Blue Cross and Blue Shield of North Carolina

Lead pricing strategies and actuarial initiatives for business segments while evaluating care management models and designing insurance products. Provide strategic thought leadership to improve processes, reduce risks, and manage external partnerships with vendors and regulators.

Leads the development and execution of market-based pricing strategies and Target Market Price (TMP) methodologies across the EBS and CDS portfolio. Partners with cross-functional leaders to optimize portfolio profitability, monitor competitive trends, and establish pricing governance frameworks.

Consult with ASO clients on pharmacy benefits and pricing while analyzing data to identify cost-savings and utilization trends. Drive healthcare redesign and partnership strategies to improve member outcomes and align with growth objectives.

The Associate Medical Director serves as a clinical interface between the company and healthcare providers to support value-based strategies and high-quality care. Responsibilities include driving healthcare initiatives, managing strategic partnerships, and analyzing clinical data to improve health outcomes.

Lead the research and development of predictive, prescriptive, and Generative AI solutions to drive organizational decision-making. Design and implement self-learning ML/DL systems and collaborate with business partners to integrate these technologies into production environments.