Jobs at Blue Cross NC

Lead statewide school-based and county DSS initiatives for the Children and Families Specialty Plan. Develop strategy, ensure compliance with educational protections for youth in foster care, establish outcomes and evaluation metrics, design programs addressing social-emotional and educational needs, collaborate with child welfare and education partners, manage a team and regional DSS liaisons, advise senior leadership, and oversee implementation, documentation, and staff development.

Coordinate and manage care for members by performing assessments, developing individualized care plans, using community resources, monitoring progress, facilitating transitions across care settings, educating members, documenting all activity, and collaborating with internal and external providers to ensure appropriate services and outcomes.

Serve as clinical advisor for employer groups to plan, implement, and manage pharmacy benefits and clinical programs (DUR, formulary compliance, prior authorization). Support sales and retention through clinical account management, analyze and report program performance, ensure regulatory compliance, develop educational materials, and engage stakeholders to improve outcomes and cost-effectiveness for self-funded group business.

Senior Facets Developer designs, develops, enhances, and supports enterprise applications for health plan operations. Provides deep expertise in Facets and EAM, delivers high-availability, scalable solutions, troubleshoots production issues, performs analysis and design, writes testable code, partners with stakeholders and architects, and mentors junior team members to improve operational efficiency and member experience.

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 development and maintenance of actuarial data marts, extracts, reports, validations and audits. Drive requirements, technical specs, automations, and financial analyses; mentor staff and coordinate with vendors and business partners to ensure accurate, auditable financial data.

Lead a team managing financial systems, ensuring application security, administration, upgrades, and data governance. Oversee audits, compliance, training, performance reporting, requirements analysis, and cross-functional system projects to support financial reporting 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.

Lead Workday HR technology configuration and integrations, translate HR/Finance requirements into technical solutions, develop and maintain integrations (EIB, Studio, Core Connectors, APIs, RaaS), manage lifecycle and releases, troubleshoot and ensure data accuracy, mentor team members, document configurations, and partner with HR, Payroll, Finance and IT to align Workday capabilities with business 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.

Lead design and engineering of complex physical and cloud data center network and telephony infrastructure. Drive requirements analysis, capacity planning, standards, vendor collaboration, project leadership, operational readiness, incident resolution, and mentorship to ensure scalable, performant network solutions.

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 a team to develop and execute full-funnel digital acquisition and retention strategies across paid channels. Build measurement frameworks, run analytics and testing, optimize ROAS and lifetime value, aggregate channel reporting and attribution, and manage audience segmentation and campaign performance to meet member acquisition and retention goals.

Senior actuarial contributor performing complex analyses to support pharmacy strategy, including rebate trend forecasting, profitability monitoring, corporate initiative support, stakeholder communication, vendor collaboration, mentoring junior staff, and maintaining actuarial credentials.