Job Description This position is a unique opportunity for someone who has the rare combination: advanced analytics + healthcare/clinical insight + technology-forward innovation + enterprise influence. This is not a traditional analytics leader or care management role. The differentiator is someone who can use data and clinical insight to build end-to-end care pathways that improve patient outcomes while directly addressing medical expense and affordability. We are seeking a highly analytical, technology-forward healthcare leader who can develop innovative, data-driven approaches to care pathways and patient engagement. The ideal candidate will bring deep expertise in healthcare analytics, medical expense/cost-of-care strategy, population health, or related disciplines and demonstrate the ability to translate complex clinical and financial data into actionable interventions and measurable outcomes. Experience designing end-to-end care pathways, identifying opportunities for earlier intervention, and leveraging advanced analytics, AI, and personalization to improve patient outcomes and affordability is highly preferred. Candidates should demonstrate strong enterprise leadership, executive influence, and the ability to bring strategic clarity to complex initiatives that span multiple functions and stakeholders. Hiring Preferences / Ideal Candidate Profile Must-Have Qualifications & Experience Advanced analytics expertise with demonstrated ability to translate complex healthcare data into actionable strategies, interventions, and measurable business outcomes. Healthcare experience with a strong understanding of healthcare economics, medical expense/cost of care, utilization, patient populations, or healthcare delivery. Payer experience is highly valuable, but candidates with adjacent healthcare experience who can quickly learn the payer environment should be considered. Technology-forward and innovative mindset. Must be energized by using emerging technology, advanced analytics, AI, and data-driven approaches to solve complex healthcare problems. Proven ability to move beyond reporting and traditional analytics to identify opportunities, develop hypotheses, design interventions, and drive action from insights. Experience solving complex, cross-functional problems where ownership and decision rights are distributed across multiple teams or functions. Strong executive presence and ability to influence senior leaders and establish clarity across competing priorities, perspectives, and initiatives. Demonstrated ability to prioritize high-value opportunities and translate strategy into a roadmap or portfolio of initiatives. Strongly Preferred Clinical credential and/or significant clinical expertise, ideally an MD or equivalent depth of clinical knowledge. Clinical credentials are strongly preferred but should not outweigh exceptional analytics and healthcare capabilities. Experience designing or optimizing care pathways, patient journeys, population health strategies, or patient/member engagement interventions. Understanding of disease progression and opportunities for earlier intervention or prevention, rather than focusing exclusively on management after a condition has been diagnosed. Experience connecting clinical, financial, behavioral, and engagement data to determine where and how interventions will create the greatest value. Experience with healthcare affordability, medical expense management, cost-of-care strategies, actuarial analytics, or related disciplines. Experience working in environments where analytics informs personalized engagement, intervention timing, channel strategy, or AI-enabled healthcare experiences. What Will Differentiate the Strongest Candidates The strongest candidate will be able to demonstrate that they have: Built something, not just analyzed something. Look for examples where analytics led to a new intervention, program, care model, pathway, or material change in strategy. Connected clinical outcomes to financial outcomes. Candidates should be comfortable discussing both patient impact and healthcare cost/medical expense implications. Thought across the entire patient journey. For example, rather than only improving diabetes disease management, they can identify opportunities upstream, such as identifying pre-diabetic populations, determining the appropriate intervention, designing the engagement strategy, and measuring whether the intervention prevented progression. Worked successfully across organizational boundaries. The role will need to bring coherence across areas that may currently have fragmented strategies, analytics, priorities, or decision rights. Used technology as a strategic lever. Candidates should be curious and credible around AI, advanced analytics, personalization, predictive modeling, and emerging approaches rather than relying only on traditional healthcare analytics. Salary Range At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs. *Based on annual corporate goal achievement and individual performance. $210,268.00 - $336,430.00 Skills Analytics, Data Visualization, Predictive Modeling, Stakeholder Management, Statistical Analysis, Strategic Planning _____________________________________________________________________ JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: [email protected]. About Us It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians. Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all. Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives. Authorization to Work in the United States We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview for English or Visión General de E-Verify for Español. Request Accommodations Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application, hiring process, or have technical issues that prevent you from completing your application please notify HR at [email protected]. Blue Cross NC is a Hybrid Flex company. Whether the role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any of our approved states: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming Notice to staffing agencies and search firms: Blue Cross NC does not accept unsolicited resumes from agencies or third parties and is not responsible for fees associated with unsolicited resumes.

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