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EDI Operations Manager - Palmetto GBA

BlueCross BlueShield of South Carolina
United States, South Carolina, Columbia
Aug 06, 2025
Internal Reference Number: R1046230
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. Palmetto GBA is one of the few Medicare contractors with experience in all Medicare business segments - Medicare Part A, Medicare Part B, Durable Medical Equipment (DME), Home Health and Hospice (HHH), and Medicare Advantage (MA) Part C and Part D. This broad experience base offers CMS a contractor with unique expertise and the ability to offer customized, creative, and proven solutions to complex problems. Description

Position Purpose:

Manages staff performing EDI technical support functions. Ensures timely and cost effective processing of all EDI products and services. Assists in the development and acquisition of new business. Supports divisional goals and monitors departmental results to assist in meeting those goals.

What You Will Do:

  • Provides managerial, technical, and administrative direction to staff and other associates interacting with the department in the technical support, customer service and products delivered by department to customers for all applicable contracts.
  • Ensures timely, cost effective processing of all orders for EDI products and services as well as effective distribution of all EDI products, documentation, and notifications.
  • Assists in development and acquisition of new business and continually improves EDI support strategies relevant to the user community while maintaining compliance with all regulations.
  • Coordinates with upper management and intradepartmental management to provide direction and consulting to EDI customers including software vendors.
  • Provides input and assistance toward the professional development of the EDI staff including performance plans and career path development.
  • Participates in and promotes total quality management initiatives. Interacts regularly with other areas for planning, training, report monitoring, and management purposes.

To Qualify For This Position, You'll Need:

Required Education:

  • Bachelor's degree in a job related field (no degree equivalency for Celerian Group)

Required Work Experience:

  • 6 years of applicable EDI experience including either 2 years of technical support area management or supervisory experience OR 2 years of equivalent military experience in grade E4 of above.

Required Skills and Abilities:

  • Demonstrated ability to effectively lead a technical support area, including the ability to analyze and resolve technical systems problems.
  • Comprehensive knowledge of relevant EDI software and tools used by the company/contract.
  • Project management expertise and advanced technical support skills involving customers at all technical levels.
  • Excellent negotiation, presentation, organizational, judgment, customer service, and both verbal and written communication skills.
  • Excellent spelling, punctuation, and grammar skills. Basic business math skills.
  • Advanced understanding of data analysis concepts.
  • Ability to handle confidential or sensitive information with discretion.

Required Software and Tools:

  • Microsoft Office.

We Prefer That You Have:

  • Experience managing a call center

Work Environment: Typical office environment. Some in-town and out-of-town travel required.

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 disabilitiesand 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 mycareer.help@bcbssc.comor 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 moreinformation.

Some states have required notifications. Here's more information.

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