Director, Provider Service – BlueCard Claims

E-Verify Program

Leading strategic vision for provider customer service as Director of Provider Service. Overseeing BlueCard claims processing and maintaining relationships with key providers.

Posted 5/29/2026full-timeKentucky, North Carolina, Utah, Wisconsin, Wyoming • 🇺🇸 United StatesLead💰 $143,616 - $229,786 per yearWebsite

About the role

Key responsibilities & impact

Direct end‑to‑end BlueCard claims processing, adjustments, and financial recovery activities.
Develop the strategic vision and key processes for the provider contact center.
Partner with Operational leads and workforce management to supplement strategy.
Direct and improve Strategic Provider Services offering, maintaining close relationships with key providers.
Oversee support of non-platinum providers through virtual contact centers.
Ensure plan-to-plan contacts are handled in line with BCBSA standards and service level expectations.
Communicate with managers and team leads on the provider service strategy.
Resolve complex escalations and contribute to training development.
Monitor and review service performance ensuring that provider service agreements are met.
Report operational updates to the Claims AVP and Operations VP.
End to end inventory management to align with all regulatory guidelines.

Requirements

What you’ll need

Bachelor's degree or advanced degree (where required)
10+ years’ experience in Health Care Delivery and Operations
In lieu of degree, 12+ years of experience in related field.
Deep health plan claims and service expertise.
5+ years of progressive leadership experience.
Deep expertise in BlueCard (Out-of-Area) claims operations.
Strong analytical skills with the ability to drive transformational, consumer centric change while managing operations.
Six Sigma/Continuous improvement experience - highly preferred.

Benefits

Comp & perks

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.

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

BlueCard claims processingfinancial recovery activitiesclaims operationsinventory managementanalytical skillsSix SigmaContinuous improvement

Soft Skills

leadershipcommunicationproblem-solvingrelationship managementstrategic vision development