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⏰ Full-time

Principal Business Operations Advisor

BlueCross BlueShield of North Carolina
Location 📍 Remote Flex, United States
Posted 📅 June 17, 2026
Work Type ⏰ Full-time

Position Overview

**Job Description**

Payment Integrity Ideation Lead - Drives the creation of new audit concepts, data models, and reimbursement policies to reduce overpayments. They leverage AI, vendor intelligence, claims data, and policy analysis to generate new savings opportunities and shift post-pay claim rework to proactive, pre-pay claim accuracy.

Provides oversight and coordination of departmental strategic planning, business and workforce plan development, business relationship management, reporting, data and/or budget analysis and special projects as assigned.

**What You Will Do**

+ Create new recurring and ad-hoc concepts to identify cost avoidance/overpayment opportunities using large data sets on multiple variables. Provide data, analysis and recommendations to management on all findings affecting payments; including policy, contract issues, provider errors, pricing, systems and claim processes.
+ Integrates deep data analysis and modeling analyze co...

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Job Details

Employment Type
Full-time
📊
Category
other-general
🏠
Work Arrangement
On-site
📍
Location
Remote Flex, United States