Blue Cross NC · 13 hours ago
Lead Membership Specialist
United States
Full-time
Remote
Mid, Senior Level
$46K/yr - $73K/yr
3+ years expBlue Cross NC is a health insurance organization that is seeking a Lead Membership Specialist to facilitate the enrollment of groups and members while maintaining membership records. The role involves engaging with vendors, performing audits, analyzing data, and fostering relationships with stakeholders throughout the membership lifecycle.
Financial ServicesHealth InsuranceInsurance
Responsibilities
Facilitates the maintenance of membership information by ensuring our vendors processes member enrollment, additions, deletions, and/or changes on all products and systems for complex groups and/or electronic groups
Supports moderate and high complexity group level enrollment for health and ancillary products
Identify, document, and report system and process problems/trends using root cause analysis and implements solutions for assigned pod
Resolves complex and sensitive issues related to the administration of eligibility of subscribers/members based on federal/state guidelines and external and internal governing agencies
Leads work for health and ancillary products within their pod, including setting up group and member records, scheduling the release of member ID cards, group contract(s) and invoices
Responsible for knowledge management activities within the assigned pod; i.e. documenting processes, desktop procedures, and delivering the applicable training to the vendor and less experienced team members
Conduct quality assurance peer audits and provide coaching/training as needed
Builds strong relationships with all customers to facilitate a strong group and member experience
Serve as a subject matter expert for less experienced department employees
Qualification
Required
High school Diploma or GED and 5 years of member enrollment experience, or
Bachelors degree and 3 years of member enrollment experience
Preferred
Proven formal or informal leadership experience strongly preferred
Background in health insurance operations, benefits administration, or group administration
Adaptability: Remains flexible and responsive in dynamic environments, adjusting priorities and approach based on changing business needs or new information
Critical thinking and Problem-Solving: Track record of anticipating risks, addressing complex issues proactively, and making sound decisions under pressure while balancing people, process, and outcomes
Benefits
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
Company
Blue Cross NC
It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way.
5001-10000 employees
H1B Sponsorship
Blue Cross NC has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (4)
2024 (1)
2023 (2)
2022 (5)
2021 (13)
2020 (5)
Funding
Current Stage
Late StageLeadership Team
Tunde Sotunde
President and Chief Executive Officer
Caleb Davies
Medicaid Market CFO - Healthy Blue of NC Medicaid
Recent News
2026-01-06
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