Clinical Reporting Supervisor- CGS Administrators, LLC

Nashville, TN, US • Posted 1 day ago • Updated 2 hours ago
Full Time
On-site
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Job Details

Skills

  • Medicare
  • Leadership
  • Logistics
  • Supervision
  • FOCUS
  • Trend Analysis
  • Collaboration
  • Business Requirements Gathering
  • Testing
  • Training
  • Privacy
  • Policies and Procedures
  • Health Care
  • Data Analysis
  • Analytical Skill
  • Presentations
  • Critical Thinking
  • Decision-making
  • Reasoning
  • Management
  • Accounting
  • Reporting
  • Database
  • IBM DB2
  • SQL
  • Easytrieve
  • RDBMS
  • Life Insurance
  • Expect
  • Recruiting
  • Communication
  • Requirements Management
  • EXT
  • SAP BASIS
  • ProVision

Summary

Summary
Working at CGS Administrators, LLC

CGS Administrators, LLC (CGS) is part of BCBSSC '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.

Medical Affairs Team supports non-clinical operations for the Medical Review team, including government inquiries and contract requirements, with leadership over a team of 12 Senior Analysts.
Description

Logistics: CGS -one of BlueCross BlueShield's South Carolina subsidiary companies.

This position can be fully remote for the right candidate.

Sponsorship: This position is not eligible for sponsorship now or in the future.

Work Environment:
  • Typical office environment. Some travel between office buildings.


Position Purpose:

Provides supervision and direction of the statistical reporting function and data analysis to support clinical reporting function.

What you'll do:
  • Monitors adherence to statistical reporting requirements, updates systems as necessary. Sets and maintains general direction/focus of statistical reporting function. Perform analysis and reporting including performing clinical trend analysis. Develop reports through various data reporting tools. Develop data driven solutions to improve outcomes.
  • Collaborate with other areas to reduce expense through data analysis, including gathering business requirements, documentation, testing, and delivery of reporting. Serve as internal subject matter expert and point of contact for query/design for clinical analysis. Identifies data analysis needs based on customer.
  • Supervises staff including directing work, addressing performance, and providing training. Review work and coaches subordinates.


Values:

Consistently demonstrates high standards of integrity by supporting the Company's mission and values and adhering to the Corporate Code of Conduct.

Confidentiality: Maintains high regard for member, customer and/or beneficiary privacy in accordance with the corporate confidentiality, privacy and security policies and procedures.

To Qualify for This Position, You'll Need:

Required Education:
  • Associate's degree


Required Work Experience:
  • 5 years of experience in healthcare data analysis and data retrieval.


Required Skills and Abilities:
  • Strong written and verbal communication skills; strong analytical, judgment, presentation, critical thinking, organizational and planning skills; working knowledge of statistical concepts, population statistical and analysis methods.
  • Comprehensive understanding of statistical principles and practices.
  • Strong decision-making, reasoning and mathematical skills.
  • Effectively direct and coordinate multiple tasks.
  • Able to effectively manage complex project incorporating participation from key personnel across various areas of the company.
  • Basic knowledge of accounting principles.


Required Software and Other Tools :
  • Proven experience with database query/reporting tools, software and other applications, such as Access Databases, DB2, SQL, and Easytrieve.
  • Strong understanding of relational database structures, theories, principles, and practices with exposure to the analysis of relational database software and data retrieval methodologies.


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 .
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: BCBSSC
  • Position Id: R1050555
  • Posted 1 day ago

Company Info

About BlueCross BlueShield Of South Carolina

When you hear "BlueCross BlueShield of South Carolina," you'll see people nodding in recognition. Most everyone knows who we are. As the only South Carolina-owned and operated health insurance carrier, we have been offering security to Palmetto State citizens for more than 75 years. We are also one of South Carolina's largest employers.

Our financial stability is on record. In December 2021, AM Best reaffirmed our A.M. Best rating of A+ (Superior) - making us the only health insurance company in South Carolina with that rating. One of the few companies nationwide to achieve this distinction, this year also marks the 20th consecutive year that BlueCross met this high standard. For the latest ratings, access www.AMBest.com.

We offer the largest provider networks in the state, offering members the greatest choice in doctors, hospitals and other health care providers.
Our extensive menu of health plans, discounts, added values and online services means more choices for our members, with plans to fit every budget and lifestyle.

What you may not know is just how diverse our company is. Included in our family of companies is BlueChoice HealthPlan of South Carolina, our managed care subsidiary, which also includes Healthy BlueSM, our Medicaid health plan. BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association.

But there is also a lot more to us than health insurance. We have many affiliated companies that are not licensed with the Blue Cross and Blue Shield Association. These companies are located in South Carolina, Georgia, Ohio, Tennessee and Texas. Some offer other insurance products, such as life insurance and behavioral health benefits and administration. Others administer contracts for the federal government. Some even focus on technology.

BlueCross is also a major supporter of community and charitable causes. We support health care-related research, education and service in South Carolina through the BlueCross BlueShield of South Carolina Foundation.

We're BlueCross BlueShield of South Carolina.

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BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross Blue Shield Association.

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