Teams 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.