Blue Cross and Blue Shield of North Carolina

The Director will define and execute enterprise technology and architecture strategies to support business growth, innovation, and digital transformation, while establishing and enforcing architecture standards, principles, and governance across the enterprise. This role involves providing strategic guidance on key technology decisions, leading modernization efforts, and acting as a thought leader to drive business value through technology.

This role involves facilitating complex research and analysis to support business operations, discerning needs, and managing requirements to solve complex business problems through technology or process improvements. Responsibilities include developing business and functional requirements, communicating them to technical partners, and driving business readiness activities for changes.

The Bilingual Specialist will ensure the quality translation of communications and marketing materials into Spanish, manage the terminology database, and lead Spanish enrollment meetings and community events. Responsibilities include translating various materials, interacting enterprise-wide for translations, and managing project schedules and vendor relationships.

The Manager, Financial Planning & Analysis will oversee financial reporting, budgeting, and analytical support for operating divisions while collaborating with senior leadership to drive strategic initiatives. This role involves leading the development and communication of annual operating budgets and monthly forecasts, ensuring alignment with strategic goals.

The Coding Specialist will analyze medical records and charts using clinical and coding expertise to evaluate the appropriateness of provider coding, ensuring compliance with CMS HCC payment methodology. This role involves identifying physician practices with complex coding patterns and reporting relevant data to the Centers for Medicare and Medicaid Services (CMS).

Responsible for the development, maintenance, and ongoing improvement of the IT controls framework, including documentation, risk management, training, and associated processes. Provides oversight of the audit process within IT and the process for tracking open audit findings, te...

The role is accountable for completing complex actuarial or analytical projects, ensuring timeliness, compliance, and quality of work while providing strategic thought leadership to improve processes and meet enterprise objectives. The actuary will also achieve segment financial targets, explain variances, and manage external partnerships with vendors and regulators.

This role leads the development and implementation of comprehensive federal public affairs strategies to advocate for commercial and government insurance and healthcare delivery interests with legislative and executive branches and regulators. The advisor will also serve as the primary lobbyist and representative for Blue Cross NC with North Carolina state government branches and policy organizations.

This role supports the design, administration, and continuous improvement of employee benefit and wellness programs by analyzing costs, regulatory requirements, and market competitiveness. The analyst will also develop and deliver clear employee communications for various channels, including onboarding and annual open enrollment.

The Case Manager coordinates appropriate care, resources, and services for selected member populations, promoting effective utilization of healthcare resources to drive quality care. This involves serving on multidisciplinary teams, performing comprehensive assessments, and developing member-centric plans for treatment and discharge.