Medical Review Director
CGS Administrators LLC | |
life insurance, paid time off, tuition assistance, 401(k) | |
United States, South Carolina, Columbia | |
Jan 24, 2025 | |
Summary Why should you join CGS Administrators and 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. BlueCross BlueShield of South Carolina is one of the nation's leading administrators of government contracts and operates one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies, including CGS Administrators, that allows us to build on a variety of business strengths. 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 deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Position Purpose: As the Director of the DME Medical Review department, you will oversee the operations of a dynamic team of approximately 150 dedicated clinical and non-clinical professionals. With primary responsibility for the following: *Operational Oversight: Ensuring smooth and efficient day-to-day operations within the department *Team Leadership: Guiding and mentoring a diverse team to achieve their full potential. *Performance Management: Setting and monitoring performance expectations to drive excellence. *Compliance Assurance: Upholding stringent compliance standards to meet regulatory and customer contractual requirements. *Financial Stewardship: Strategically managing resources to achieve financial objectives and sustain departmental growth. Description Logistics: This position is full-time (40 hours/week, 8 hours/day) Monday - Friday ONSITE at One Century Plaza (OCP), Nashville, TN or the Government Programs Complex (GPC), Columbia, SC What You'll Do:
To Qualify for This Position, You'll Need:
We Prefer You to Have:
What Blue 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. Our comprehensive benefits package includes:
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. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Some states have required notifications. Here'smore information. 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 minorities, females, disabled individuals and 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 physical and mental disabilities. If you need special assistance or an accommodation while seeking employment, please e-mail mycareer.help@bcbssc.com or call 1-800-288-2227, 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. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Some states have required notifications. Here's more information. Equal Employment Opportunity StatementBlueCross 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 minorities, females, disabled individuals and 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 physical and mental disabilities. If you need special assistance or an accommodation while seeking employment, please e-mail mycareer.help@bcbssc.com or call 1-800-288-2227, 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. |