Job Description We are seeking a Special Investigations Unit (SIU) Investigator to conduct timely and thorough health care fraud investigations on behalf of our Company. Responsibilities include maintaining confidentiality, adhering to SIU Policies and Procedu…

Job Description Acts as a senior member of the strategic function by contributing to the achievement of innovation-based goals through new forms of pharmacy reimbursement, healthcare redesign consultation, payer/provider engagement and market offer opportuniti…

Job Description As a Consulting Actuary -ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical services for our organization. Responsibilities include leading pricing strategies and actuarial initiatives for b…

Job Description The Consulting Actuary - Pharmacy serves as a senior-level individual contributor within the Pharmacy Analytics team, supporting the organization's pharmacy strategy through advanced actuarial and analytical expertise. This role is responsible …

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 pricing, valuation, healthcare economics…

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 improve the health experience of our member…

Job Description The Director of Managing Counsel will oversee the delivery of legal services and advice for the Company, acting as the main attorney for Blue Cross NC's Privacy Program. This role manages both attorneys and non-attorneys and oversees Blue Cross…

Job Description We are seeking a Special Investigations Unit (SIU) Investigator to conduct timely and thorough health care fraud investigations on behalf of our Company. Responsibilities include maintaining confidentiality, adhering to SIU Policies and Procedu…

Job Description Acts as a senior member of the strategic function by contributing to the achievement of innovation-based goals through new forms of pharmacy reimbursement, healthcare redesign consultation, payer/provider engagement and market offer opportuniti…

Job Description Leads enterprise efforts supporting the design, operationalization, and optimization of value-based care programs across the full operational lifecycle. The Principal Value-Based Care Operations Advisor provides subject matter expertise spannin…