Job Description Summary
Palmetto GBA is one of the nation’s largest providers of high-volume claims and transaction processing, contact center operations, and technical services to the federal government and other commercial customers. Our core business is providing services to CMS Medicare beneficiaries, providers, and health plans.
Our team leads the organization’s statistics, data analysis, and research functions. We support strategic decision making by delivering high quality analytics, actionable insights, and data driven recommendations. We work closely with cross functional partners to improve performance, measure outcomes, and strengthen organizational learning.
Our culture is collaborative, curious, and mission driven. We value analytical rigor, integrity, and continuous improvement. Team members support each other through open communication, shared problem solving, and a commitment to professional growth. We encourage creativity in methodological approaches, welcome diverse perspectives, and maintain a positive and respectful work environment.
Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies.
Position Purpose :
Develops comprehensive reports and analyzes data in order to identify patterns and trends. Assists in creating materials that aid in illustrating analytical/data findings. Identifies opportunities for improvement that can be addressed with educational initiatives.
What You’ll Do :
Uses multiple software platforms to produce reports in accordance with work requests, internal initiatives, and requests from customers. Codes, maintains, and executes simple to complex database programs for the extraction and presentation of data for standard and ad hoc reporting. Develops supporting material and guidelines on report design and resulting data.
Evaluates data integrity to assure compliance with customer requirements and makes recommendations for corrective and preventative actions. Provides input on database design.
Illustrations, other graphics, and narrative reports to identify and explain patterns and trends. Identifies opportunities for improvement that can be addressed with educational initiatives.
Assists with performing quality checks on new and existing relational database changes. Creates support documentation outlining procedures.
To Qualify for This Position, You’ll Need the Following :
Required Education:
Required Skills and Abilities:
Good organizational
Customer service
Analytical skills
Ability to use complex mathematical calculations
Demonstrated knowledge of mathematical or statistical concepts
Relevant computer programming skills.
Required Software and Tools:
We Prefer That You Have the Following :
Experience with Prior Auth programs and Review Choice Demonstration reporting
Experience conducting literature reviews
Develop and maintain SAS programs for analyzing Medicare claims data and identifying trends in medical claims.
Conduct data extraction, manipulation, and validation using PROC SQL, PROC REPORT, PROC TABULATE, and macro programming.
Code, maintain, and execute database programs for the extraction and presentation of data for standard and ad hoc reporting.
Develop supporting material and guidelines on report design and resulting data.
Perform statistical analysis and hypothesis testing for fraud detection and risk assessment.
Ensure compliance with industry standards, data integrity, and regulatory reporting requirements.
Collaborate with cross-functional teams to optimize reporting workflows and develop submission-ready datasets.
1 Year-Statistical programming or related information technology or research and analysis experience including Relational database experience. (may be concurrent).
Good oral and written communication skills.
Computer systems support knowledge.
SAS, Business Objects, and/or DB2 or other relational database.
What We 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 access and opportunity to develop their skills, advance their careers and contribute their unique abilities to the growth of our company.
Our comprehensive benefits package includes:
Subsidized health plans, dental and vision coverage
401K retirement savings plan with company match
Life Insurance
Paid Time Off (PTO)
Nine paid holidays
On-site cafeterias and fitness centers in major locations
Wellness program and healthy lifestyle premium discount
Tuition assistance
Service recognition
Employee Assistance
Discounts to movies, theaters, zoos, theme parks and more
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.
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 individuals with disabilities and protected 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 disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company.
If you need special assistance or an accommodation while seeking employment, please email [email protected] or call 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. Here's more information .
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