Job Description

What You’ll Do

• Manages the maintenance and optimization of the Actuarial Systems Data Marts

• Performs monthly data refreshes, financial validations and quality assurance checks to support Actuarial reporting and analytics

• Independently analyze business problems or opportunities; develop recommendations and solutions, implement those solutions, and provide communication on the associated actions, business impacts, and results.

• Develop decision support solutions; including medical and pharmacy claim financial data builds, data extracts, reports, data mart tables, views and analysis.

• Ensures financial granular detail data is appropriately auditable, snapshotted and stored for quarterly and year end audits.

• Establishes vendor and inter-departmental relationships to ensure the accuracy and completeness of financial data.

• Keeps abreast of changes in the company and with our external vendor; data that affects the departmental processes & systems, make recommendations of actions needed and implement changes to the applicable Actuarial Systems and processes where needed.

• Serve as the lead for multiple application areas, including data definitions, usage and file structure, technical structure of the code and the business rules, and structure of requirements that governs the functionality of the system.

• Provide technical leadership and application expertise to business project teams and non-project related activities for the full understanding and execution of all types of assignments.

• Plan and serve as a key liaison with business areas during development and implementation

• Provide detailed configuration expertise to customers and business partners. This includes verbal, written, and electronic communication, and delivering presentations when needed.

• Provide analytical support for departmental, divisional and corporate projects as needed to accomplish their business goals and to ensure the business needs are met.

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.

 Bonus Points 

• 5+ years of SQL Development/Analysis experience - Highly preferred

• 5+ years of healthcare claims data experience

• Healthcare data analytics experience, including experience with Government and Commercial lines of business.

• Facets experience a plus

• Experience leading project teams required.

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   

• Learn more   

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.
 

Skills

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