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Principal Business Operations Advisor

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BlueCross BlueShield of North Carolina
πŸ“ Remote Flex, United States
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Location Remote Flex
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Posted June 21, 2026
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Commute Local Area
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Job Description

**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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πŸ“ Location Details

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City
Remote Flex
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Country
United States
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Commute
Local Area

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