Risk Management Specialist

7 days ago


Columbia, South Carolina, United States BlueCross BlueShield of South Carolina Full time

Job Summary:

We are seeking a highly skilled and experienced Stop Loss Manager to join our team at BlueCross BlueShield of South Carolina. As a key member of our organization, you will be responsible for managing daily stop loss related activities, analyzing program effectiveness, and implementing marketing strategies.

Key Responsibilities:

  • Manage stop loss claim filings, RFP & RFI responses, and weekly/monthly activity/production reports.
  • Analyze stop loss program effectiveness and implement marketing strategies to improve program outcomes.
  • Coordinate with claims operations, membership, accounting/finance, and customers to obtain supporting documentation for stop loss claim filings.
  • Monitor system reports, logs, and stop loss database entries to ensure prompt identification and accurate submission of stop loss claims.
  • Maintain and provide stop loss reports to management, informing them of the status of all stop loss specific and aggregate claims, as well as proposal activity.
  • Recruit and develop stop loss personnel, policies, procedures, and correspondence to provide excellent service to internal and external customers.

Requirements:

  • Bachelor's degree in a related field, such as business, management, or marketing.
  • 5 years of proven experience in sales and/or account management, with 2 years of lead and/or supervisory experience or equivalent military experience.
  • Excellent verbal and written communication skills, with ability to work independently, prioritize effectively, and make sound decisions.
  • Strong customer service, organizational, presentation skills, with proficiency in spelling, punctuation, and grammar skills.
  • Ability to analyze data, make sound decisions, and persuade others.
  • Ability to handle confidential information with discretion.
  • Proven ability to direct, motivate, and assess performance of others.

Preferred Qualifications:

  • Bachelor's degree in business, management, marketing, or a related field.
  • 3 years of previous healthcare insurance sales experience.

Work Environment:

  • Typical office environment, with occasional travel between office buildings and out-of-town travel.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer.



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