E-Verify Program

Affiliate Manager

• Serve as a strategic HR partner and coach to site leadership, influencing business decisions and people strategies
• Lead and support employee relations, including interpretation of the Collective Bargaining Agreement and grievance management
• Drive workforce planning initiatives, including talent management, succession planning and critical role development
• Contribute to and deploy the Human Capital strategy, acting as a change agent across both sites
• Support managers with HR best practices, policies and compliance with employment laws and regulations
• Lead health & safety culture initiatives, including injury management and return-to-work programs
• Partner with cross-functional teams to enhance employee engagement and organizational effectiveness
• Participate actively in plant leadership committees and continuous improvement initiatives

Human Capital Business Partner

Software Engineer

• Leads the development of ideas from inception through successive stages of the product development process to market launch
• Contributes to the commercial success of product initiatives by owning key components, including business case development, design, and go-to-market execution
• Evaluates product opportunities and external vendor partnerships to determine impact on sales and profitability
• Works cross-functionally across the enterprise to develop proofs of concept, business cases, product designs, business requirements, program management models, and functional specifications
• Presents product and program designs and business cases across multiple levels of the organization and the Diversified Business Group’s portfolio of asset companies to secure approval, resources, budget, and stakeholder buy-in
• Collaborates with actuarial resources to define pricing strategy and obtain leadership alignment
• Partners with marketing and sales leadership to define go-to-market strategy and launch plans
• Updates product documentation to reflect product or program changes
• Reviews and approves marketing materials, training content, technical specifications, and testing plans and results
• Develops and maintains expertise in competitive products and broader market dynamics
• Serves as a product and program resource across the enterprise
• Prepares projections, analyzes operational impacts, and identifies actions needed to manage and enhance product lines
• Collaborates within a dynamic team on highly visible, high-impact initiatives that drive value for Blue Cross NC, the Diversified Business Group, and external partners
• Demonstrates the ability to quickly learn and apply knowledge across domains, including payer operations, care delivery, and emerging industry trends

Senior Product Developer – Diversified Business

Business Analyst

• Elicit, analyze, document and manage requirements for changes to business processes, policies, information, and information systems for larger and/or more complex business problems
• Develop and elicit requirements for departmental and corporate projects that are more complex in nature as requested by internal/external customers; prepare business and functional requirements
• Ensure creation of and adherence to requirements approach and management plan in alignment with an overall project plan
• Collaborate with project teams to adhere to solution scope and create and maintain requirements traceability
• Support business readiness activities including the communication plan to support changes to technology, processes and people
• Develop new procedures, specifications for systems changes or other solution recommendations for more complex product and/or process changes
• Work with cross-functional management and staff to implement changes
• Identify the business process and organizational impact of solutions; conduct analysis of workflow process and designs, test and implement solutions
• Ensure managed requirements change request process and documentation throughout project lifecycle
• Create effective presentations for review by varied levels of leadership; thoroughly document all analysis assumptions, procedures and results in a manner appropriate for both senior executive and management review
• Proactively identify areas of potential business risk, on projects both within and outside of control, make recommendations related to mitigation and escalate as necessary
• Build and support strong business vendor relationships by documenting business issues, determining project needs, and supporting training as needed

Senior Business Analyst, Member Payments

Accounts Payable

• Utilizes analytical skills to perform assigned tasks proactively and independently within deadlines.
• Develops, directs plan, and evaluates accounts payable policies and procedures, and ensures external and internal controls and policies are adhered to.
• Maintains W-9s files, coordinates year-end issuance and ensures compliance with IRS related regulations for Risk Management vendors.
• Trains new hires and supports the cross training of team members on department processes and system enhancements and upgrades.
• Provides leadership, coaching, support & problem-solving assistance, and knowledge transfer to others.
• Reviews and assesses if sales and use tax is properly accounted for on purchasing card transactions and 3rd party supplier invoices.
• Prepares QTR account reconciliation and also reports to the tax team what needs to be filed with the applicable states.
• Assists with external and internal audits by providing requested information to auditors and working with management to resolve issues and draft resolutions.
• Maintains and enhances internal controls and performs self-testing.
• Initiates projects to improve processes/controls, partners with project teams to ensure resolution of project/post-project issues and participates on cross-functional projects as a procurement representative.

Senior Accounts Payable Analyst

Actuary

• Accountable for completion of complex actuarial or analytical projects, ensuring timeliness, compliance, and quality of work
• Provide proactive and strategic thought leadership of ways to improve processes, reduce risks, and meet department and enterprise objectives to achieve profitable growth and/or improve value, quality, and access for Blue Cross NC customers
• Achieve segment financial targets and provide concise explanations of results and variances to expectations; act as a financial steward for the company
• Communicate effectively with all levels and divisions within the organization, including Divisional Leadership
• Manage external partnerships with vendors, auditors, regulators, and health care providers, including effective negotiation of contracts and/or rates
• Develop and maintain strong business relationships with internal partners through business expertise and exceptional support; act as a strategic advisor
• Meet continuing education standards required for job function, thought leadership and maintenance of actuarial credentials.
• Develop measurement models for various cost savings initiatives across the company’s many strategic areas including, but not limited to clinical care management, alternative payment arrangements with providers, medical coding and policy adherence practices, and other emerging drivers of trend.

Principal Actuary, Cost of Care

• Perform research and analysis to support reimbursement policy governance and related business operations.
• Elicit, document, develop, and track business and functional requirements to address intermediate‑level business needs.
• Support governance and operational execution by maintaining tracking tools and documentation.
• Develop and document business requirement deliverables for projects supporting reimbursement policy governance.
• Document new procedures and supporting artifacts (e.g., work instructions, workflow diagrams).
• Maintain and manage SharePoint and other document repositories.
• Use industry‑standard analysis techniques (e.g., workflow analysis, business process mapping).
• Perform quality assurance on reimbursement policy documentation and deliverables.

• Use expertise in mathematics, statistics, health insurance, and business to support complex pricing, valuation, and financial forecasting.
• Lead analyses that shape pricing models, care management programs, and insurance product development.
• Turn complex data into clear, actionable recommendations that guide strategic decisions.
• Identify emerging risks and opportunities in a rapidly evolving industry.

Principal Actuary – ACA Pricing

Support Engineer

• Provide consultative support to assigned customers in defining or designing business processes and identifying enabling technologies based on customer requirements.
• Create, test, and support integrations using EIB, Studio, Core Connectors, APIs (REST/SOAP), RaaS, PECI, XML/XSLT.
• Partner with HR, Finance, Payroll, and IT teams to understand business needs and translate them into technical specifications.
• Resolve integration errors, monitor performance, and ensure data accuracy and security.
• Oversee the integration lifecycle, including deployments, system upgrades, and alignment with SDLC.
• Research, test, and implement new HR system capabilities; manage Workday updates and new feature adoption, including impact analysis, testing, and deployment.
• Develop and maintain documentation for configurations, integrations, and technical processes.
• Work with internal teams, vendors, and third parties to implement solutions.
• Act as a mentor to other team members, providing guidance and sharing HR functional and technical expertise.
• Perform system integration activities for projects (technical integration testing, assessments, etc.).
• Facilitate development of business solutions that combine knowledge of HR business processes, technological options, and process facilitation techniques.
• Serve as an information source concerning human resources technology needs for internal HR management and staff.
• Partner with enterprise HR functions regarding necessary changes to master data for payroll, recruitment, organizational management, training, and compensation.

Principal Workday Technical Analyst

Analyst

• Provides assistance and financial support for the basic functions of the provider compensation administration processes.
• Learns about the healthcare industry, various compensation practices and provides support for a range of activities including, payroll and general ledger analysis, table maintenance, database querying and variance analysis.
• Maintains current finance processes, and aids in financial analysis with business partners in areas of minimal complexity.
• Conducts or assists in the documentation of simple to moderate financial analysis projects.
• Assists in the collection, organization, and analysis of varying levels of data.
• Aids in the monthly and quarterly accrual and reporting processes.
• Maintains key tables in support of provider compensation and evaluate exception reports.
• Identifies and monitors variances between budget and actual outcomes.
• Maintains spreadsheets or processes which support the workflows within Finance.
• Other duties as assigned.

Provider Compensation Analyst Associate

• Identify, analyze, and determine medical necessity, pre-existing conditions, benefit eligibility and/or individual consideration reimbursement allowances for claims
• Ensure review and determinations meet all requirements by Regulatory and Accrediting bodies
• Identify, document, and escalate system and process problems
• Review physician-submitted and member-submitted claims for specified services
• Issue denials according to department protocols
• Maintain confidentiality of all PHI in compliance with state and federal laws
• Recognize and report inappropriate billing patterns or utilization trends
• Communicate with members and providers to obtain additional information
• Document the required clinical information for decision-making
• Perform post adjudication review of claims related to coding, billing, and reimbursement.

Medical Review Analyst

Program Manager

• Leads and oversees the design of population health strategy initiatives and programs to improve care coordination and health outcomes including developing efficiencies in programs (clinical and non-clinical)
• Works alongside senior leadership to monitor the effectiveness of care and identifying areas for process improvement to manage costs and to comply with federal and state regulations
• Collaborates closely with project team members, business owners and sponsors to develop, implement and monitor initiatives that can improve member health outcomes, reduce provider administrative burden, and/or reduce medical or operational expense through a variety levers, including clinical workflow innovation, operational efficiency, prior authorization management, and AI-enabled care
• Leads the development of population health strategies focused on advancing care coordination, improving health outcomes, and increasing program efficiency
• Gathers input from across the enterprise, division, community, members and through competitive intelligence to identify opportunities, assess needs and develop strategic design of solutions
• Ensures alignment of solutions across the enterprise
• Develops business cases, strategy concept designs and program requirements
• Serves as a subject matter expert, routinely briefing leaders and key stakeholders on program goals and initiatives
• Develops project plans and recommendations in support of compliance objectives and leads implementation
• Tracks and reports on the status of projects
• Assesses project risks, develops mitigation and contingency plans
• Identifies analyzes and understands target audiences and their specific program needs
• Develops and deploys marketing strategy to increase member engagement in maternal health programs
• Leads vendor identification, evaluation, selection and contract negotiations for new vendor relationships
• Works with senior leadership team to support clinical initiatives and/or programs are in accordance with National Committee for Quality Assurance (NCQA) guidelines, state mandates, and/or government contract requirements
• May work across multiple Line of Business and states to encompass program needs into population health strategies
• Establishes and monitors performance metrics and goals for assigned programs, including process measures, outcomes measures, financial measures and methodologies for implementing programs
• Documents and presents program results through operational reports, outcomes studies and presentations
• Owns and makes needed decisions to ensure the successful resolution of issues within the program to achieve milestones and program deliverables
• Incorporates evaluation planning into the overall strategy
• Establishes key performance indicators for programs, including process measures, outcomes measures and financial measures
• Ensure program is designed in such a way that these metrics can be collected and monitored

Senior Project/Program Manager

• Evaluates, analyzes and monitors staff or provider performance to achieve excellence in quality
• Provides timely, relevant, accurate, and objective feedback to staff, providers, and the management team which includes a plan of action or recommendations when deficiencies are identified
• Acts as technical resource and develops learning solutions that engage the learner and produces desired business goals and objectives
• Performs quality audits of staff/providers to ensure compliance with departmental, Plans and regulates policies and procedures
• Assists in designing effective learning solutions based on analysis of quality audit results and when quality deficiencies are identified
• Monitors and reports on individual and department results to include benchmarking and trending
• Acts as a day-to-day resource for technical assistance and clinical decision making
• Provides guidance with interpretation of clinical aspects of Corporate Medical Policy and other clinical guidelines to assist in making medical decisions
• Aligns clinical decision-making processes with regulatory requirements (e.g. DOI/ERISA/NCQA)
• Keeps abreast of medical knowledge, care patterns, regulatory and governmental rules and regulations
• Works with management team to support decisions on workflow process, quality improvement, goal setting and data driven information-based decision-making
• Provides timely feedback to management on staff/provider performance
• Acts to facilitate change efforts and promote department, division and corporate goals

Clinical Quality Management Analyst

Performance Marketing

• Lead demand generation strategy, planning, and execution, including budget allocation, channel mix, and performance measurement aligned to business objectives
• Develop and execute integrated, omni-channel campaigns (digital, direct response, CRM, and email) that drive pipeline growth and customer engagement
• Partner across business functions to identify growth opportunities and translate customer and market insights into actionable marketing strategies
• Leverage data, research, and customer intelligence to inform targeting, messaging, and channel optimization decisions
• Build and optimize media strategies that improve brand affinity and drive measurable demand outcomes
• Lead and develop a high-performing team, providing coaching, direction, and clear expectations to elevate team capability and performance
• Operate with strong ownership and accountability, proactively driving initiatives from concept through execution and results

Manager, Demand Generation

Client Services Representative

• Responsible for a customer-facing, service relationship with clients, maintaining a high level of engagement around service delivery, issue resolution, and healthcare initiatives unique to clients
• Intake, manage, track and resolve inquiries, issues, and escalations raised by client representatives, agents/consultants
• Monitor channels for inquiry intake, documenting and managing client representative concerns
• Arranges and facilitates all meetings to review the service plan and client specific issues
• Reviews the status of the deliverables with the internal teams involved
• Escalate high-priority or high-risk issues to Client Success Lead as needed
• Develop relationships with clients to understand their goals, processes, procedures and systems to provide support for the relationship with Blue Cross NC
• Provides plan/benefit administration support to client
• Coordinates the required corrective action as identified via data and root cause analysis
• Delivers client specific reporting, including reporting related to service issues and network disruption
• Identifies opportunities to control segment and book of business administrative or medical expense

Client Service Advisor – Sales Delivery Expert

QA Automation Engineer

• Develop and maintain internal tools and systems that automate existing work and increase productivity using AI
• Rapidly prototype AI-enabled utilities/automations and deploy them into production
• Troubleshoot and resolve automation issues and recommend preventive actions
• Partner with teams across I&O to identify high-impact automation opportunities
• Communicate system issues, resolution plans, and recommendations clearly