Kentucky, United States · Hybrid
$108k–$173k/yr
Job Description In this role you will manage, plan, design, and develop multiple, larger and/or more complex programs on an enterprise level. Provide full end to end program management including strategic planning, needs…
Skills: Program Management, Strategic Planning, Budget Management, Vendor Management, Data Analysis
North Carolina, United States · Hybrid
$81k–$130k/yr
Job Description The Business Solutions Developer creates technical solutions to address moderately complex business capability needs by utilizing at least one technical application; including but not limited to: Business…
Skills: SQL, VBA, Business Objects, Crystal Reports, Access
North Carolina, United States · Remote OK
$74k–$118k/yr
Job Description We’re hiring a National Committee Quality Assurance (NCQA) Program Manager to lead our Health Plan Accreditation activities with a primary focus on Member Experience and Credentialing standards. This role…
Skills: Budgeting, Office Administration, Process Improvements, Program Administration, Program Documentation
Kentucky, United States · Hybrid
$191k–$306k/yr
Job Description As a Senior Counsel - Employment, you will provide strategic legal guidance on complex matters that may include high-value transactions, litigation, regulatory compliance, and corporate initiatives with s…
Skills: Affordable Care Act (ACA), Business Law, Business Litigation, ERISA Fiduciary, Labor And Employment Law
Kentucky, United States · Hybrid
$108k–$173k/yr
Job Description The Senior Facets Developer serves as a senior technical contributor responsible for the design, development, enhancement, and support of enterprise applications supporting health plan operations. This ro…
Skills: Agile Methodology, Cloud Software, Information Systems, Information Technology (IT), IT Solutions
Durham, California, United States · Hybrid
$119k–$190k/yr
Job Description Proactively manages and measures experience lifecycle from conception to implementation, iteration, and maintenance, optimizing the outcome for the product/experience while prioritizing work and communica…
Skills: Business Process Strategy, Business Process Transformation, Customer Journey Mapping, Lean Six Sigma, Performance Management
Durham, California, United States · Hybrid
$144k–$230k/yr
Job Description The Director, Strategic Communications is a key leader within the Communications function, responsible for shaping narratives, strengthening organizational reputation, and conditioning the environment so …
Skills: Communications Strategy, Content Strategy, Digital Communications, Executive Leadership, Marketing Communications
Wyoming, Michigan, United States · Hybrid
$119k–$190k/yr
Job Description As the Manager, Financial Planning & Analysis, you’ll lead a finance team and serve as a trusted partner to assigned operating divisions. In this role, you’ll provide leadership across financial reporting…
Skills: Cost Analysis, Finance Strategy, Financial Analysis, Financial Forecasting, Financial Management
Durham, California, United States · Hybrid
$74k–$118k/yr
Job Description 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 wh…
Skills: Clinical Decision Support, Clinical Quality Management, Clinical Research, Healthcare Operations, Healthcare Policies
Durham, California, United States · Hybrid
$108k–$173k/yr
Job Description The Senior Data Modeler designs, implements, and documents more complex data architecture and data modeling solutions, which include the use of relational, dimensional, and NoSQL databases. These solution…
Skills: Data Analysis, Data Architecture Development, Database Design, Data Designing, Data Dictionary
Durham, California, United States · Hybrid
$131k–$209k/yr
Job Description As a Domain expert in IT Healthcare Integrations and Interoperability solutions with an understanding of Healthcare Payer/Provider clinical data exchange you will own and lead valuable deliveries that imp…
Skills: Data Integration, Data Solutions, Data Warehousing, Enterprise Data, Information Technology
Durham, California, United States · Hybrid
$81k–$130k/yr
Job Description Responsible for facilitating and performing complex research and analysis to support business operations. Discerns business needs, elicits, documents, and manages requirements, and develops business and f…
Skills: Requirements Elicitation, Business Process Mapping, Functional Decomposition Analysis, Data Flow Modeling, Use-Case Analysis
Wyoming, Michigan, United States · Hybrid
$89k–$143k/yr
Job Description As the Senior Category Manager, you will lead sourcing and vendor governance activities for assigned IT categories, including hardware, software, and services. This role focuses on reducing total cost of …
Skills: Category Management, Category Sourcing, Process Improvements, Procurement, Sourcing Strategies
North Carolina, United States · Hybrid
$108k–$173k/yr
Job Description Responsible for leading the development, evaluation, management, and governance of Health Plan performance—including driving cross functional accountability for actions, outcomes, managing relevant proces…
Skills: Business Strategies, Enterprise Strategies, Innovation, Innovation Development, Market Research
Durham, California, United States · Hybrid
$108k–$173k/yr
Job Description In this role you will lead small to medium scale, enterprise-wide Product Development initiatives. Acts as a thought leader for the generation of ideas and carries through to product design, requirements …
Skills: Product Development, Strategic Planning, Business Case Development, Go-To-Market Strategy, Stakeholder Management
Kentucky, United States · Hybrid
$81k–$130k/yr
Job Description Join our team as an Actuarial Analyst, where you will use your expertise in mathematics, probability, statistics, and business principles to support a variety of actuarial functions, including rating and …
Skills: Actuarial Analysis, Actuarial Science, Analytical Support, Data Analysis, Data Verification
Durham, California, United States · Hybrid
$81k–$130k/yr
Job Description CuraCor Solutions is seeking a Strategic Advisor with experience delivering innovative, consumer-centric healthcare workstreams to join our growing Care Delivery Services Team! We are looking for a driven…
Skills: Strategic Planning, Business Case Development, Data Analysis, Project Management, Alliance Management
Kentucky, United States · Hybrid
$89k–$143k/yr
Job Description We're hiring a Senior Data Analyst to join the Government Pharmacy Programs Department! The Senior Data Analyst, Quality Review – Medicare Pharmacy Claims is responsible for ensuring accurate, compliant a…
Skills: Business Analysis, Business Data Analysis, Business Intelligence (BI), Cloud Applications, Communication
Kentucky, United States · Remote OK
$144k–$230k/yr
Job Description Serve as the senior AI/ML scientist to identify, research, and develop transformational predictive, prescriptive, and Generative AI (GenAI) solutions that translate structured and unstructured data into s…
Skills: Artificial Intelligence (AI), Benchmarking, Best Practices Development, Data Analysis, Data Science
Kentucky, United States · Remote OK
$67k–$107k/yr
Job Description We are seeking an early-career Actuarial Associate who is eager to apply their knowledge of mathematics, probability, statistics, and business principles in a supportive, team-based environment. Under dir…
Skills: Actuarial Calculations, Financial Forecasting, Rating and Pricing, Valuation, Healthcare Economics
Sign up with Clera and we'll reach out the moment a role actually fits you — no more spraying applications into the void.
Manage and design complex enterprise-level programs from end-to-end, including strategic planning and implementation. Oversee budget management, vendor contracts, and performance metrics to ensure program goals and regulatory standards are met.
Requires a Bachelor's or advanced degree with 8+ years of related experience, or 10+ years of experience in lieu of a degree. Must have a proven track record in managing large-scale programs and coordinating interdepartmental functions.
Plan, develop, implement and manage multiple/and or large complex programs on an enterprise level. Coordinate interdepartmental functions in order to minimize delays; work with program/project team members on a regular basis to review deliverables and ensure deadlines are met.
Identify, analyze and understand target audiences and their specific program needs.
Develop program strategy and supporting business case. Lead/direct the development of the strategic approach for the program, its major time frames and a definition of its major deliverables to address needed goals and outcomes.
Develop the overall program plan and create high-level plans to guide detailed planning at the component level.
Lead the program management team in establishing program direction, identifying interdependencies, communicating program requirements, tracking progress, making decisions, and resolving conflicts and issues.
Confer with team to explain program/project and individual responsibilities for functions and phases of programs/projects. Responsible for effective assignment and use of staff, contractors and consultants to maximize the application of their capabilities and their contribution value for cost to the program. Manage and change assignments in the program within agreed upon decision-making authority.
Direct and coordinate activities concerned with implementation and carrying out objectives of programs.
Establish and monitor performance metrics and goals for programs, including process measures, outcomes measures and financial measures. Document and present program results through operational reports, outcomes studies, presentations and publications.
Monitor all program project executions, progress to plan and production of major deliverables, intervening when necessary to review the current state and direct adjustments to plans and execution.
Own and make needed decisions to ensure the successful resolution of all issues, problems and changes within the program that do not alter or defer significantly from the agreed upon milestones and major deliverables.
Direct the development and maintenance of plans, practices and assignments to identify, quantify and contain the occurrence and potential impact of risks and risk events on the execution of a program and its likelihood of success.
Evaluate programs to ensure they meet program goals.
Identify specific program evolutionary needs and/or changes and direct the development of appropriate approach, plans and/or deliverable alterations focused on optimizing success and goal achievement.
Develop and manage budgets to control expenditures in accordance with budget allocations, together with the conformance to timing, limits and usage of funding as agreed upon in the spending plan for the assigned program(s).
Ensure that programs meet appropriate regulatory and accreditation standards. Ensure that the program fully cooperates with the organizational governance functions and provides oversight for the definition and exercise of regular iteration and reporting required by organizational governance policies.
Manage vendor relationships and negotiate, administer and monitor program contracts to ensure vendors meet service level agreements.
What You’ll Get
The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community
Work-life balance, flexibility, and the autonomy to do great work
Medical, dental, and vision coverage along with numerous health and wellness programs
Parental leave and support plus adoption and surrogacy assistance
Career development programs and tuition reimbursement for continued education
401k match including an annual company contribution
Where You’ll Work
Our Hybrid Flex approach is built on presence with a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplace that’s flexible, connected, and future focused.
In a Hybrid-Flex role, you’ll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you’ll work virtually, with a few in-office visits each year for meaningful moments that matter.
Whether your 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 states listed on this job posting. Onsite expectations will be discussed during the interview process.
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.
_____
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].
Improving the health and well-being of our customers & communities - we won’t stop until health care is better for all
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. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. 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].
Offices: 4613 University Drive, Durham, NC 27707, US
Improving the health and well-being of our customers & communities - we won’t stop until health care is better for all
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. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. 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].
Offices: 4613 University Drive, Durham, NC 27707, US
