RN Medical Informatics Administrator – Anywhere
BlueCross BlueShield of South Carolina
full-time
Posted on:
Location Type: Remote
Location: South Carolina • United States
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About the role
- Integrate clinical and medical data with automated technologies to support healthcare operations and informatics
- Act as a liaison between clinical expertise, data systems, and regulatory standards to ensure compliance and improve service delivery
- Evaluate system performance, validate workflows, and drive process improvements that enhance provider and patient experiences while reducing compliance risk
- Submit IT data requests, conduct validity testing, perform quality check processes, manage escalations, contribute to process improvements, and communicate updates to key stakeholders
- Analyze prior authorization and code set data to ensure alignment with clinical guidelines, regulatory standards, contracts, and operational requirements
- Partner with operations, IT, and vendors to implement and validate clinical decision rules and workflows that support strategic and regulatory objectives
- Identify opportunities to enhance automation, reduce provider friction, and improve service turnaround times through collaboration with internal teams and external partners
- Monitor data quality and develop reporting tools for leadership and compliance purposes
- Translate complex clinical and data insights into actionable strategies
- Evaluate system enhancements and participate in testing and validation activities to ensure successful implementation and continuous improvement
Requirements
- Bachelors in a job-related field
- 7 years’ clinical experience
- 3 years’ experience in medical systems coordination/project implementation (concurrent with the 7 years)
- Excellent organizational, customer service, verbal and written communication, and analytical or critical thinking skills
- Strong problem solving, presentation and project management skills
- Good judgment skills
- Proficient basic business math
- Ability to handle confidential or sensitive information with discretion
- Microsoft Office
- Advanced knowledge of medical systems support and medical terminology
- Active, unrestricted RN licensure from the United States and in the state of hire, OR, active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC)
Benefits
- Subsidized health plans
- Dental and vision coverage
- 401k retirement savings plan with company match
- Life Insurance
- Paid 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
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical data integrationmedical data analysissystem performance evaluationworkflow validationquality check processesdata quality monitoringreporting tools developmentclinical decision rules implementationprocess improvementbusiness math
Soft Skills
organizational skillscustomer serviceverbal communicationwritten communicationanalytical thinkingcritical thinkingproblem solvingpresentation skillsproject managementjudgment skills
Certifications
RN licensurecompact multistate RN license