Jobs at Blue Cross NC

Design and deliver BI reports, dashboards, scorecards and analytic solutions for Medical Economics. Partner with business, actuarial, and technical teams to gather requirements, define business rules, manage BI development lifecycle, investigate trends, maintain knowledge base, and support analytics projects to inform cost and performance decisions.

Lead configuration and administration of the Facets packaged system, act as SME for plan/product setup and business rules, develop modification and interface requirements, validate data with SQL, support SDLC activities, liaise with business stakeholders, and mentor junior staff.

Lead development and improvement of short-, medium-, and long-term cash flow forecasts. Analyze cash trends and drivers, communicate insights to senior leadership and the board, partner with finance, actuarial, investments, and treasury operations, and optimize excess cash per investment policy to support capital allocation and operational planning.

Lead accounting and reporting team to ensure accurate, timely financial reporting, manage close activities, controls, reconciliations, audits, and stakeholder reporting. Design and improve accounting policies/processes, oversee journal entries, vendor and budget management, and manage offshore vendor and external examiners.

Lead strategy, execution, and performance management for Medicare Part D Stars. Drive analytics, reporting, forecasting, and cross-functional initiatives to achieve 4+ Star performance. Manage and develop the Quality & Stars team, partner with PBMs, pharmacy operations, product, and compliance, and translate CMS requirements into operational plans and improvement actions.

Support actuarial teams with rating, pricing, valuation, and forecasting for health programs. Perform data retrieval/validation, experience studies, statistical analyses, ALR/UCL calculations, rate filings, and reporting. Collaborate with underwriting, network, finance, and other stakeholders and participate in the Actuarial Development Program.

Lead advanced actuarial modeling, pricing, valuation, and financial forecasting for health insurance products. Support rate development, rate filings, medical trend and experience studies, underwriting, network management, and product development. Provide consultative expertise and occasional project leadership while maintaining actuarial credentials and continuing education.

Provide strategic employment law counsel on hiring, performance management, terminations, benefits, wage-and-hour and regulatory compliance; draft policies; oversee employment litigation and EEOC matters; support corporate transactions and due diligence; select and manage outside counsel; advise senior leadership; mentor legal team and deliver training.

Lead complex actuarial projects focused on ACA risk adjustment, pricing, forecasting, and competitive benchmarking. Provide strategic actuarial guidance, manage vendor and regulator relationships, achieve financial targets, and communicate results to senior leadership while maintaining actuarial credentials.

Serve as a strategic finance leader partnering with senior leadership to drive financial strategy, multi-year planning, and operational cost optimization. Lead complex financial analyses, develop financial models and executive presentations, identify operational improvements, and oversee implementation to realize value. Influence cross-functional initiatives and provide thought leadership across divisional and enterprise planning.

Lead an FP&A team partnering with divisional leaders to deliver budgeting, forecasting, reporting, cost analysis, and operational-to-financial integration to support strategic decision-making and resource stewardship.

Lead design, development, and delivery of ML, DL, and Generative AI systems for production. Apply prescriptive analytics, optimization, recommendation, and reinforcement learning. Build and evaluate models, run experiments, develop prototypes, benchmark methods, and collaborate with business partners to translate data into actionable recommendations and influence strategy.

Lead sourcing and vendor governance for IT categories (primarily hardware, also software and services). Develop sourcing strategies, run RFP/RFI/RFQ events, negotiate contracts, manage supplier relationships, track vendor performance and risk, and coordinate compliance with Legal, Audit, and Risk teams. Support stakeholders on vendor selection and implement vendor management plans and process improvements.

Design and deliver complex physical and cloud data center infrastructures (network, compute, storage, telephony, middleware, database). Lead capacity planning, lifecycle management, standards, and vendor partnerships. Provide expert support during incidents, produce engineering documentation, and mentor junior engineers.