About the role
Job Description
Under general supervision and utilizing solid functional/technical area knowledge of relevant systems/applications, the incumbent defines, evaluates, and validates requirements, business functional design, and technical design for small to moderately complex business issues within their domain areas. They act as a liaison representing their department and the processes and workings within it to develop effective technical solutions and minimize operational and system/application impacts. Supports IT with problem resolution, testing, software upgrades and related projects as needed.What You'll Do
Technical Support/Business Expertise
Provide technical knowledge and support in operational system/application and procedural issues to the business and IT and help the business find technical solutions to meet their goals.
Work in some phases of systems analysis and consider the business implications of the application of technology to the current business environment
Provide ongoing user support for ad hoc questions, inquiries, and service requests.
Provide timely and accurate reporting/data on inventory, productivity, user activity, and system performance on a regular and/or as requested basis.
Issue Resolution
Resolve medium, moderately complex production issues by:
Performing initial triage for severity and business impact of system/application failures.
Troubleshooting and analyzing to determine root cause of issues
Developing applicable business processes and solutions to ensure quality, cost effectiveness, timeliness of customer service, and regulatory requirements and mandates are met.
Coordinating with IT, other teams and vendors as needed to communicate issues and devise and implement long term remedies.
Develop system support processes with IT; coordinate daily to resolve production support issues, including application failures and user errors; document, track and report all system support activities
Project/Program Support
Work collaboratively on projects and initiatives with the business and IT by eliciting and documenting business requirements and preparing appropriate functional specifications while considering technical capabilities of the system/application.
May act as Business Lead/Coordinator on moderate single area/department projects.
Business Testing
Coordinate testing plans with Business area and IT
Serve as point of contact for business testing activities and ensure testing will appropriately meet business requirements
Document and may, in some cases, execute test plans and scenarios
Analyze and verify testing results for accuracy, relevance and completeness
Provide impact assessments and make assist in formulating recommendations to the business owner regarding issues, risks, etc.
Assist IT with hardware and software upgrades, security changes, and architectural enhancements as needed.
System Configuration
Configure and maintain moderately critical system tables and data elements across multiple system environments
Analyze, develop and implement configuration changes to improve system performance and user efficiency
Monitor configuration for accuracy and compliance to change control processes.
What You Have
Bachelor's degree or advanced degree (where required)
3+ years of experience in related field.
In lieu of degree, 5+ years of experience in related field.
Bonus Points
Experience working with Facets claims, including creating, processing, researching, and validating claim outcomes.
Strong SQL skills, including querying, validating, and analyzing data across multiple tables.
Experience working with complex Excel workbooks, including large data sets, formulas, and macro-enabled files, with the ability to navigate and update content accurately without disrupting workbook functionality.
Exposure to or working knowledge of CGS+ and its role in claims processing, configuration, testing, or operational support.
Healthcare industry experience strongly preferred
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
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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JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.
Aplyr's read
Blue Cross and Blue Shield of North Carolina is a key player in health insurance, attracting professionals committed to improving healthcare access and quality in the state.
What's promising
- •Strong focus on improving healthcare access and quality in North Carolina.
- •Diverse range of roles from actuarial analysis to strategic advisory.
- •Commitment to value-based care and innovative health solutions.
What to watch
- •Limited public information about work-life balance and company culture.
- •Potential challenges in navigating complex healthcare regulations.
- •Dependence on state-specific market could limit broader career opportunities.
Why Blue Cross and Blue Shield of North Carolina
- •Exclusive focus on North Carolina allows for tailored healthcare solutions.
- •Emphasis on value-based care sets it apart in the insurance industry.
- •Offers specialized roles that align with healthcare innovation and strategy.
Aplyr’s read is generated by AI from public sources. Was it useful?
About Blue Cross and Blue Shield of North Carolina
Blue Cross NC is a health insurance provider that offers a variety of health plans and services to individuals, families, and businesses in North Carolina.
