Project Manager

Responsible for managing claims data initiatives that support risk adjustment and population health programs across ACA, Medicare Advantage, and Medicaid. Leads and coordinates projects involving data management, reporting, system enhancements, and process improvements to ensure regulatory compliance, data accuracy, and operational effectiveness. Collaborates with stakeholders, supports the implementation of new systems and technologies, provides training on complex changes, and serves as a resource and mentor to less experienced staff. 

• →Leads planning and implementation of projects to include coordinating the development and implementation of project and procedural enhancements, data gathering, process analyses, procedural documentation, leading development teams, training management and non-management staff, and establishing processes to monitor and sustain effective changes.
• →Facilitates the definition of project missions, goals, tasks, and resource requirements, service levels and customer requirements. Communicates with information systems and internal staff relative to project assigned. Provides continuity between groups through attendance and participation in work sessions, scope and design walkthroughs and weekly status meetings.
• →Manages project budget and resource allocation. Administers scheduling, planning, reporting, development and implementation within timelines and budgets. Provides technical and functional assistance to project team members during all project phases.
• →Functions as lead in reviewing proposed enhancements and identifying issues related to project business requirements. Resolves or assists in the resolution of conflicts within and between projects or functional areas. Directs testing and coordination of changes/enhancements. Oversee the development of test matrices and coordination of internal and external personnel for testing of implemented changes.
• →Provides training and documentation to customers and staff related to project status, procedures and changes. Provides education and training regarding policies and procedures that are changed or developed as a result of changes and projects. Generates internal and external reports to support management in determining productivity and efficiencies of programs or operational processes. Analyzes processes to ensure accuracy and quality. Makes recommendations to improve processes and drive efficiency in quality. Assists in the identification of potential cost savings. Completes other tasks assigned by management.

• Bachelor's degree

•  4 years job-related work experience OR
•  Associate's degree AND 2 years of job-related work experience

• 7 years of progressively responsible experience working in various functional areas, such as operations, research and analysis, project management, strategic planning, business process engineering or quality improvement.
• 3 years’ experience coordinating or leading project teams from inception through implementation phases (may be concurrent).

• Microsoft Office

• Excellent and effective communication and time-management skills.
• Strong knowledge of business process engineering methodology.
• Ability to communicate complex information with understanding to a variety of audiences who have different levels of experience and knowledge.
• Advanced analytical and decision-making skills.
• Thorough understanding of project management phases, techniques and tools.
• Demonstrated aptitude for effective leadership of staff. Ability to recognize problems or situations that are new or without clear precedent and offer solutions.

• Minimum 1 year of experience in the healthcare or insurance industry.
• Experience managing projects involving data file integration, implementation, and ongoing maintenance.

• Strong vendor management and coordination skills, with the ability to oversee cross-functional initiatives and deliverables.
• Working knowledge of SQL, including the ability to create and run simple queries to retrieve, analyze, and validate data.
• Proficiency in Microsoft Excel

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 mycareer.help@bcbssc.com or call 800-288-2227, 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.

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