Blue Cross NC · 11 hours ago
Principal Business Operations Advisor
United States
Full-time
Remote
Senior Level, Lead/Staff
$119K/yr - $190K/yr
8+ years expBlue Cross NC is partnering with the North Carolina Department of Health and Human Services to operationalize the Children and Families Specialty Plan. The Principal Business Operations Advisor will oversee monitoring and evaluation of key aspects of plan execution and lead the development of data management and reporting strategies to support quality improvement efforts.
Financial ServicesHealth InsuranceInsurance
Responsibilities
Develop and implement Continuous Quality Improvement framework and Monitoring and Evaluation plan
Build and facilitate repeatable and Plan-focused strategic planning processes that include confirmation of continued relevance, progress evaluation and communication to affected stakeholders
Advise and communicate with Plan leadership and external stakeholders, including senior leadership, regarding programs, projects, initiatives, emerging issues and challenges within the child welfare systems
Develop and use key improvement metrics, such as dashboards, team reporting, regulatory reports and scorecards to review program data and results in comparison with benchmark metrics and expected outcomes
Monitor and evaluate delegated staff functions activities for compliance and effectiveness
Proposes a variety of solutions to business issues/problems utilizing appropriate analysis tools (ie Cost/Benefit Analysis, Flowcharting, etc)
Lead the development of a Monitoring and Evaluation Plan, focused on Plan execution and achievement of objectives and goals
Lead the coordination, planning, and facilitation of various Plan-level monitoring and evaluation workgroups to make them more effective, data-driven, and outcomes based
Lead monitoring and evaluation strategy development and activities addressing staffing, staff to member ratios, and staff performance
Support development of business plans and analysis under guidance from Plan leadership
Facilitate the adoption of CQI-driven Plan operating procedures and processes for the Plan and assist with the communication to and education of external stakeholders and delegated partners
Provide input and recommended strategy for Plan leadership’s public speaking engagements and/or Board or committee meetings
Facilitate change management work to support business and process improvements and overall Plan effectiveness
Lead and coordinate work for special projects or initiatives for the Plan as assigned
Evaluation of potential opportunities and recommendations to reduce costs/improve efficiencies
Review and evaluation of best or next practice opportunities for potential adoption
Develop recommendations based on important industry literature and ensure leadership is briefed on current and emerging issues of importance to the organization
Serve as lead on engagements with external entities (i.e. consultants, external stakeholders, delegated partners) and coordinate data gathering and research efforts based on the direction of Plan leadership
Manage tracking of initiatives/projects for the division and independently create presentations of initiative/project progress for varied audiences, which may include Senior Plan Leadership
Lead the consolidation and standardization of data analysis and reporting for relevant Plan operations
Provide analysis and insights for proposed strategic initiatives by leveraging a unique perspective on the end-to-end operations of the Plan
Support Plan budget analysis, provide input into and monitor budget forecasts, and review progress against administrative cost reduction goals
Track and evaluate goal progress, including data collection and analysis of key performance metrics (KPIs)
Qualification
Required
Bachelor's degree or advanced degree (where required)
8+ years of experience in related field
In lieu of degree, 10+ years of experience in related field
Preferred
Continuous quality improvement experience within a Managed Care Organization
Experience with Child Welfare systems, data analytics, KPIs, and metrics
Expert in excel, tableau and/or other data management tools
Experience in working in a matrixed environment, facilitating work across multiple teams and priorities
Benefits
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
Company
Blue Cross NC
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.
5001-10000 employees
H1B Sponsorship
Blue Cross NC has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (4)
2024 (1)
2023 (2)
2022 (5)
2021 (13)
2020 (5)
Funding
Current Stage
Late StageLeadership Team
Tunde Sotunde
President and Chief Executive Officer
Caleb Davies
Medicaid Market CFO - Healthy Blue of NC Medicaid
Recent News
2026-01-06
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