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Use statistics, financial theory, mathematics, and basic financial and actuarial principles to assess the impact of internal and/or external proposals, activities, or initiatives for the Federal Employee Program (FEP), the Federal Employee Dental and Vision Insurance Program (FEDVIP), and other departments within BCBSA and the Plans as needed. Operate with a high level of autonomy for purposes of pricing, underwriting, reserving, forecasting and other actuarial functions. Manage small projects and communicate complicated concepts, information, and recommendations, and present technical information to non-technical audiences. Work product affects management decisions as well as financial soundness of Blue Plans, FEP, and FEDVIP.<li>Provides the evaluation, implementation, and maintenance of models and studies, which use actuarial principles for the purposes of pricing, underwriting, reserving, trend analyses, rating support, forecasting, and other actuarial functions, including peer review, as needed. Summarizes results, provides observations and recommendations to assist with management decisions.</li><li>Develops, analyzes, and quantifies the effects of new initiatives, proposals, environmental changes such as: laws/regulation, tax policy; trend; competitor, member, and provider behavior impacting FEP, FEDVIP, BCBSA, or Blue Plans, as appropriate. Analyzes the financial effect and determines the estimated actuarial impact and recommends appropriate solutions. </li><li>Responds to a variety of technical inquiries or requests and provides technical actuarial assistance to internal customers or external customers (OPM, Congress, etc.), and Blue Plans upon request. Supports and evaluates the Plan Trend Surveys and other BCBSA publications as requested. </li><li>Maintains actuarial credentials which may include continued progression through the actuarial examination process. </li><li>Supports actuarial presentations at meetings, conferences, and training sessions as requested.</li>The posting range for this position is: $103,677.00-$149,129.62 Qualifications Education <ul><li>Required Bachelor's Degree Actuarial Science, Mathematics, Statistics, or related field; or equivalent work experience</li></ul>Experience <ul><li>5+ Years actuarial experience, with multiple years in medical, dental, vision insurance, or other health related experience Required</li></ul> Knowledge Skills and Abilities <ul><li>Moderate health actuarial and related technical expertise in rating, underwriting, valuation, product development, trend analysis, forecasting, rate filings, financial statements, legislative analysis, policy development, and R&amp;D projects is required.</li><li>General understanding of data support systems and data requirements.</li><li>Ability to work effectively in multi-disciplinary team environment .</li><li>Excellent oral and written communication skills and the ability to present technical information to non-technical audiences</li><li>Ability to work in unfamiliar and potentially politically driven situations with limited data.</li><li>Demonstrated technical skills with the Microsoft Office Suite are required, including Microsoft Excel</li><li>Skilled in basic accounting and financial analysis.</li><li>Certifications &amp; Licenses </li><li>Required: Associate of the Society of Actuaries (ASA) - SOA</li></ul><ul><li>Extra Posting Information:Five years of actuarial experience, with multiple years in medical, dental, vision insurance, or other health related experience Experience in Access, SAS, SQL, Visual Basic, R, or other programming skills.</li></ul>#LI-Hybrid The posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Blue Cross Blue Shield Association

Associate Actuary

This full time role will be responsible for the Cloud, Infrastructure, Information Security project delivery execution. The role partners with leaders across business units to manage project execution. It oversees the software delivery methodology and aligns project leadership from internal or external sources to ensure successful delivery. The role may also serve as the Agile Release Train (ART) leader for significant projects or programs. It involves communicating with stakeholders, mitigating impediments, and managing issues and risks. Additionally, the role leads the project portfolio to achieve benefits and control not available from managing individual projects.<li>Leads and partners with business stakeholders, development teams, and vendors to establish and maintain the backlog through the Program Increment (PI) planning process.</li><li>Monitor feature execution, ensuring alignment with business objectives, manage dependencies and risks, and facilitate ART events. Drive feature readiness, and summarize Team PI Objectives into Program Objectives, and work to improve Agile adoption within the ART.</li><li>Agile Training, coach and mentor Scrum Masters, product owners, and teams on Agile practices. Promote a culture of continuous improvement within the AR.</li>The posting range for this position is: $131,908.00-$189,737.99 Qualifications Education <ul><li>Required Bachelor's Degree in Computer Science, Information Systems, Business Administration or equivalent work experience in similar work environment.</li></ul>Experience <ul><li>7+ Years experience managing software development projects including Agile experience Required</li></ul> Knowledge Skills and Abilities <ul><li>Effective team-oriented interpersonal skills.</li><li>Superior analytical skills to support quality decision making in support of the project or program.</li><li>Demonstrated political and interpersonal savvy</li><li>Ability to manage conflicts by reading situations quickly, identifying potential solutions and gaining cooperation with minimal disruption.</li><li>Ability to establish and maintain high level customer trust and confidence</li><li>Demonstrated development and maintenance of business relationships</li><li>Superior conceptualization skills to quickly grasp and understand business and architectural concepts and frameworks.</li><li>Outstanding organizational skills to manage and prioritize multiple tasks.</li><li>Ability to work independently, attention to detail and customer service orientation.</li><li>Outstanding communications skills, ability to effectively present concepts and issues for both business and technical audiences.</li></ul>Extra Posting Information:<ul><li>Expertise in managing complex project, with preferred experience in Cloud, Infrastructure, Information Security project management.</li><li>Proficient in managing work using a project management dispipline and methodologies.</li></ul>The posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Lead Agile Release Consultant (Cloud, Infrastructure, Information Security)

The hiring range for this role is: &nbsp;$155,000.00 - $175,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Synergie Medication Collective is a new medication contracting organization founded by a group of Blue Cross and Blue Shield affiliated companies to serve both Blues and select independent health plans. Synergie is focused on improving affordability and access to costly medical benefit drugs — ones that are injected or infused by a health care professional in a clinical setting — for nearly 100 million Americans. The Trade Client Strategy Director liaises with Synergie Participants and manages clinical policies to comply with manufacturer contracts, implements Trade strategies and initiatives, and collaborates with and supports Synergie’s Client Relations team for Trade related inquiries. This includes medical and pharmacy drug policies, cross benefit management, and rebate qualification for manufacturer contracts. This position will establish and maintain cross functional partnerships with internal teams to drive the identification, development and successful execution of Synergie’s rebate programs. This position will be the primary Trade point of contact for Synergie’s Participant facing activities and will support clinical decision making at the Participant level to comply with manufacturer contracts.Primary Job Functions<ul><li>Consult with Client Relations team on Trade related inquiries, initiatives, and opportunity pull through with Participants</li><li>Understands downstream impact of rebate and formulary strategy and can convey appropriate messaging to health plan participants for adoption of said strategies and policies</li><li>Has working knowledge of PBM operations and understanding of drug and UM strategy and policy implementation</li><li>Has experience in reading and interpreting pharmaceutical manufacturer drug contracts and understanding how to align terms and conditions and translate into UM policy and criteria</li><li>Manage medical and pharmacy clinical policies with Participants to ensure manufacturer contract compliance</li><li>Collaborate and support Client Relations team for Trade related inquiries from Participants</li></ul>Partner with the following stakeholders:<ul><li>Analytics Team – Collaborate on drug trends and utilization data to inform clinical policy decisions, medical policy and formulary compliance, drug share shift and utilization management strategies</li><li>Client Relations – Serve as Trade’s primary point of contact for all Participant questions on Trade initiatives and manufacturer contracts and escalate issues as needed to Trade’s leadership</li><li>Clinical Team – Liaise with Clinical team to review clinical data and policy requirements as needed </li><li>Invoicing Team – Maintain current library of Participant medical and pharmacy policies and support Invoicing team with manufacturer inquiries regarding clinical policies</li><li>Product Team – Provide medical policy support for manufacturer related contracts including, but not limited to, cell and gene therapies and other outcomes programs ​</li></ul>Education, Experience, and Certification<ul><li>Pharmacy degree and Pharm D. preferred</li><li>5-7 years of related work experience in healthcare, pharmacy benefit management (PBM), utilization management, pharmaceutical contracting, client relations, or analytical contracting</li><li>Must be eligible to work in the United States without need for work visa or residency sponsorship</li><li>Excellent verbal and written presentation skills</li><li>Ability to establish rapport and build relationships at all levels within an organization</li><li>Practical application of clinical data to drive financial value</li><li>Strong business and financial acumen, with advanced proficiency in Excel and PowerPoint</li></ul>Knowledge, Skills, and Abilities<ul><li>Pharmacy residency training or equivalent experience</li><li>Experience within the PBM industry, Medicaid, Medicare, and health plans</li><li>Experience with contract language and risk mitigation concepts</li></ul>Travel Requirements: Up to 10% of the time.Work is generally performed in a remote setting.#LI-Remote

Director Trade Client Strategy - Synergie Medication Collective

Job Description Summary: This role identifies and proactively develops policy recommendations that further the BCBS mission and drive solutions. Identifies and analyzes proposed regulatory and legislative initiatives at the federal and state level which present significant implications to BCBS Plans' members and clients. Identifies policy questions, advances meaningful policy solutions, and builds consensus with BCBS Plans and stakeholder allies on high-profile issues. Prepares formal comments regarding recommended policies and communicates key updates from BCBSA and federal/state policymakers to BCBS Plans. Leads BCBS Plan workgroups to advance corporate goals for assigned programs and/or issues. Works closely with BCBSA leadership to develop strategy around regulatory and legislative priorities for engagement with the White House, Administration, Congress and other key stakeholders in Washington. A strong knowledge of the Medicare Advantage program and Medicare payment systems required with the ability to demonstrate expertise in these areas and apply this knowledge to policy analysis and development.Responsibilities include but are not limited to:<ul><li>Leads the development of effective, consensus-based policy recommendations to promote BCBSA and BCBS Plan objectives at both state and federal levels. Manages the review of legislation and regulations to identify and provide feedback to policymakers and staff on strategic and business considerations. Develops advocacy documents to support these activities, including key messaging, one-pagers, and briefing materials. Provides policy support for coalitions, third-party inquiries and internal business partners on select focus areas. Brings forward new ideas and strategic thinking to promote BCBSA priorities and objectives.</li><li>Leads projects within assigned regulatory and legislative focus areas, including the identification of key business issues, legislative or regulatory analysis. Develops comment letters and resources for policymakers and educational materials for BCBS Plans. Produces bill summaries, policy analysis and memos on key issues and BCBSA positions for use by Plans. Leads BCBSA and Plan meetings to inform staff of key issues and actions taken by P&amp;A staff. Responsible for researching and developing responses to Plan inquiries.</li><li>Leads workgroup and related calls on focus areas. Identifies and communicates key regulatory and legislative activities to internal audiences, BCBS Plans and other external audiences. Collaborates with peers and others on BCBSA's business/operations team to support synchronized efforts to assess current landscape, identify opportunities for engagement for BCBSA leadership, and assist with implementing a forward-thinking, comprehensive, coordinated, strategy for assigned programs and/or issues.</li><li>Keeps up to date on legislative and regulatory positions and priorities, strategies, federal policymaking activities, external stakeholder positioning, and health care issues generally in order to maintain an understanding of key issues and strategies. May provide policy support to State Affairs team and work with state-based organizations (SBOs). Takes on various health policy projects as assigned.</li><li>Collaborates with BCBS Plan representatives, Policy and Advocacy staff and broader BCBSA staff. Engages with external stakeholders including federal policymakers and third-party representatives as appropriate.</li><li>Ensures senior management, senior leadership team and BCBS Plan representatives are informed as to pertinent legislative and regulatory developments.</li></ul>The posting range for this position is: $111,878.00-$160,925.77Required Education, Certifications and Experience:Education: <ul><li>Required Bachelor's Degree in Political Science, Public or Health Policy, Business or Public Administration; or equivalent work experience</li><li>Preferred Master's Degree in Health Policy, Public Policy, Health Administration, Public Heath or relevant subject</li></ul>Experience:<ul><li>7+ Years equivalent work experience Required</li></ul> Knowledge Skills and Abilities:<ul><li>Advanced knowledge of health care systems and understanding of legislative and policymaking process.</li><li>Strong communications skills; the ability to communicate effectively and persuasively, both orally and in writing</li><li>Strong planning and organizational skills</li><li>Strong human relations skills; and the ability to work with others in obtaining feedback/input, accomplishing goals, and meeting deadlines</li><li>Sophisticated/strategic thinking to determine how best to influence decision/policy makers</li><li>Comprehensive understanding of health policy issues and the legislative process, as well as experience with policy writing</li><li>Excellent interpersonal skills; demonstrated ability to develop and maintain relationships and influence outcomes</li><li>Excellent verbal and written communication skills, with the ability to identify issues and develop appropriate advocacy recommendations</li><li>Demonstrated ability to manage time and competing priorities</li></ul>Additional Preferred Experience:<ul><li>Experience working on one or more of the following Medicare Advantage policy areas: Stars program, Quality Bonus Payments, Medicare Advantage prescription drug plans, fraud, waste and abuse in Medicare, prior authorization processes and utilization management in Medicare, and telehealth policies.</li><li>Additional experience with Health insurance contracts and payment structures specific to Medicare Value-based care models and affordability initiatives in MedicarePolicy and legislative analysis related to Medicare regulations and legislation</li><li>Prior experience working for a health insurer, Congress, the Administration, or third-party stakeholders focused on Medicare programs is highly desirable. Experience working with public officials or in government is also valued.</li></ul>#LI_HYBRIDThe posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Legislative and Regulatory Senior Policy Program Manager (Medicare Advantage)

The hiring range for this role is: &nbsp;$230,000.00 - $250,000.00This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Synergie Medication Collective is a new medication contracting organization founded by a group of Blue Cross and Blue Shield affiliated companies to serve both Blues and select independent health plans. Synergie is focused on improving affordability and access to costly medical benefit drugs — ones that are injected or infused by a health care professional in a clinical setting — for nearly 100 million Americans. The Vice President, Trade Negotiator of Synergie Medication Collective, in collaboration with the Chief Trade Relations Officer and Head of Medical Trade Relations, will negotiate contracts and maintain relationships with pharmaceutical manufacturers for the GPO. The VP Trade Negotiator will have significant experience in negotiating contracts and relationship management with pharmaceutical manufacturers. The leader will work to leverage the assets that currently exist within the Blue System and through the leadership and management of a larger organization to maximize scale in support of driving better costs for members. This position will report to the Head of Medical Trade Relations and will be a critical member of the executive leadership team. This initiative is nothing less than transformative, with the goals of positioning the BCBS health plans to deliver on the quadruple aim in health care (service, access, quality, and affordability). We are looking for someone passionate about transforming health care, building, and growing an organization and collaborating on future innovation.Responsibilities include but are not limited to:<ul><li>Lead and manage high-stakes negotiations with pharmaceutical manufacturers, wholesalers, and other suppliers to secure favorable terms and pricing including VBA’s and cell and gene therapies</li><li>Develop and implement comprehensive negotiation strategies that align with the organization's goals and objectives.</li><li>Build and maintain strong relationships with key stakeholders, including suppliers, manufacturers, and internal teams.</li><li>Analyze market trends, pricing data, and competitive intelligence to inform negotiation strategies and decisions.</li><li>Collaborate with cross-functional teams, including legal, finance, and operations, to ensure successful contract execution and compliance.</li><li>Monitor and evaluate the performance of negotiated agreements, making adjustments as necessary to optimize outcomes.</li><li>Provide leadership and mentorship to the negotiation team, fostering a culture of excellence and continuous improvement.</li><li>As a leader, partner with Synergie teams to develop, review, and align strategies and negotiate with pharmaceutical manufacturers; collaborate on rebate bid analysis and rebate agreement process to ensure alignment with corporate goals, performance standards and expected outcomes</li><li>Partner with the Head of Trade Relations and Chief Trade Relations Officer in the development and implementation of strategic initiatives and collaborate with key internal teams to create program/product value to clients, members, providers, and pharmaceutical manufacturers</li><li>Work closely with Synergie teams, related to medical policy and drug list development, pharmaceutical manufacturer programs and contracts, and ongoing evaluation of drug therapy classes for rebate and other financial opportunities; ensure effective communication and strategic collaboration within GPO</li><li>Represent Synergie’s objectives and perspective to external partners (i.e., pharmaceutical manufacturers, clients, others) and communicate to ensure understanding of mutual objectives</li><li>Ensure manufacturers’ products are brought forth internally to evaluate rebate and management opportunities for Synergie’s business</li><li>Serve as a department resource for escalated client issues, contract analysis, and contract language needs in rebate contracting</li><li>Represent Trade Relations on committees to identify net-cost effective policy opportunities; support client alignment and adoption of strategies; assure communication with committee members</li><li>Other duties as assigned</li></ul>Required Education, Certifications and Experience:<ul><li>Bachelor’s degree in business, healthcare management or other related field of study or equivalent combination of education and/or related work experience; HS diploma or GED is required</li><li>10-15 years of related work experience in pharmacy benefit management (PBM), pharmaceutical payer contracting, and/or analytical contracting.</li><li>Must be eligible to work in the United States without need for work visa or residency sponsorship.</li><li>Excellent verbal and written presentation skills</li><li>Ability to establish rapport and build relationships at all levels within an organization</li><li>Expert negotiation and influencing skills</li><li>Strong business and financial acumen, with advanced proficiency in Excel and PowerPoint</li></ul>Preferred Qualifications:<ul><li>MBA, other graduate work, or equivalent training and/or experience</li><li>Experience within the PBM industry, Medicaid, Medicare, and health plans</li><li>Experience with contract language and risk mitigation concepts</li></ul>Minimum Physical Job Requirements:<ul><li>Ability to travel up to 25% of the time</li><li>Constantly required to sit, use hands to handle or feel, talk and hear</li><li>Frequently required to reach with hands and arms</li><li>Occasionally required to stand, walk and stoop, kneel, and crouch</li><li>Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds</li><li>Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus</li></ul>Reporting Structure:<ul><li>Reports to the Chief Trade Relations Officer</li></ul>#LI-Remote

Vice President, Trade Negotiator - Synergie Medication Collective

This role leads and executes strategic data initiatives to enhance reporting capabilities and deliver actionable insights for internal stakeholders and BCBS Plans. The incumbent designs and manages data-driven solutions that align with organizational goals, improve operational efficiency, and support decision-making across departments.<li>Leads projects to develop and enhance reporting tools and the underlying data that supports them. Develops service design concepts and policy and technical operational components. Develops process documents and executes implementation plans.</li><li>Designs analytic approaches and analyzes data from various sources, both internal and external, to contribute to design and enhancement of reporting needs. Analyzes business issues to develop methodologies, solutions and communication materials to improve reporting services.</li><li>Facilitates Plan and internal workgroups to develop consensus on goals and processes. Obtains Plan input for business requirements and development issues. Interacts with internal and Plan staff, building productive relationships</li><li>Summarizes the results of analyses in reports, notes, manuals, spreadsheets and charts and develops presentation slides. Contributes significantly to process documentation and summary white papers.</li><li>Facilitates and conducts communications of new initiatives, requirements, and opportunities. Presents findings to internal and Plan staff; participates in/leads project team discussions of the conclusions and direction of analytical work</li>The posting range for this position is: $112,443.00-$161,738.53 Qualifications Education <ul><li>Required Bachelor's Degree or equivalent work experience</li></ul>Experience <ul><li>7+ Years experience in data analysis and business operations Required</li></ul> Knowledge Skills and Abilities <ul><li>Ability to prepare project work plans and work product assignments in mid-sized projects (budget and resources) and portions of projects Strong analytical and reporting skills Excellent written and verbal communications skills Strong relationship-building skills Demonstrated ability to lead portions of client presentations and make presentations to internal staff members.</li><li>Experience in data analysis and business operations. Experience in identifying data/information needs; acquiring and organizing data, delivering analysis and identifying major findings. Experience in leading data gathering activities, framing problems and guiding construction of survey instruments.</li></ul>#LI-Hybrid The posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Data Intelligence Specialist

This role provides advanced analytical support for clinical market strategy through statistical modeling, valuation, and trend analysis. It contributes to strategic decision-making by developing and implementing models that assess market dynamics and opportunities. The role is highly technical and operates independently, collaborating with internal stakeholders and national peers<ul><li>Data Synthesis &amp; Reporting</li><li>Extract and synthesize data from literature and internal sources to support strategic assessments.</li><li>Prepare clear, concise reports and visualizations using R, Python, and SQL Communicate findings effectively to senior leadership and cross-functional teams.</li><li>Clinical Market Modeling &amp; Analysis</li><li>Develop and apply mathematical, statistical, and econometric models to evaluate clinical market trends and opportunities.</li><li>Incorporate time-value of money and probabilistic forecasting into market segmentation and valuation.</li><li>Conduct comparative analysis of modeling methodologies and assess risk and volatility.</li><li>Technical Execution</li><li>Maintain and update datasets using backend Linux scripts and SQL queries.</li><li>Ensure data integrity and reproducibility of modeling outputs.</li><li>Contribute to the development of reusable frameworks and protocols for future analytics.</li></ul>The posting range for this position is: $113,008.00-$162,551.28 Qualifications Education <ul><li>Required Bachelor's Degree ; or equivalent experience</li><li>Preferred Doctorate in Mathematics, Econometrics, or Statistics; or equivalent experience</li></ul>Experience <ul><li>7+ Years program management experience in a complex environment requiring multiple deliverables and timelines Required</li></ul> Knowledge Skills and Abilities <ul><li>Technical Skills</li><li>Advanced proficiency in R and Python for modeling and visualization.</li><li>Skilled in SQL for data manipulation and extraction.</li><li>Familiarity with Linux scripting for data operations.</li><li>Ability to create mathematical and statistical models for hypothesis testing and machine learning, including non-linear, dynamic, and stochastic models.</li><li>Demonstrated ability to edit complex economic and market reports, to achieve technical accuracy, clarity of expression and consistency of presentation and style. Other skills</li><li>Demonstrates creative thinking and adaptability to manage increasing volume and complexity of workload and variety of users.</li><li>Demonstrated ability to lead quantitative analysis in order to deliver on multiple product lines.</li><li>Demonstrated ability to manage divergent deliverables with overlapping timetables in a fast-paced business setting</li><li>Extra Posting Information:</li><li>Minimum 7 years of program management experience in a complex environment requiring multiple deliverables and timelines. Experience with mathematical and statistical analytic software, including Stata and Mathematica. Experience engaging with national peers skilled in mathematical and statistical modeling.</li></ul>#LI-Hybrid The posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Health Care Data Lead Analyst

Job Description Summary: This role is responsible for developing and executing BCBSA's policy research agenda and supporting the deep development and rich analysis of policy solutions. This role bridges data-centered insights and advocacy, ensuring that policy research and strategy support lobbying, communications and public affairs efforts – all with the ultimate goal of driving adoption of our solutions with policymakers.Responsibilities include but are not limited to: ​<ul><li>Strategic Policy Leadership<ul><li>Directs short- and long-term strategic planning aligned with BCBSA’s mission and advocacy goals, including environmental scanning, forecasting, and impact analysis.</li><li>Collaborates with senior leadership and cross-functional policy and advocacy teams to identify emerging issues, assess risks and opportunities, and develop actionable solutions.</li><li>Leads the creation and execution of advocacy action plans, ensuring alignment with legislative, regulatory, and health policy priorities.</li><li>Facilitates engagement and consensus-building with Plans, executives, committees, and cross-organizational teams to unify BCBSA’s policy positions.</li></ul></li></ul><ul><li>Policy Research, Data, and Evaluation<ul><li>Oversees the design and execution of high-impact research initiatives, including micro-simulation modeling, internal and external data analysis, and publication of white papers, blogs, and policy briefs.</li><li>Leverages BCBSA’s proprietary data assets to generate insights that inform policy development and advocacy strategies.</li><li>Leads the Blue Cross Blue Shield Center for Policy Research, translating complex data into actionable insights for policymakers, partners, and media on key issues such as affordability, coverage, public programs, drug pricing, and market dynamics.</li></ul></li></ul><ul><li>Policy and Research Promotion<ul><li>Engages with congressional offices, federal agencies, and state-based organizations to advance advocacy goals through evidence-based research.</li><li>Partners with communications and public affairs to represent BCBSA in media interviews, op-eds, and public forums, amplifying policy solutions and research findings.</li><li>Builds strategic alliances with research institutions to enhance BCBSA’s credibility and influence in the policy research community.</li></ul></li></ul><ul><li>Team and Operational Leadership<ul><li>Manages a multidisciplinary team of researchers and policy analysts, fostering collaboration and professional development.</li><li>Coordinates with finance, procurement, and executive leadership to oversee budgets, contracts, external consultants, and project reporting.</li></ul></li></ul>The posting range for this position is: $196,194.00-$300,296.36Required Education, Certifications and Experience: Education:<ul><li>Required Bachelor's Degree in Political Science, Public Administration, Public Policy or a related field; or equivalent experience</li><li>Preferred Master's Degree in Political Science, Public Administration, Public Policy or a related field.</li></ul>Experience:<ul><li>12+ Years in a related government relations environment, preferably in a healthcare organization, reflecting progressively responsible roles and demonstrating knowledge and understanding of the federal marketplace and the political and legislative environment and processes. Required</li></ul> Knowledge Skills and Abilities:<ul><li>Innovative thinker with ability to leverage data assets to advance strategy and policy initiatives.</li><li>An understanding of the healthcare marketplace and industry is essential, as is an understanding of how the related federal regulatory and legislative issues could impact BCBS business strategies.</li><li>Requires excellent oral and written communications skills with the capabilities to negotiate, persuade, and make effective presentations to varying audiences internal and external to BCBSA.</li><li>A high level of executive presence for interacting with and influencing key leadership.</li><li>Excellent interpersonal skills for building and fostering key relationships.</li><li>Must be able to effectively represent BCBS in various forums and with various audiences.</li><li>The ability to establish credibility and drive decisions and results while balancing considerations/priorities is critical.</li><li>Applies judgment and critical thinking skills to problem analysis/resolution at both the strategic and functional levels.</li><li>Must have demonstrated leadership skills relative to staff management and achieving results through others.</li><li>Ability to confidently and credibly interact with Plan senior management, Members of Congress (including House and Senate Leadership, Committee Chairs), external consultants, industry experts, and other health policy resources/audiences.</li></ul>#LI_HYBRIDThe posted salary range is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

Senior Director, Policy Strategy and Research

The hiring range for this role is: &nbsp;142,690.17 - 219,876.89This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Job Description Summary The Data Governance and Emerging Technologies Counsel partners across the organization to provide legal and strategic guidance on initiatives involving data use, privacy, and advanced technologies such as artificial intelligence, machine learning, and analytics. This role supports legal team efforts related to data governance, regulatory compliance, intellectual property, and risk management strategies associated with emerging technologies. The position also engages with attorneys and business teams from affiliated health plans to support the implementation and operational oversight of data use practices across the broader system.Responsibilities include but are not limited to:<ul><li>Identify and assess legal risks for moderately complex matters for assigned practice area with minimal supervision and direction. Assigned practice area may include one or more of the following litigation, special investigations, legal operations, healthcare/regulatory law, contracts, etc.</li><li>Builds knowledge of the business context</li><li>Performs routine legal work.</li><li>Handles moderately complex legal questions and projects.</li></ul>Required Education, Certifications and Experience:Education:<ul><li>Required Juris Doctor</li></ul>Experience:<ul><li>5+ Years legal practice experience Required</li></ul> Knowledge Skills and Abilities:<ul><li>Proficient written and oral communication skills</li><li>Proficient organizational and project management skills, including follow through skills</li><li>Strong legal research, analysis and drafting</li><li>Problem solving skills</li><li>Preferred knowledge of healthcare insurance industry, including state and federal regulatory environment</li></ul>Certifications &amp; Licenses:<ul><li>Required: Bar Admission - Various</li></ul> Additional experience preferred:<ul><li>Legal practice experience, practice experience in contracts, corporate law, health law, HIPAA/privacy, litigation, and/or health insurance law</li></ul>#LI_HYBRID

Associate General Counsel, Data and Emerging Technologies

The hiring range for this role is: &nbsp;173,188.05 - 283,639.61This is the lowest to highest salary we, in good faith, believe we would pay for this role at the time of this posting.&nbsp; We may ultimately pay more or less than the hiring range andthis hiringrange may also be modified in the future. A candidate’s position within the hiring range may be based on several factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, shift, travel requirements, and business or organizational needs.&nbsp;This job is also eligible for annual bonusincentivepay.We offer a comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, generous 401(k) matching, lifestyle spending account and many other benefits to eligible employees.Note: No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable. The amount and availability of any bonus, commission, or any other form of compensation that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.Job Description Summary: The Compliance and Privacy Official is responsible for providing strategic direction and oversight for the organization's corporate compliance and privacy programs, ensuring alignment with evolving healthcare regulations, industry standards, and internal policies. As a key advisor to executive leadership, the Board of Directors, and governance committees, the role fosters a culture of ethics, accountability, and transparency across the enterprise. The Compliance and Privacy Official leads a team of compliance and privacy professionals, driving continuous improvement and operational excellence. This role is critical for risk mitigation, regulatory readiness, and the development of policies and practices that safeguard patient and organizational data.Responsibilities include but are not limited to:<ul><li>Privacy Program Leadership<ul><li>Oversee the organization’s Privacy Program, including HIPAA and GDPR compliance.</li><li>Lead cross-functional efforts to investigate and resolve privacy incidents.</li></ul></li></ul><ul><li>Corporate Compliance Oversight<ul><li>Manage the Compliance and Ethics Program, including the Code of Business Conduct and annual reporting to leadership and the Board.</li><li>Address compliance issues in collaboration with internal stakeholders.</li></ul></li></ul><ul><li>Government Programs Compliance<ul><li>Serve as the subject matter expert for Medicare Part D and other government program compliance.</li><li>Chair the MPDP Compliance Committee and report findings to senior leadership.</li></ul></li></ul><ul><li>Team Leadership<ul><li>Lead and develop a high-performing compliance and privacy team, fostering professional growth and a positive, inclusive work environment.</li></ul></li></ul><ul><li>Systemwide Engagement<ul><li>Promote best practices and coordinate incident response efforts across the system.</li></ul></li></ul><ul><li>Training &amp; Education<ul><li>Oversee compliance and ethics training programs for Blue Plan Compliance leaders.</li></ul></li></ul>Required Education, Certifications and Experience: Education:<ul><li>Required Bachelor's Degree or equivalent work experience</li><li>Preferred Master's Degree in Law; Business Administration; or equivalents</li></ul>Experience:<ul><li>12+ Years Experience in the healthcare industry with demonstrated knowledge of regulatory, privacy (HIPAA), and compliance and ethics issues Required</li></ul> Knowledge Skills and Abilities:<ul><li>Proven ability to lead teams, drive organizational change, and influence cross-functional initiatives in complex environments.</li><li>Deep understanding of healthcare compliance, privacy program administration, and data security technologies, including HIPAA and GDPR.</li><li>Strong capability to assess regulatory and operational risks and develop effective mitigation strategies.</li><li>Excellent analytical skills with sound business judgment, creativity, and initiative to solve complex problems.</li><li>Advanced interpersonal and communication skills, including experience facilitating training and presenting to executive leadership and governance bodies.</li><li>Ability to build and maintain credible relationships with internal and external stakeholders, including senior executives and board members.</li><li>Skilled in strategic project planning and execution, with the ability to remain composed and tactful under pressure.</li><li>Competent in Microsoft Office applications and other relevant compliance and privacy tools. Understanding of data security technologies and privacy program administration</li></ul>Certifications &amp; Licenses:<ul><li>Preferred: Licensed Attorney (varies by state) - Various</li><li>Preferred: Professional, Academy for Health Care Management (PAHM) - AHIP</li><li>Preferred: Certified Information Privacy Professional (CIPP) - IAPP</li></ul>Additional Information:<ul><li>Minimum twelve years' experience in the healthcare business arena with demonstrated knowledge of current regulatory and compliance and ethics issues, including knowledge of and experience working with Centers for Medicare and Medicaid Services/Medicare compliance requirements.</li><li>Experience managing privacy programs subject to healthcare laws and regulations, including HIPAA</li><li>Must have at least one year of experience managing privacy programs subject to healthcare laws and regulations, and a proven track record of leading and implementing regulatory compliance initiatives.</li><li>Direct experience with CMS/Medicare compliance requirements is required.</li><li>Proven record in leading and implementing regulatory compliance programs</li></ul>#LI_HYBRID

16 Blue Cross Blue Shield Association Jobs