Lead medium scale, enterprise wide Product Development initiatives aimed at keeping the current product offering for a specific market segment current and competitive. Acts as the primary liaison between segment sales, segment strategy, and the different delivery teams ensuring that their respective refresh/scope optimally delivers on the desired business outcomes. Act as

This is a provider facing role. Evaluates and monitors provider performance to achieve excellence in risk adjustment coding. Participates in regular provider meetings and/or calls with other internal BCNC teams for collaboration on Blue Premier success. Provides timely, relevant, accurate, and objective feedback to providers, and the management team which includes a plan

As a Contract Negotiation Analyst, you will prepare, analyze, and negotiate customer contracts, with a primary focus on standard template agreements. Manage contract negotiation process from sale date to execution, as well as contract renewals and retention. Work within the framework of sales contracting and legal strategies, law, administrative regulations, and company p

As the Sr Product Owner you will own the team/sprint backlog and set priorities to deliver value based on customer roadmap and features for complex, higher value, and/or multiple products. Work with internal team members to ensure customer desires and business priorities are effectively communicated and reflected in the product backlog. Enable streamlined execution of pro

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is seeking a Strategic Advisor to join our growing Care Delivery Services Team! We are looking for a driven and entrepreneurial individual that is excited by a role that involves executing a strategic vision for the company. You are the art of the possible, able to successfully support projects related to high v

IT is different here. Our work as technology specialists pushes the boundaries of what's possible in health care. You will build solutions that make a real difference in people's lives. Driven by the importance of their work, our team members innovate to elevate. We're encouraged to be curious, collaborate, and turn ideas into solutions that can make health care better fo

Reporting to the Manager of Product Development in the Digital Strategy team, this role will lead product development efforts targeting the Medicare market, addressing the needs of both direct shoppers and agents. The Product Owner will leverage industry expertise to oversee the strategy and implementation of projects and yearly renewals for Medicare Advantage, Medicare S

The Sr Pharmacy Fraud Investigations Analyst is responsible to conduct timely and thorough health care fraud investigations on behalf of the Company. Investigations are confidential and are conducted in accordance with SIU Policies and Procedures, contractual obligation and in accordance with applicable state and federal regulation. Conducts investigations in accordance w

Leads and manages the day to day operational and tactical aspects of all Medicare related PBM (Pharmacy Benefit Manager) activities, new initiatives, and other ongoing business deliverables in accordance with business needs. Identifies, evaluates, and resolves issues that conflict with PBM related deliverables. Collaborates closely with project team members, business owne

This role is responsible for utilizing strong functional/technical area knowledge and expertise to define, evaluate, and validate requirements, business functional design, and technical design for complex business issues. Acting as a liaison between the Pharmacy departments and IT, the incumbent will develop effective technical solutions to minimize operational and system

This position drives implementation for standard groups within specific customer segments. Responsible for activities supporting the sales lifecycle to ensure successful implementation of standard groups. Effectively works with the appropriate personnel to facilitate implementation of benefits, eligibility, and administrative services. Tracks and manages implementation is

This Consulting Actuary with a Medicare Part D focus on the Medicare Pricing team, will provide pricing, forecasting, and strategic support for all Blue Cross NC Medicare products with a particular emphasis on Medicare Part D. You will identify and evaluate risks and strategic opportunities involving Blue Cross NC's Medicare business through the deployment of actuarial co

SQL programming (Advance SQL programming) Demonstrated experience with design and implementation of analytic models and methodologies for new applications Proficiency in Python Advanced experience working with large and complex data sets to develop regression and classification models. Deep knowledge of state of the art techniques in machine learning, statistics, optimiza

Responsible for the retention and the sale of new product lines to existing clients to support the goals and objectives of the business segment. This position is the lead Relationship Manager for all key stakeholders of the client and is accountable for the development / execution of the specific account management strategy plan. As the lead client liaison for the organiz

The Sr Financial Advisor leads and coordinates work efforts to provide divisional leadership teams with analytical insight, financial discipline and business outputs to actualize our financial strategy. Works collaboratively to build cross functional relationships and drive financial results. Functions as financial strategy leader with assigned business partners to create