We take great strides to ensure our employees have the resources to live well, be healthy, continue learning, develop skills, grow professionally and serve our local communities. We invite you to apply for a career with Blue Cross.

Please note that effective Jan. 4, 2022, Blue Cross and Blue Shield of Louisiana will require any employee who enters any of our offices or who interacts in person with anyone for company business purposes to be fully vaccinated for COVID-19, unless legally entitled to a reasonable accommodation related to religious or medical exemptions. Please note this is subject to change at any point in time to ensure compliance with company policy or government mandates.

Residency in or relocation to Louisiana is preferred for all positions.

POSITION PURPOSE
POSITION PURPOSE: Directs and coordinates operational activities of the department. Develops and/or revises standard operational and working practices to ensure customer satisfaction and compliance with quality, quantity and timeliness regulations. Manager is accountable for annual budget preparation and monitoring of ongoing expenses. Accountable for complying with all laws and regulations associated with duties and responsibilities.

NATURE AND SCOPE

• Manages People
• This role directly manages workers
• This role directly manages these jobs: SUPERVISOR, CUSTOMER SERVICE
• This role reports to this job: DIRECTOR, CUSTOMER SERVICE
• Necessary Contacts: In order to effectively fulfill this position, the Manager must be in contact with:
  
  Various internal departments and staff including, but not limited to, Member Services, Provider Services, Legal, Internal Audit, IT, Accounting, Marketing, other Benefit Operations Management and staff, Enrollment and Billing, Administrative Services, and District Offices.
  
  Various external entities including, but not limited to, Providers, Members, Lawyers, Groups, Commissioner of Insurance, other insurance companies, and other Plans.

QUALIFICATIONS

Education

• Bachelor's in Business or related field is required
• Four years of related experience can be used in lieu of a Bachelor's degree.

Work Experience

• 5 years in an environment analyzing policies and procedures, improving operational processes and providing proactive service solutions is required
• Claims experience is preferred
• 2 years of leadership experience required
• Experience can run concurrently

Skills and Abilities

• Must have working knowledge of relevant software (e.g. MS Word, Excel, Outlook, etc.) and related software as well as other corporate programs and applications and the ability to learn new systems.
• Must have strong organizational and analytical abilities and effective interpersonal skills. Must be able to recognize inconsistencies and gaps in business processes and take appropriate actions.
• Must be able to prioritize multiple responsibilities, make decisions, find solutions and work independently in order to meet aggressive deadlines, and adapt to a fast-paced, changing environment.
• Must demonstrate verbal and communication skills with the ability to interpret and communicate information with tact, diplomacy, patience and professionalism.
• Must be able to coach and develop front line staff
• Able to cohesively work in team environment to ensure efficient and effective completion of all tasks for assigned groups.
• Must have thorough insurance knowledge to apply company policies and procedures, company guidelines, state and federal laws and mandates to ensure information is current and accurate.

Licenses and Certifications

• None Required

ACCOUNTABILITIES AND ESSENTIAL FUNCTIONS

• Manages multiple supervisory and staff level positions by administering all HR functions, including but not limited to, hiring, terminating, conducting performance reviews, managing work schedules, managing a budget, assigning and directing workload, training and developing staff, coaching, etc. to help ensure departmental, divisional and/or corporate goals are set and obtained.
• Manages and reviews task inventory. To include monitoring, tracking and reporting on caseload, issues around timeliness and resolution. Includes communication with CMS.
• Manage corporate initiates, including but not limited to on-boarding, live chat, and social media.
• Participates in strategic planning designed to achieve departmental, divisional and/or company goals.
• Reviews and develops policies and procedures with appropriate internal and/or external audiences to manage service level agreements, quality assurance and timeliness to ensure compliance, consistency, effectiveness and efficiency across all assigned units.
• Analyzes system usage to identify problems, design, test, and initiate changes, as well as improve, develop and implement processes with appropriate departments to ensure optimal system design and usage.
• Resolves non-routine issues with appropriate internal and/or external audiences to ensure appropriate resources are allocated and available to provide customer service that aligns with departmental, divisional and/or corporate goals.
• Serve on corporate committees/project teams to design and implement customer and/or provider service programs that support corporate initiatives and call center objectives.
• Manages staff turnover, schedule adherence, quality performance and employee, member and/or provider satisfaction based on established metrics to help ensure departmental, divisional and/or company goals are met.
• Develops and manages peer relationships in other divisions across the company to help ensure that all areas of member touch points are engaged and work to improve member and/or provider satisfaction.

Additional Accountabilities and Essential Functions
The Physical Demands described here are representative of those that must be met by an employee to successfully perform the Accountabilities and Essential Functions of the job. Reasonable accommodations may be made to enable an individual with disabilities to perform the essential functions

• Perform other job-related duties as assigned, within your scope of responsibilities.
• Job duties are performed in a normal and clean office environment with normal noise levels.
• Work is predominately done while standing or sitting.
• The ability to comprehend, document, calculate, visualize, and analyze are required.

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An Equal Opportunity Employer

All BCBSLA EMPLOYEES please apply through Workday Careers.

PLEASE USE A WEB BROWSER OTHER THAN INTERNET EXPLORER IF YOU ENCOUNTER ISSUES (CHROME, FIREFOX, SAFARI)

Additional Information

Please be sure to monitor your email frequently for communications you may receive during the recruiting process. Due to the high volume of applications we receive, only those most qualified will be contacted. To monitor the status of your application, please visit the "My Applications" section in the Candidate Home section of your Workday account.

If you are an individual with a disability and require a reasonable accommodation to complete an application, please contact [email protected] for assistance.

In support of our mission to improve the health and lives of Louisianians, Blue Cross encourages the good health of its employees and visitors. We want to ensure that our employees have a work environment that will optimize personal health and well-being. Due to the acknowledged hazards from exposure to environmental tobacco smoke, and in order to promote good health, our company properties are smoke and tobacco free.

Blue Cross and Blue Shield of Louisiana performs background and pre-employment drug screening after an offer has been extended and prior to hire for all positions. As part of this process records may be verified and information checked with agencies including but not limited to the Social Security Administration, criminal courts, federal, state, and county repositories of criminal records, Department of Motor Vehicles and credit bureaus. Pursuant with sec 1033 of the Violent Crime Control and Law Enforcement Act of 1994, individuals who have been convicted of a felony crime involving dishonesty or breach of trust are prohibited from working in the insurance industry unless they obtain written consent from their state insurance commissioner.

Additionally, Blue Cross and Blue Shield of Louisiana is a Drug Free Workplace. A pre-employment drug screen will be required and any offer is contingent upon satisfactory drug testing results.