Jobs at BlueCross BlueShield of South Carolina

Leads digital experience implementation initiatives from requirements gathering and solution research through testing, deployment, and launch. Translates customer needs and business objectives into documented requirements and implementation recommendations. Coordinates stakeholders, technical teams, vendors, timelines, risks, dependencies, testing, and releases. Reviews project artifacts and problem logs, supports solution delivery, communicates business direction, and mentors less experienced business systems analysts.

Conducts quality control audits across claims, membership, customer service, workflow, and processing operations. Identifies errors and root causes, recommends process improvements, monitors corrective actions, prepares quality performance reports, updates procedures and training materials, trains employees, and supports system or business implementation testing.

Provides blended learning solutions by facilitating technical and non-technical training, assessing learner needs, designing instructional materials, evaluating course effectiveness, and maintaining training systems. Partners with subject matter experts and business teams to address performance gaps, support training plans, and manage administrative training functions. Delivers orientation, job-specific, company-specific, and e-learning programs for new and existing employees.

Creates and maintains database reports, retrieves and manipulates data, analyzes reporting methods, and supports testing and technical operations. The role gathers reporting requirements from customers, updates programming logic, generates recurring reports, develops data retrieval systems, assists with training, and participates in projects implementing new processes and applications. It requires database, mainframe, spreadsheet, and reporting experience, including Easytrieve, DB2, SQL, or similar tools.

Manages enterprise websites, portals, and digital content by improving quality, accessibility, compliance, SEO, and user experience. Coordinates web projects from scoping through implementation, leads collaboration between business and technical teams, resolves web issues, develops multimedia presentations, documents processes, and supports reporting and digital strategy. The role is fully remote and requires strong organization, communication, writing, analytical, and project coordination skills.

Design end-to-end digital experiences for a health insurance portal and app across mobile, tablet, and desktop. Conduct user research, usability testing, task-flow analysis, prototyping, and iterative design. Collaborate with stakeholders, product owners, and developers to translate complex requirements into accessible, effective interfaces. Create documentation, UI copy, and design standards while mentoring designers and advancing UX practices, including adoption of AI tools.

Provides administrative and project support, coordinates area-specific projects, prepares reports and presentations, manages confidential records, organizes workflow, coordinates supplies, and completes special projects. The role requires strong organization, communication, judgment, business math, analytical skills, and proficiency with Microsoft Office. This is a full-time onsite position in Columbia, South Carolina, requiring the ability to obtain a security clearance.

Conducts market research and leads marketing, product, and Medicaid program initiatives. Manages vendors, budgets, reporting, compliance, member escalations, communications, training, project plans, timelines, and stakeholder coordination. Supports product enhancements, strategic planning, new business implementations, and customer satisfaction analysis while ensuring alignment with organizational goals and regulatory requirements.

Conducts financial, compliance, and operational audits; evaluates internal controls and business risks; analyzes data for fraud, duplication, and regulatory noncompliance; prepares audit reports and recommendations; tests corrective actions; performs special audit studies; and supports other auditors. The role requires clear communication, sound judgment, confidentiality, and travel between office locations or out of town as needed.

Provides blended learning solutions by assessing training needs, designing and revising instructional materials, facilitating technical and non-technical training, evaluating learner performance, and maintaining training systems. Partners with subject matter experts and business teams to address performance gaps, support onboarding and ongoing development, and manage training outcomes.

Manages claims data initiatives supporting risk adjustment and population health programs across ACA, Medicare Advantage, and Medicaid. Leads project planning, budgets, resources, requirements, testing, system enhancements, process improvements, reporting, documentation, training, and regulatory compliance. Coordinates cross-functional teams, analyzes operational processes, resolves project issues, and recommends efficiency and quality improvements.

Administers government, commercial, and subcontract agreements; reviews contract terms, modifications, legal documents, pricing, proposals, invoices, and compliance requirements. Serves as the primary liaison with customers and internal stakeholders, maintains contract files, monitors deliverables, supports negotiations, and ensures adherence to federal regulations, applicable laws, and company policies.

Performs entry-level accounting activities, including account reconciliations, general ledger and journal entries, spreadsheet preparation, financial reporting, budgeting and forecasting analysis, and maintenance of accurate G/L accounts. Assists with regulatory filings, special projects, process controls, and coordination across departments. Requires knowledge of fundamental accounting concepts, analytical and organizational skills, discretion with sensitive information, and proficiency with Microsoft Office and data retrieval applications.

Audit and adjudicate medical stop loss claims, authorize reimbursements within limits, and identify cost-mitigation and subrogation opportunities. Initiate investigations and vendor referrals, interpret plan language, communicate with carriers and vendors, generate claims reports, adjust reserves, and assist with form development, internal auditing, and training of claims auditors.

Provides enterprise technical architecture and strategic technology direction for infrastructure and hybrid cloud initiatives. Leads architecture analysis, solution design, technology research, roadmaps, and project artifact approvals. Advises technical and business leaders, coordinates with cloud vendors, and ensures security, compliance, audit, and business alignment. The role emphasizes IBM z/OS storage environments, including DASD, DFSMSdss, SMS, HSM, tape virtualization, replication, and related mainframe storage technologies.

Associate Actuary responsible for compiling actuarial reports, analyzing risk levels and rates, reviewing rating bureau changes, preparing rate filings, determining bulk loss and loss expense reserves, and evaluating reserve methodologies. Requires a bachelor’s degree in a quantitative or finance-related field and an FCAS, ASA, or ACAS designation.

Researches insurance statutes, regulations, bulletins, and NAIC models; prepares and obtains approval for policy form filings; reviews contracts; maintains regulatory reports and corporate documents; interprets compliance directives; manages complaints; and supports policy and certificate issuance systems through programming, troubleshooting, and maintenance.

Supports Model Audit Rule and SOX compliance through risk assessments, process documentation, control identification and testing, deficiency evaluation, remediation oversight, and management reporting. Performs peer reviews, maintains audit workpapers and risk-control matrices, supports internal and external auditors, and assists with projects improving compliance processes. The role requires collaboration with management and auditors in a hybrid position based in Columbia, South Carolina.