause Analysis (RCA), Define, Measure, Analyze, Improve, Control (DMAIC), etc.
Working knowledge of or the ability to develop highly proficient personal computer skills (PC skills are needed to facilitate training activities and support training curriculum maintenance).
Strong time management and organizational skills.
Deep understanding of Medicare regulations and guidelines.
Our comprehensive benefits package includes the following:
401(k) retirement savings plan with company match
Fantastic health plans and free vision coverage
Life insurance
Paid annual leave - the longer you work here, the more you earn
Nine paid holidays
On-site cafeterias and fitness centers in significant locations
Wellness programs and a healthy lifestyle premium discount
Tuition assistance
Service Recognition
What We Can Do for You:
We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
What to Expect Next:
After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements. Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications
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.
Zippia gives an in-depth look into the details of CGS, including salaries, political affiliations, employee data, and more, in order to inform job seekers about CGS. The employee data is based on information from people who have self-reported their past or current employments at CGS. The data on this page is also based on data sources collected from public and open data sources on the Internet and other locations, as well as proprietary data we licensed from other companies. Sources of data may include, but are not limited to, the BLS, company filings, estimates based on those filings, H1B filings, and other public and private datasets. While we have made attempts to ensure that the information displayed are correct, Zippia is not responsible for any errors or omissions or for the results obtained from the use of this information. None of the information on this page has been provided or approved by CGS. The data presented on this page does not represent the view of CGS and its employees or that of Zippia.
CGS may also be known as or be related to CGS, Cgs (computer Generated Solutions), Computer Generated Solutions, Computer Generated Solutions Inc and Computer Generated Solutions, Inc.