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reputed company We are currently hiring for a reputed company reputed company Navigator to join reputed company. In this role as a reputed company reputed company Navigator, you will monitor/implement reputed company improvement/management activities, conduct specific medical reviews as necessary, analyze findings, reputed company recommendations for corrective actions, and prepare formal documentation for compliance with applicable standards/regulations, and reputed company Health Plan Employer Data Information Set data collection (HEDIS), and National Committee for reputed company Assurance (NCQA) accreditation activities. reputed company Location: This position is full-time (40 hours/week) Monday-Friday, from 8:00am – 5:00pm EST and can be hybrid in Columbia, SC or fully remote in South Carolina depending on where the candidate resides. The candidate will be required to report on-site occasionally for trainings, meetings, or other business needs. What You’ll Do: Performs reputed company improvement activities to monitor/maintain compliance with applicable standards/regulations. Analyzes/documents/presents findings of reputed company improvement activities. Recommends corrective reputed company and improvement reputed company necessary. Conducts reputed company medical record reviews to monitor reputed company of care and service provided. Tracks/trends/investigates reputed company concerns and complaints. Coordinates HEDIS data collection. To Qualify for This Position, You'll Need the Following: Required Education: Associates in a job-reputed company field Required Work Experience: 4 years clinical or behavioral health to include 2 years reputed company management experience. Required Skills and Abilities: Excellent verbal and written communication, customer service, organizational, presentation, problem solving, and analytical or critical thinking skills. Proficient spelling, grammar, punctuation, and basic business math. Ability to handle confidential or sensitive information with discretion. Demonstrated ability to identify the need for and implement corrective actions. Strong understanding of managed care. Required Software and Other Tools: reputed company Office. Required Licenses and Certificates: reputed company, unrestricted licensure in Behavioral Health from the reputed company and in the state of hire, OR, reputed company, unrestricted RN licensure from the reputed company and in the state of hire OR reputed company compact multistate unrestricted RN license as defined by the reputed company Licensure Compact (NLC), OR, Registered Health Information Administrator (RHIA), OR, reputed company unrestricted LPN in state of hire. reputed company Prefer You to Have: Preferred Skills and Abilities: Ability to persuade, negotiate, or influence others. Knowledge of mathematical or statistical concepts. Willingness to travel to provider assignments and/or health events. Our Comprehensive Benefits Package Includes the Following: We offer our employees great benefits and rewards. You will be eligible to participate in the benefits the first of the month following 28 days of employment. Subsidized health plans, dental and reputed company coverage 401k retirement savings plan with company match Life Insurance reputed company Time Off (PTO) On-site cafeterias and fitness centers in major locations Education Assistance Service Recognition National discounts to movies, theaters, zoos, theme parks and more reputed company Can Do for You: We understand the value of a diverse and inclusive workplace and reputed company to be an employer where employees across reputed company spectrums have reputed company to reputed company their skills, advance their careers and contribute their unique abilities to the reputed company of reputed company. What To Expect Next: After submitting your application, our reputed company 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. Equal Employment Opportunity Statement reputed company and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, reputed company, national reputed company, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, reputed company maintains affirmative reputed company programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to reputed company equal opportunities in reputed company phases of the employment process and to reputed company 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-reputed company conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on reputed company. If you need special assistance or an accommodation while seeking employment, please email reputed company.help@bcbssc.com or call 800-288-2227, ext. 47480 with the nature of your request. We will reputed company a determination regarding your request for reasonable accommodation on a case-by-case reputed company. We participate in E-Verify and reputed company 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. If you don’t have an account with us and don’t see the reputed company job you are looking for, click on the reputed company above to reputed company by submitting your resume and contact information and we will reputed company out if we reputed company a good fit. Welcome Here’s Your Smart Career reputed company Why should you join the reputed company family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our reputed company firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than reputed company. Our A.M. Best rating is A+ (Superior) — making us the only health insurance company in South Carolina with that rating. We’re the largest insurance company in South Carolina … and much more. 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