Responsible for maximizing membership via new sales and retention opportunities in their assigned territory by partnering with Producers and Consultants. The primary focus is managing the designated territory and selling BCBSNC health and ancillary products in the small group and individual market segment. This position is the lead relationship manager for Producers selli

This Account will prepare journal entries and account reconciliations related to Postal Services Health Benefits Program (PSHB) and Inter Plan Program (IPP). Specifically related to weekly cash draws, outstanding list, Postal administration charge, working capital and IPP daily Home/Host cash reconciliation. Assist with other monthly activities and general accounting func

s of programs. Establish and monitor performance metrics and goals for programs, including process measures, outcomes measures and financial measures . Document and present program results through operational reports, outcomes studies, presentations and publications. Monitor all program project executions, progress to plan and production of major deliverables, intervening

The Sr Program Manager will leads and manages the operation of multiple Specialty Value Based Care programs within the Value Strategy and Program Operations team. Identifies, evaluates, and resolves issues that conflict with program operations and project deliverables. Collaborates closely with project team members, business owners and sponsors to develop and successfully

The Sr Financial Portfolio Analyst will maximize value created through strategic programs by supporting value capture plan and monitoring and enforcing value capture activities to ensure organization achieves annual and three year value targets. Provide full end to end program management including strategic planning, needs analysis, content development, program design, im

The Sr Strategic Advisor, Healthcare will act as a senior member of the strategic function by contributing to the achievement of innovation based goals through new forms of healthcare reimbursement, healthcare redesign consultation, payer/provider engagement and market offer opportunities. Leverages industry experience and expertise to promote enterprise understanding of

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 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