Job DescriptionServes as a strategic analytics partner to the Special Investigations Unit (SIU) and Payment Integrity teams by delivering actionable business intelligence, financial reporting, operational insights, and statistically sound audit support. This role combines advanced data
Job DescriptionThis role is responsible for providing advanced analytical and modeling expertise supporting value-based care performance measurement and population risk normalization. The Sr. Population Risk Performance Analyst applies population risk models to attributed member populations to
Job DescriptionWe’re hiring a National Committee Quality Assurance (NCQA) Program Manager to lead our Health Plan Accreditation activities with a primary focus on Member Experience and Credentialing standards. This role drives organizational readiness, ensures ongoing compliance,
Job DescriptionThe Principal Actuary delivers a broad range of actuarial or analytical work for the company, such as conducting pricing and actuarial strategy for a business segment, evaluating advanced care management models, performing competitive benchmarking analysis,
Be the one building AI-powered experiences where they matter most. At Genesys, we help organizations create better customer experiences through AI-powered experience orchestration. Our platform connects people, systems, data and AI to help organizations deliver more
Job DescriptionBlue Cross NC is seeking a Senior Actuarial Analyst to join our Medical Economics Enablement team. In this role, you will apply actuarial expertise and advanced analytical skills to transform complex healthcare data into actionable
Job DescriptionActs as a senior member of the strategic function by contributing to the achievement of pharmacy affordability goals through specialty pharmacy network design, contracting strategy, network optimization, and innovative market-based pricing approaches. Leverages industry experience
Job DescriptionBlue Cross NC is hiring a Director, Enterprise Risk Management to lead the design, execution, and continuous improvement of the organization’s enterprise risk management framework. This role is responsible for proactively identifying, assessing, managing, and
Job DescriptionThe Senior Technical Project/Program Manager leads complex, technology-driven projects and initiatives from planning through delivery, release, and post-implementation transition. This role is responsible for and equally accountable for the successful completion of one or more
Job DescriptionThe Business Solutions Developer creates technical solutions to address moderately complex business capability needs by utilizing at least one technical application; including but not limited to: Business Objects, Access, Crystal Reports, SQL, VBA, etc. Acts
Job DescriptionWe’re hiring a Case Manager to join the FEP Case Management Team! Dependent on clinical discipline, the Case Manager coordinates appropriate care, resources and/or services of selected member populations. Provides guidance and promotes effective utilization
Job DescriptionIn this role you will oversee Blue Cross NC’s Vendor Integration program for clients requesting employer-specific integrations with their third-party vendors. Provide full end-to-end program management including strategic planning, needs analysis, resource development, implementation oversight, and
Job DescriptionIdentify business requirements and solutions related to the support of the specific business area for implementation of a packaged system software. Lead configuration and administration of the Packaged Software, and participating in process design, and