Jobs · OTHR · South Carolina

Manager, Enrollment

BlueCross BlueShield of South Carolina · Columbia, SC · 4 wk ago
OTHRFull-time
We need to output HTML fragment with sections: About the role? The posting includes Summary, Description, Logistics, What You'll Do, To Qualify..., We Prefer..., Our Comprehensive Benefits..., What We Can Do For You, What To Expect Next, EEO etc. We must remove boilerplate: cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. So we should drop EEO statement, "What To Expect Next" maybe considered application instructions? It says after submitting application... that's application instructions, should be removed. Also "What We Can Do For You" maybe generic but could be kept? It's about diversity and inclusion; not boilerplate? Might be considered EEO-ish but it's a statement about diversity; could be considered boilerplate but maybe keep? The instruction: remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate. "What We Can Do For You" is about diversity and inclusion, could be considered EEO-related. Safer to remove it. Also "Our Comprehensive Benefits Package" is benefits, we should keep as Benefits section. Also "What You'll Do" is responsibilities. "To Qualify For This Position" is requirements/qualifications. "We Prefer That You Have" is preferred qualifications. Also "Summary" maybe about the role; we can treat as About the role. Also "Description Logistics:" includes location, schedule, sponsorship. We need to include Schedule if present: they say full-time 40-hours/week Monday-Friday, 8-hour shift 8:00AM-5:00PM. So we can include Schedule section. Pay not mentioned, so omit Pay. Benefits we have. Location maybe part of About the role or separate? Not required heading; we can embed in About the role paragraph. We must not repeat job title as heading. No Job ID. We must use

for section headings. Use
  • for any list of duties/requirements/benefits. Use

    for prose. We need to preserve all substantive information, not invent or summarize away detail. So we need to include all details from sections we keep. Let's extract content: Summary: "Manages the provider enrollment unit ensuring the accurate and timely enrollment of providers, meeting all regulatory requirements, and maintains the national provider file database." Description Logistics: "Palmetto GBA– one of BlueCross BlueShield's South Carolina subsidiary companies." Location: "This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. This role is located onsite at 17 Technology Circle, Columbia, SC, 29203." Sponsorship: "This position is not eligible for sponsorship now or in the future." (We could include sponsorship in About the role or maybe drop as minor metadata? It's not required heading; we can fold into short p.) What You'll Do: list of duties (multiple sentences). Need to turn into

    • items. Let's parse sentences: - Provides day-to-day management oversight of enrollment staff and activities ensuring the accurate and timely completion of all aspects of the provider enrollment process and claims administration. - Manages individual and unit performance to ensure productivity, quality, and timeliness standards are met. - Ensures compliance with all applicable laws and regulations and keeps abreast of new requirements. - Directs the efforts of the analyst staff to be vigilant in the awareness and identification of potential fraud situations, and in working with and following through on fraud investigations. - Interacts with management staff to define and revise goals, objectives and performance measures. - Develops and maintains quality assurance activities. - analyzes reports and trends to identify areas to improve efforts through outreach and educational activities. (Note lowercase 'analyzes' but keep) - Maintains effective working relationships with other internal departments to implement process and system improvements and troubleshoot any issues. - Prepares and verifies reports as necessary. We'll make each a
    • . To Qualify For This Position, You'll Need The Following Required Education: Bachelors in a job-related field. Required Work Experience: 5 years of healthcare, Medicare, health insurance operations, or operations experience; 2 years of leadership experience (may be concurrent with the 5 years) Required Skills and Abilities: list: Excellent verbal and written communication, organizational, customer service skills. Excellent presentation, analytical or critical thinking skills. Excellent problem-solving skills. Good judgment skills. Proficiency in spelling, grammar, and punctuation skills. Ability to persuade, negotiate, or influence others. Ability to handle confidential or sensitive information with discretion. Ability to listen effectively and respond quickly. Required Software and Tools: Microsoft Office. We Prefer That You Have The Following Preferred Education: Bachelor's degree-in Business Administration, Healthcare Administration or other job-related field. Preferred Work Experience: 7 years of healthcare program management or provider network experience. 4 of the 7 must be in supervisory experience OR 4 years of equivalent military experience in grade E4 or above. Preferred License and Certificate: Active RN licensure in state hired. 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 We need to turn benefits into list items. Now decide sections: - About the role: could combine Summary + Description Logistics (location, schedule, sponsorship). Use

      About the role

      then

      with summary and logistics details. - Responsibilities:

      Responsibilities

      then
      • ... items. - Requirements: maybe combine Required Education, Experience, Skills, Software. Could be

        Requirements

        with sublists? But we need to use
        • for any list of duties/requirements/benefits. So we can make a list for each category? Could combine into one list but might lose clarity. Better to have separate headings for Education, Experience, Skills, Software? But the instruction: Prefer a few substantive sections over many thin ones. So maybe one Requirements section with multiple paragraphs, each containing lists. Use

          for prose and

          • for lists. Thus:

            Requirements

            Education: Bachelors in a job-related field.

            Experience: 5 years of healthcare, Medicare, health insurance operations, or operations experience; 2 years of leadership experience (may be concurrent with the 5 years)

            Skills and Abilities:

            • Excellent verbal and written communication, organizational, customer service skills.
            • Excellent presentation, analytical or critical thinking skills.
            • Excellent problem-solving skills.
            • Good judgment skills.
            • Proficiency in spelling, grammar, and punctuation skills.
            • Ability to persuade, negotiate, or influence others.
            • Ability to handle confidential or sensitive information with discretion.
            • Ability to listen effectively and respond quickly.

            Software and Tools: Microsoft Office.

            Similarly Preferred Qualifications could be another section:

            Preferred Qualifications

            with lists. Benefits:

            Benefits

            then
            • items. Schedule: Could be included in About the role paragraph; but we could also have a Schedule section if we want. The instruction: include a section ONLY when the posting has real, specific content for it — never emit a heading followed by filler/placeholder text. Schedule is present: full-time 40-hours/week Monday-Friday, 8-hour shift 8:00AM-5:00PM. So we could make a Schedule section. However we already have location etc in About the role. Might be better to have About the role include summary and location, and Schedule separate. But that creates two thin sections. Prefer few substantive sections. Could combine location, schedule, sponsorship into About the role paragraph. That's fine. Thus sections: About the role, Responsibilities, Requirements, Preferred Qualifications, Benefits. Check we didn't miss any substantive info: The summary about managing provider enrollment unit, maintaining national provider file database. That's in About the role. Logistics: Palmetto GBA subsidiary, location, schedule, sponsorship. All included. What You'll Do: responsibilities list. To Qualify: required education, experience, skills, software. We Prefer: preferred education, experience, license/certificate. Benefits: list. We removed EEO, What We Can Do For You, What To Expect Next, etc. Now ensure we don't repeat job title as heading. No Job ID. Now produce HTML fragment. We need to ensure proper nesting:

              About the role

              then

              ... maybe multiple paragraphs. Let's craft:

              About the role

              Manages the provider enrollment unit ensuring the accurate and timely enrollment of providers, meeting all regulatory requirements, and maintains the national provider file database.

              Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies. This position is full-time (40‑hours/week) Monday‑Friday in a typical office environment; you will work an 8‑hour shift during normal business hours of 8:00 AM‑5:00 PM. The role is located onsite at 17 Technology Circle, Columbia, SC, 29203. This position is not eligible for sponsorship now or in the future.

              Now Responsibilities:

              Responsibilities

              • Provides day-to-day management oversight of enrollment staff and activities ensuring the accurate and timely completion of all aspects of the provider enrollment process and claims administration.
              • Manages individual and unit performance to ensure productivity, quality, and timeliness standards are met.
              • Ensures compliance with all applicable laws and regulations and keeps abreast of new requirements.
              • Directs the efforts of the analyst staff to be vigilant in the awareness and identification of potential fraud situations, and in working with and following through on fraud investigations.
              • Interacts with management staff to define and revise goals, objectives and performance measures.
              • Develops and maintains quality assurance activities.
              • Analyzes reports and trends to identify areas to improve efforts through outreach and educational activities.
              • Maintains effective working relationships with other internal departments to implement process and system improvements and troubleshoot any issues.
              • Prepares and verifies reports as necessary.
              Now Requirements:

              Requirements

              Education: Bachelors in a job‑related field.

              Experience: 5 years of healthcare, Medicare, health insurance operations, or operations experience; 2 years of leadership experience (may be concurrent with the 5 years)

              Skills and Abilities:

              • Excellent verbal and written communication, organizational, customer service skills.
              • Excellent presentation, analytical or critical thinking skills.
              • Excellent problem‑solving skills.
              • Good judgment skills.
              • Proficiency in spelling, grammar, and punctuation skills.
              • Ability to persuade, negotiate, or influence others.
              • Ability to handle confidential or sensitive information with discretion.
              • Ability to listen effectively and respond quickly.

              Software and Tools: Microsoft Office.

              Now Preferred Qualifications:

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