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Job Description
Responsible for a customer-facing, service relationship with clients, maintaining a high level of engagement around service delivery, issue resolution and healthcare initiatives unique to clients. Takes a multi-faceted and creative approach in managing the overall service strategy for the client. Partners with internal teams to maintain compliance with contractual agreements, effective cost control measures, policies, procedures and workflows to resolve service inquiries. Drive excellence in sales delivery and support by efficiently and effectively addressing needs and issue escalations expressed by internal team members. Build sustainable relationships with internal team members by providing market-leading service and support experience.
What You'll Do
Identifies, analyzes and resolves complex operational issues impacting clients. Intake, manage, track and resolve inquiries, issues, and escalations raised by client representatives, agents/consultants. Monitor channels for inquiry intake, documenting and managing client representative concerns. Designs, develops and maintains the integrity of service plans. Arranges and facilitates all meetings to review the service plan and client specific issues. Secures the service deliverables with the account and identifies task and expectations from the client and fulfills deliverables. Reviews the status of the deliverables with the internal teams involved. Escalate high-priority or high-risk issues to Client Success Lead as needed to determine and carry out resolution. Develop relationships with clients to understand their goals, processes, procedures and systems to provide support for the relationship with Blue Cross NC. Provides plan/benefit administration support to client. Administer and monitor client contract provisions, and maintain compliance with contractual agreements. Addresses client customer concerns and non-compliance contract/administrative issues. Coordinates the required corrective action as identified via data and root cause analysis. Maintains a collaborative relationship with sales. Reports issues to sales, performs research, identifies issues, and root cause and proposes solutions. Identifies the support area to manage the analysis for root cause issues, as needed. Partner with sales team and cross-organizational support staff to identify and execute solutions for client service requests. Develops and manages documentation that captures issues across the plan, dates for completion and other key deliverables. Represents Blue Cross NC in critical service related customer meetings to address issues, or administrative inefficiencies. Participates in customer-facing sales meetings as requested by the sales team. Delivers client specific reporting, including reporting related to service issues and network disruption, and assists with communication plans. Reviews service related reporting with clients. Leverage historic client inquiry and issue data to actively identify future resolution, optimizing inquiry management and issue resolution Identifies operational inefficiencies and collaborates with Sales team to create a strategy to address. Identify and document best practices, and communicate key client issue resolution experiences to suggest process, product delivery, and client service improvement opportunities. Identifies opportunities to control segment and book of business administrative or medical expense and deploys action plans to accomplish specific expense reduction goals. Assists in the analysis of products, identifies any deficiencies and makes recommendations for improvement. Identifies trends with issues.
**25% Travel Required within North Carolina** What You Have
Bachelor's degree or advanced degree (where required) 3+ years of experience in related field In lieu of degree, 5+ years of experience in related field Must be able to obtain a North Carolina Health and Life Insurance license within the 60 days of employment in this position. Must possess and maintain a valid driver's license.
Bonus Points
Agency or brokerage experiencestrongly preferred. Flexibility and willingness to travel when needed. North Carolina residents highly preferred.
The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community Work-life balance, flexibility, and the autonomy to do great work Medical, dental, and vision coverage along with numerous health and wellness programs Parental leave and support plus adoption and surrogacy assistance Career development programs and tuition reimbursement for continued education 401k match including an annual company contribution Learn more Our Hybrid Flex approach is built on presence with a purpose - giving you flexibility to work remotely with intentional in-person connection - that supports a workplace that's flexible, connected, and future focused. In a Hybrid-Flex role, you'll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you'll work virtually, with a few in-office visits each year for meaningful moments that matter. Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any states listed on this job posting. Onsite expectations will be discussed during the interview process. Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $55,370.00 - $88,592.00
Skills _____________________________________________________________________
JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.
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Blue Cross and Blue Shield of North Carolina
$55,370.00 - $88,592.00
life insurance, parental leave, paid time off, tuition reimbursement, 401(k)
Jun 03, 2026