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Highmark Health
Senior Business Systems Analyst
Highmark Health Columbia, SC, USA
Company : Highmark Inc. Job Description : JOB SUMMARY This is a fully remote position, allowing you to work from anywhere. We are actively seeking a highly skilled and experienced Senior Business Systems Analyst with a specialized focus on the GuidingCare platform to join our dynamic team. This pivotal role encompasses the entire IT lifecycle, demanding expertise from initial solutioning and meticulous requirements gathering through to robust configuration, comprehensive testing, and precise environment synchronization. A core responsibility will be the design, configuration, and ongoing maintenance of FICO and SQL rules within GuidingCare, vital for supporting diverse business processes, clinical guidelines, and operational requirements. The successful candidate will collaborate closely with business stakeholders to translate complex needs into actionable functional and technical specifications, proposing innovative solutions to optimize GuidingCare...

Dec 16, 2025
PT
Senior Compliance Analyst (Regulatory Change Management) - Remote
Prime Therapeutics Columbia, SC, USA
At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Senior Compliance Analyst (Regulatory Change Management) - Remote Job Description The Senior Compliance Analyst assists in the implementation of Prime's compliance programs and leads initiatives within their designated areas. This role partners with key internal stakeholders to monitor aspects of compliance and validate policies, procedures, licensure, and program manuals are effectively followed and maintained. Responsibilities Executes compliance procedures and enforces policy governance across the organization to validate regulatory reporting requirements are met and that business operations are aligned with expectations of applicable regulatory guidance Lead project management efforts for highly sensitive...

Dec 21, 2025
PT
Business Analyst Senior - Remote
Prime Therapeutics Columbia, SC, USA
At Prime Therapeutics (Prime), we are a different kind of PBM, with a purpose beyond profits and a unique ability to connect care for those we serve. Looking for a purpose-driven career? Come build the future of pharmacy with us. Job Posting Title Business Analyst Senior - Remote Job Description The Business Analyst (BA) Senior will execute on medium projects as a liaison among business operations, technology groups, clients, business partners, vendors, and project/program team to understand, analyze, and facilitate business needs, requirements, and impacts of business changes as a result of strategic initiatives, operational changes, compliance requirements, client needs, and technology or operational improvements. Additionally, this role will participate with leadership and/or the Center of Excellence to define and implement the best practice activities for Business Analysis. Responsibilities Execute independently on medium sized projects or as part of a...

Jan 10, 2026
BC
Full time
 
Sr Provider Enrollment Analyst
BlueCross BlueShield of South Carolina Columbia, SC, USA
Summary Acts as a Team Lead by providing guidance/direction/training to Provider Enrollment Analysts and/or other Provider Enrollment area staff. Responsible for the processing of difficult enrollment applications and/or complex inquiries. Description Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located onsite at 17 Technology Circle, Columbia, SC, 29203. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary...

Jan 10, 2026
Highmark Health
Sales Support Analyst
Highmark Health Columbia, SC, USA
Company : Highmark Inc. Job Description : JOB SUMMARY This job is responsible for the overall administration and oversight of sales support activities for the sales office. The individual could perform one or more of the following types of tasks in support of the sales process: new and renewal processing, product implementation, re-enrollment activities, vendor interaction, group set-up or cancellation, running reports, preparing meeting materials, developing proposals and benefit grids, research, problem resolution, and other administrative and account relationship activities. ESSENTIAL RESPONSIBILITIES Effective management of work flow: Ensuring efficient assignment and completion of work product deliverables, including educating external customers on simplified submission processes; identifying and implementing process improvements; prioritizing volume to ensure deadlines are met; preparing and/or reviewing proposals for accuracy and reasonableness...

Jan 09, 2026
BC
Full time
 
Provider Enrollment Analyst
BlueCross BlueShield of South Carolina Columbia, SC, USA
Summary Responsible in the provider enrollment process to review, research, analyze, and process provider enrollment applications. Ensures provider file integrity and that suppliers are in compliance with established standards and guidelines. Description Logistics: Palmetto GBA – one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full-time (40-hours/week) Monday-Friday in a typical office environment. You will work an 8-hour shift scheduled during our normal business hours of 8:00AM-5:00PM. It may be necessary, given the business need to work occasional overtime. You may be required to travel between buildings. This role is located onsite at 17 Technology Circle, Columbia, SC, 29203. Government Clearance: This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. SCA Benefit Requirements: BlueCross BlueShield of South Carolina and its subsidiary...

Jan 09, 2026
Highmark Health
Senior Clinical and Population Health Analyst - Social Health Analytics
Highmark Health Columbia, SC, USA
Company : Highmark Health Job Description : JOB SUMMARY This role delivers high-impact analytics and insights focused on Social Determinants of Health (SDOH) to support enterprise strategy and population health initiatives. The position contributes to the development and evolution of enterprise SDOH dashboards and self-service analytic tools, with a focus on analytical rigor, scalability, and alignment to high-value use cases. The incumbent serves as a consultative analytic partner to the Enterprise SDOH team, collaborating to refine analytic questions and translate complex needs into clear, actionable analytic approaches. As reporting capabilities mature, this role will support advanced analysis of varied and multilevel data in exploratory, evaluative, and research-adjacent analytic work, and development of insights that inform program design and strategic decision-making. ESSENTIAL RESPONSIBILITIES Supports and leads the design, development, execution,...

Jan 09, 2026
BC
Full time
 
Senior Quality Assurance Analyst
BlueCross BlueShield of South Carolina Florence, SC, USA
Summary Performs quality control audits to evaluate accuracy and effectiveness of departmental operations functions including, but not limited to, claims, membership, customer service/call center, workflow, processing support systems, procedures, documentation, etc. Identifies problems, analyzes cause and effect, and makes recommendations for improvements. Description Location This role is full time M-F 8am-5pm, onsite at our Florence, SC location. Government Clearance : This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. SCA Benefit Requirements : BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days...

Jan 08, 2026
Highmark Health
Senior Stop Loss Claims Analyst - HNAS
Highmark Health Columbia, SC, USA
Company : Highmark Inc. Job Description : JOB SUMMARY This job reviews, evaluates, and processes various Stop Loss (Excess Risk and Reinsurance) claims in accordance with established turnaround and quality standards. Responsible for building positive client relationships, providing education, and analyzing client claim losses as well as current issues regarding client activities; disseminates necessary information to the management. Follows up on pended claims in accordance with department standards. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve. ESSENTIAL RESPONSIBILITIES Processes daily incoming Stop Loss claims including...

Dec 26, 2025
Highmark Health
Senior Reporting Analyst - HNAS
Highmark Health Columbia, SC, USA
Company : Highmark Inc. Job Description : JOB SUMMARY This job collects, validates, analyzes, and organizes data into meaningful computerized reports by manipulating and extracting data to meet customer needs, generates reports through mainframe and/or PC applications by utilizing established applications/programs or developing new applications/programs, develops work plans to meet deadlines, accurately estimating completion dates and communicating report status to customers and management, and resolves business problems related to automated systems and provide data analysis and recommend solutions. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we...

Dec 26, 2025
Highmark Health
Associate Account Support Analyst
Highmark Health Columbia, SC, USA
Company : United Concordia Dental Job Description : JOB SUMMARY This job provides account support activities associated with the implementation and administration of groups and accounts. Provides assistance with non-standard benefit implementation tasks. Identifies and resolves problems related to benefit interpretations, non- standard benefits, handle rating concerns, and coordinate claim extracts and any subsequent adjudication requirements. The incumbent may have direct interaction with producers, clients and sales reps to ensure complete implementation, on-going service and all renewal activity. The incumbent is new to the role and is developing competence in performing work assignments. ESSENTIAL RESPONSIBILITIES Load and maintain group information and benefit files. Interact and provide support activities to Account Managers (For UCD: Accounts Support Analysts are account managers for all small market clients. May also be involved with managing...

Dec 22, 2025
CBRE
Process Improvement Sr. Analyst - Automation
CBRE Goose Creek, SC, USA
Process Improvement Sr. Analyst - Automation Job ID 251342 Posted 18-Dec-2025 Service line GWS Segment Role type Full-time Areas of Interest Facilities Management Location(s) Goose Creek - South Carolina - United States of America, Moncks Corner - South Carolina - United States of America About the Role The CBRE team is expanding its support for autonomous and semi-autonomous robotics across a global data center portfolio and is seeking a Senior Process Improvement Analyst to help drive these initiatives. Based in Moncks Corner, SC, this role applies construction, safety, and operational best practices to streamline the deployment of robotics-focused automation solutions. You'll collaborate with engineers, project managers, CAD/BIM specialists, technical writers, and suppliers while communicating regularly through video calls, email, and internal ticketing systems. What You'll Do Design and document optimized future-state processes using Lean...

Dec 22, 2025
CBRE
Process Improvement Sr. Analyst - Automation
CBRE Moncks Corner, SC, USA
Process Improvement Sr. Analyst - Automation Job ID 251342 Posted 18-Dec-2025 Service line GWS Segment Role type Full-time Areas of Interest Facilities Management Location(s) Goose Creek - South Carolina - United States of America, Moncks Corner - South Carolina - United States of America About the Role The CBRE team is expanding its support for autonomous and semi-autonomous robotics across a global data center portfolio and is seeking a Senior Process Improvement Analyst to help drive these initiatives. Based in Moncks Corner, SC, this role applies construction, safety, and operational best practices to streamline the deployment of robotics-focused automation solutions. You'll collaborate with engineers, project managers, CAD/BIM specialists, technical writers, and suppliers while communicating regularly through video calls, email, and internal ticketing systems. What You'll Do Design and document optimized future-state processes using Lean...

Dec 22, 2025
Highmark Health
Senior Digital Marketing Analyst
Highmark Health Columbia, SC, USA
Company : Highmark Health Job Description : JOB SUMMARY The Senior Marketing Analytics Analyst plays a critical role in transforming customer, digital, and campaign data into insights that improve acquisition, retention, member experience, and marketing effectiveness. This role works across Marketing, Digital, Sales, and Enterprise Analytics to translate business questions into analytical approaches, build performance dashboards, evaluate campaign ROI, and uncover opportunities to improve engagement across the member and patient lifecycle. This individual must bring strong statistical rigor, advanced marketing analytics skills, and deep understanding of healthcare customer journeys-including Medicare, Medicaid, Commercial, and provider engagement pathways. Experience with enterprise data platforms such as Salesforce Data Cloud, Adobe AEP/CJA, and Tableau is preferred. ESSENTIAL RESPONSIBILITIES Develops, evolves, and then communicates various digital...

Dec 22, 2025
Highmark Health
Benefit and Claims Analyst
Highmark Health Columbia, SC, USA
Company : Highmark Inc. Job Description : JOB SUMMARY This job is a non-clinical resource that coordinates, analyzes, and interprets the benefits and claims processes for clinical teams and serves as a liaison between various departments across the enterprise, including but not limited to, Clinical Strategy, Sales/Client Management, Customer Service, Claims, and Medical Policy. The person in this position must fully understand all product offerings available to Organization members and be versed in claims payment methodologies, benefits administration, and business process requirements. ESSENTIAL RESPONSIBILITIES Coordinate, analyze, and interpret the benefits and claims processes for the department. Serve as the liaison between the department and the claims processing departments to facilitate care/case management activities and special handling claims. Communicate benefit explanations clearly and concisely to all pertinent parties....

Dec 22, 2025
Highmark Health
Account Support Analyst
Highmark Health Columbia, SC, USA
Company : Highmark Inc. Job Description : JOB SUMMARY This job provides account support activities associated with the implementation and administration of groups and accounts. Provides assistance with non-standard benefit implementation tasks. Identifies and resolves problems related to benefit interpretations, non- standard benefits, handle rating concerns, and coordinate claim extracts and any subsequent adjudication requirements. The incumbent may have direct interaction with producers, clients and sales reps to ensure complete implementation, on-going service and all renewal activity. The incumbent has foundational knowledge and experience, is building higher-level knowledge and skills, and makes independent contributions to projects. ESSENTIAL RESPONSIBILITIES Load and maintain group information and benefit files. Interact and provide support activities to Account Managers (For UCD: Accounts Support Analysts are account managers for all small...

Dec 21, 2025
Highmark Health
Senior Business Process Analyst - HNAS
Highmark Health Columbia, SC, USA
Company : Highmark Inc. Job Description : JOB SUMMARY HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve. This job collects, validates, analyzes, and organizes data into meaningful computerized reports by manipulating and extracting data to meet customer needs, generates reports through mainframe and/or PC applications by utilizing established applications/programs or developing new applications/programs, develops work plans to meet deadlines, accurately estimating completion dates and communicating report status to customers and management, and resolves business problems related to automated systems and provide data analysis and recommend...

Dec 19, 2025
Highmark Health
Customer Implementation Analyst - HNAS
Highmark Health Columbia, SC, USA
Company : Highmark Inc. Job Description : JOB SUMMARY This job collaborates with internal stakeholder to understand moderate to complex business requirements and processes related client, product, and benefits configuration solutions. Performs standard and custom benefit coding and new client and group installation, translating group and client information into system configuration, including but not limited to client, group, rates, and commissions data. HNAS (Health Now Administrative Services) offers flexible, cost-effective solutions for employee health benefits. HNAS is part of Highmark Health, a national blended health organization with a mission to create remarkable health experiences. Our culture is built on your growth and development, collaborating across our organization, and making a big impact for those we serve This role is looking for someone who has ZELIS/RedCard experience along with reading and interpreting code within the health insurance...

Dec 19, 2025
Highmark Health
Senior Epic Systems Analyst
Highmark Health Columbia, SC, USA
Company : enGen Job Description : JOB SUMMARY This job is responsible for the configuration, rollout, and ongoing support of the assigned Epic application(s). Responsibilities include business/systems analysis, requirements definition and documentation, systems design, and problem resolution. The Senior Epic analyst communicates with end-users of the system to understand and resolve complex issues and implement solutions. Senior Analysts are subject matter experts in their area of knowledge. ESSENTIAL RESPONSIBILITIES Plans, designs/builds, tests, implements and maintains Epic software. Develops and documents workflow analysis while evaluating user experience. Supports and maintains environment or applications using advanced knowledge of the application(s) and technologies in the environment while recommending enterprise-level solutions. Using advanced knowledge of Epic, configures changes within the system to provide standardized,...

Dec 16, 2025
Highmark Health
Epic Systems Analyst
Highmark Health Columbia, SC, USA
Company : enGen Job Description : JOB SUMMARY This job is responsible for configuring, rolling out, and supporting the assigned Epic application(s). Responsibilities include business/systems analysis, requirements definition and documentation, system design, and problem resolution. The analyst communicates with system end-users to understand issues and implement solutions. ESSENTIAL RESPONSIBILITIES Plans, designs/builds, tests, implements, and supports the needs of Epic software. Analyzes and determines system requirements and specifications. Performs and documents workflow analysis while evaluating user experience. Supports and maintains environments or applications using domain knowledge. Creates and maintains documentation and training materials regarding the implementation of applications. Using knowledge of Epic, configures changes within the Epic environments to provide standardized, comprehensive workflows. Corrects issues, conducts...

Dec 14, 2025
CBRE
Cybersecurity Analyst
CBRE Columbia, SC, USA
Cybersecurity Analyst Job ID 248917 Posted 10-Dec-2025 Service line Corporate Segment Role type Full-time Areas of Interest Digital & Technology/Information Technology Location(s) Remote - US - Remote - US - United States of America About the role Executes on Cybersecurity governance, risk and compliance activities to evaluate and reduce information technology (IT) risk. Supports with the identification, management and mitigation of risk. This individual is learning the Cybersecurity space, and building a knowledge base of risk controls, analysis, assessments, methodologies, and mitigation strategies. Receives direction from management and takes action with manager review and approval. Individuals in this role are exploring niche spaces to specialize in, including: cyber risk management, controls, policies and standards, disaster recovery, vulnerability management, vendor risk management, assessments and control testing. What you'll do...

Dec 14, 2025
BC
Full time
 
Sr Quality Assurance Analyst
BlueCross BlueShield of South Carolina Florence, SC, USA
Summary Performs quality control audits to evaluate accuracy and effectiveness of departmental operations functions including, but not limited to, claims, membership, customer service/call center, workflow, processing support systems, procedures, documentation, etc. Identifies problems, analyzes cause and effect, and makes recommendations for improvements. Description Location This role is full time M-F 8am-5pm, onsite at our Columbia, SC location. Government Clearance : This position requires the ability to obtain a security clearance, which requires applicants to be a U.S. Citizen. SCA Benefit Requirements : BlueCross BlueShield of South Carolina and its subsidiary companies have contracts with the federal government subject to the Service Contract Act (SCA). Under the McNamara-O'Hara Service Contract Act (SCA), employees cannot opt out of health benefits. Employees will receive supplemental pay until they are enrolled in health benefits 28 days...

Dec 14, 2025
Humana
Senior Technical Finance Analyst- Medicaid
Humana Columbia, SC, USA
Become a part of our caring community and help us put health first The Senior Market Finance Professional supports more than half of Humana's Medicaid business, providing technical financial analysis and data-driven insights to drive market growth and operational effectiveness. This position resides within the Finance team and partners directly with Market CFOs, clinical teams, and provider engagement teams, focusing on Medicaid claims and premium analytics across multiple states, including established and expansion markets. Key Responsibilities: Collect, analyze, and report on market data connecting financial outcomes with operational results, particularly in Medicaid claims and premiums. Deliver project-based and ad-hoc reporting for Medicaid markets; provide insights into membership analysis, provider performance, RFPs, and market trends. Manage ad hoc requests from Market CFOs, Presidents, and leadership, ranging from member utilization to premium...

Dec 14, 2025
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