Job Description

We are hiring a Senior Business Operations Advisor to provide advanced business operations, financial, workforce, and performance analytics support for State Health Plan(SHP) Clinical Operations. You will translate operational and financial data into actionable insights, staffing and capacity recommendations, and leadership-ready reporting. Also, you will serve as the business owner for performance measures and dashboards, partnering with technical reporting teams to deliver the tools needed to monitor organizational performance.

What You'll Do

Business and Strategic Planning

• Build and facilitate repeatable planning and performance-management processes for SHP Clinical Operations, including evaluation of progress, risks, priorities, and outcomes.
• Manage the SHP Clinical Operations operating budget and financial forecast, including labor, vendor, implementation, and administrative expenses.
• Own and maintain the SHP Clinical Operations workforce plan and staffing model, including authorized and filled positions, vacancies, hiring assumptions, capacity ratios, and projected resource requirements.
• Evaluate staffing and capacity needs by comparing approved plans and original assumptions with actual workload, productivity, and service demand.
• Support the development of business cases, forecasts, and scenario models to support strategic initiatives, resource decisions, cost management, and operational planning.
• Support the development, adoption, and continuous improvement of standard operating processes, metric definitions, and performance-management practices.
• Facilitate change-management activities that support business improvements and overall organizational effectiveness.
  

Program Evaluation Oversight

• Serve as the central point of oversight for program evaluations across SHP Clinical Operations, partnering with dedicated program managers to consolidate results into a consistent, portfolio-level view of performance.
• Establish and maintain a standard program evaluation framework, including common templates, outcome measures, metric definitions, and reporting cadence, so programs are assessed consistently.
• Evaluate best and next practices, industry developments, and improvement opportunities and develop recommendations for leadership consideration.
• Gather and synthesize evaluation inputs from program managers, analytics partners, vendors, and other stakeholders; identify cross-program trends, gaps, and interdependencies.
• Support vendor performance management through review of key performance indicators, service-level performance, implementation progress, and operational trends.·
• Prepare consolidated program evaluation summaries and recommendations for leadership on program effectiveness, return on investment, and resource priorities.

Data Analysis/Reporting

• Consolidate and standardize financial, workforce, operational, clinical, vendor, and implementation-readiness reporting for SHP Clinical Operations.
• Monitor and analyze performance across Utilization Management, Care Management, Intake, and Behavioral Health, including volumes, caseloads, productivity, turnaround times, queues, backlogs, engagement, and staffing capacity.
• Track budget performance, forecast accuracy, workforce trends, staffing ratios, productivity, service levels, and other key performance indicators.
• Serve as the business product owner for operational dashboards and recurring reporting by defining measures, business rules, targets, thresholds, source-data needs, and drill-down requirements.
• Partner with technical analytics and reporting teams to develop dashboards and reporting solutions; validate that results are reliable and operationally meaningful.
• Identify trends, variances, risks, and performance gaps; investigate business drivers and recommend corrective actions, process improvements, or resource adjustments.
• Develop monthly operating reviews, financial scorecards, executive dashboards, staffing recommendations, productivity assessments, vendor summaries, and scenario analyses.
• Translate complex financial and operational data into clear, actionable insights and leadership-ready recommendations.

Business Partnerships

• Build and strengthen partnerships with Finance, Human Resources, clinical leaders, technical reporting teams, vendors, consultants, and other stakeholders, promoting proactive communication, clear accountability, and effective issue resolution.
• Partner with Finance and clinical and operational leaders to define reporting needs, interpret results, quantify the financial impact of operational changes, and convert insights into measurable actions.
• Coordinate vendor relationships as needed, including performance discussions, reporting requirements, and follow-up actions.
• Provide leadership with relevant analyses, briefing materials, and recommendations for executive, governance, and stakeholder discussions.

What You Bring

• Bachelor's degree or advanced degree (where required)
• 5+ years of experience in related field.
• In lieu of degree, 7+ years of experience in related field.

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.

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.
 

$89,174.00 - $142,679.00

Skills

Business Operation Management, Change Management, Client Vendor Relationship, Operations Management, Organizational Strategic Planning, Partnership Strategy, People Management, Process Improvements, Staffing Operations, Strategic Consulting

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