Qureos Mentor

Blue Cross and Blue Shield of North Carolina

<div></div><div>We're seeking a Senior Episodic Care Manager to join our Behavioral Health Team! The Senior Episodic Care Manager - Behavioral Health Autism Services utilizes advanced knowledge and experience in utilization management and medical reviews to perform varied senior-level functions for the department. Drives operational efficiencies, works with internal and external partners for care coordination, and provides input to valuable Utilization Management (UM) initiatives that support the delivery of high quality and cost-effective care across the health care system.<div></div><div>
What You'll Do</div><ul><li><div>
Support member care coordination and departmental goals by performing Perform clinical evaluation and review of various member services for prior authorization or transition of care needs as needed to meet departmental goals</div></li><li><div>
Act as a subject matter expert to support clinical UM staff as first point of contact with process, business, and/or clinical questions.</div></li><li><div>
Serve as point of contact for internal stakeholders to provide expertise on utilization management related to discharge planning, the review of sales documents and benefit booklets, and/or other project/initiative support.</div></li><li><div>
Apply significant expertise in discharge planning and utilization management to expedite the coordination of services and equipment and facilitate safe and effective discharge plans for our members.</div></li><li><div>
Provide precepting support and mentorship to new hires and/or those needing refresher assistance.</div></li><li><div>
Serve as co-trainer for in-services</div></li><li><div>
Create and maintain relevant desktop procedures or process documentation.</div></li><li><div>
Provide system and project testing support as needed.</div></li><li><div>
Support team effectiveness through management of UM queues and work assignments.</div></li><li><div>
May provide coverage for representation on projects in place of leadership as needed due to other priorities.</div></li></ul><div></div><div>
What You Bring</div><ul><li><div>
BCBA with at least 3 years experience in clinical work</div></li><li><div>
Additional direct experience in utilization management, with demonstrated success in the ECM role, meeting or exceeding metrics and quality goals.</div></li><li><div>
Proven expertise in UM functions, and processes and/or discharge planning.</div></li><li><div>
Must have a valid BCBA license within the US and have started application for NC license.</div></li></ul><div></div><div>
What You&rsquo;ll Get</div><div>
The opportunity to work at the cutting edge of health care delivery with a team that&rsquo;s deeply invested in the community</div><ul><li><div>
Work-life balance, flexibility, and the autonomy to do great work</div></li><li><div>
Medical, dental, and vision coverage along with numerous health and wellness programs</div></li><li><div>
Parental leave and support plus adoption and surrogacy assistance</div></li><li><div>
Career development programs and tuition reimbursement for continued education</div></li><li><div>
401k match including an annual company contribution</div></li></ul><div></div><div>
Salary Range</div><div>
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.</div><div></div><ul><li><i>Based on annual corporate goal achievement and individual performance.</i></li></ul><br>
$81,068.00 - $129,708.00<div></div><div>
Skills</div>
Clinical Decision Support (CDS), Clinical Evaluations, Clinical Experience, Clinical Support, Medical Review, Medication Management, Patient Advocacy, Patient Care Coordination, Patient Discharge Planning, Patient Education<div>
_____________________________________________________________________<br>
<br>
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 <div>https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC</div>. 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: <div>HR.Staffing@BCBSNC.com</div>.</div></div>

Senior Episodic Care Manager - Behavioral Health Autism Services

<div></div><div>Blue Cross NC is hiring a Principal Financial Advisor to provide senior leaders with financial analysis, strategic guidance, and actionable insights. The role leads cross-functional collaboration, supports company strategy and financial goals, and partners with business units to solve problems and achieve results.<div></div><div>
What You&rsquo;ll Do</div><ul><li><div>
Works directly with staff and senior leadership across the company to proactively identify, prioritize, optimize and implement financial strategies and create meaningful and actionable outputs that drive the development of multi-year financial plans aligned to the company&rsquo;s overall strategic goals</div></li><li><div>
Proactively identify, evaluate, and implement financial strategies and plans, leveraging customer and consumer insights to drive business outcomes and maximize ROI, reducing risk and exposure and enable Blue Cross NC to meet growth and cost containment goals.</div></li><li><div>
Supports the development of corporate strategic positions on behalf of senior leadership and represents those positions internally and externally including financial modeling and development of executive presentations</div></li><li><div>
Builds and manages relationships and collaborates with both internal and external partners to drive highly complex financial analyses focused on significant business strategies and opportunities with substantial levels of importance and visibility</div></li><li><div>
Leads annual and long-term financial planning efforts and analyses; provides thought leadership at a divisional, cross-divisional, and enterprise level; prepares and presents results to executive leadership.</div></li><li><div>
Drives financial innovation and stewardship through collaboration and consultation with internal stakeholders to identify, plan and execute initiatives with significant financial impact. Partners with internal clients to better understand what problems they are trying to solve, help them articulate their vision and define financial impacts and success. Provides methods and resources to support their execution of those plans and quantification and realization of benefits</div></li><li><div>
Utilizes expertise to identify operational improvements and leads the development of new ideas to understand, estimate and minimize the financial impact of existing or emerging issues the business faces. Evaluates those ideas to determine viability and opportunity for success and follows through from implementation to value realization.</div></li></ul><div></div><div>
What You Bring</div><ul><li><div>
Bachelor's degree or advanced degree (where required)</div></li><li><div>
8+ years of experience in related field</div></li><li><div>
In lieu of degree, 10+ years of experience in related field</div></li></ul><div></div><div>
Bonus Points</div><ul><li><div>
Experience with Adaptive Planning and Workday - Highly Preferred</div></li><li><div>
Experience in Capital/Risk based modeling &ndash; Highly Preferred</div></li></ul><div><br>
</div><div>What You&rsquo;ll Get</div><ul><li><div>
The opportunity to work at the cutting edge of health care delivery with a team that&rsquo;s deeply invested in the community</div></li><li><div>
Work-life balance, flexibility, and the autonomy to do great work</div></li><li><div>
Medical, dental, and vision coverage along with numerous health and wellness programs.</div></li><li><div>
Parental leave and support plus adoption and surrogacy assistance</div></li><li><div>
Career development programs and tuition reimbursement for continued education</div></li><li><div>
401k match including an annual company contribution</div></li><li><div><div>
Learn more</div></div></li></ul><div></div><div>
Salary Range</div><div>
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.</div><div></div><ul><li><i>Based on annual corporate goal achievement and individual performance.</i></li></ul><br>
$107,901.00 - $172,642.00<div></div><div>
Skills</div>
Finance, Finance Strategy, Financial Advising, Financial Analysis, Financial Execution, Financial Planning and Analysis (FP&amp;A), Operational Process Improvements, Portfolio Management, Process Improvements, Resource Management, Strategic Planning, Strategic Thinking, Strategy Development, Wealth Management<div>
_____________________________________________________________________<br>
<br>
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 <div>https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC</div>. 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: <div>HR.Staffing@BCBSNC.com</div>.</div></div>

Principal Financial Advisor

<div></div><div>Join our Compensation team and help shape pay programs that support our people and business strategy. In this role, you&rsquo;ll partner with HR and leaders to bring data-driven insights to compensation decisions, strengthen internal equity, and keep us competitive in the market. You&rsquo;ll play a key role in market pricing, job evaluation and job description review, salary structure maintenance, and annual salary planning (common review), while supporting governance, audits, and continuous process improvement.<div></div><div>
What You'll Do</div><ul><li><div>
Provide compensation consultation to HR and leaders, applying compensation philosophy, policies, and guidelines to support pay decisions (hiring, promotions, transfers, and other pay actions).</div></li><li><div>
Conduct market pricing using salary surveys and other sources; analyze competitive data, recommend range placement, and pay targets aligned to internal equity and market position.</div></li><li><div>
Support job evaluation/classification and job description reviews, including FLSA considerations, and recommend updates to job profiles and related documentation.</div></li><li><div>
Support annual salary planning (common review) by preparing job/employee data inputs, manager tools, communications, testing, troubleshooting, and post-cycle reporting.</div></li><li><div>
Maintain compensation process governance and controls, including documentation, data integrity checks, and coordination of approvals.</div></li><li><div>
Develop and deliver compensation analytics and reporting (e.g., distribution analysis, equity reviews, range penetration/compa-ratio, and survey trend summaries) to inform recommendations.</div></li><li><div>
Support compliance and audit requests by maintaining required documentation and helping interpret and apply pay-related laws and regulations.</div></li><li><div>
Stay current on compensation trends and survey methodology; contribute to continuous improvement of tools, processes, and communications.</div></li></ul><div></div><div>
What You Give</div><ul><li><div>
Bachelor&rsquo;s degree (or equivalent experience).</div></li><li><div>
3+ years of experience in compensation, HR, or a related analytical field (or 5+ years in lieu of a degree).</div></li><li><div>
Working knowledge of compensation fundamentals, including market pricing, salary ranges/structures, and pay-for-performance concepts.</div></li><li><div>
Strong analytical skills with the ability to translate data into clear insights and recommendations for non-technical audiences.</div></li><li><div>
High attention to detail and comfort working with confidential information.</div></li><li><div>
Ability to manage multiple priorities and deadlines in a cycle-driven environment (e.g., salary planning).</div></li></ul><div></div><div>
Bonus Points</div><ul><li><div>
Experience with salary survey tools and job evaluation methods.</div></li><li><div>
Advanced Excel skills (pivot tables, formulas, data modeling); experience with HRIS and compensation planning tools.</div></li><li><div>
Experience building dashboards or reports (e.g., Power BI or similar).</div></li><li><div>
CCP or other compensation-related certification (or progress toward certification).</div></li></ul><div></div><div>
What You&rsquo;ll Get</div><ul><li><div>
The opportunity to work at the cutting edge of health care delivery with a team that&rsquo;s deeply invested in the community</div></li></ul><ul><li><div>
Work-life balance, flexibility, and the autonomy to do great work</div></li></ul><ul><li><div>
Medical, dental, and vision coverage along with numerous health and wellness programs</div></li></ul><ul><li><div>
Parental leave and support plus adoption and surrogacy assistance</div></li></ul><ul><li><div>
Career development programs and tuition reimbursement for continued education</div></li></ul><ul><li><div>
401k match including an annual company contribution</div></li></ul><ul><li><div><div>
Learn more</div></div></li></ul><div>
Why This Role Matters<br>
Compensation decisions impact every employee experience moment&mdash;from joining the organization to growing a career. This role helps ensure our programs are equitable, compliant, and competitive, and that leaders have the insights and tools they need to make consistent, well-governed pay decisions.</div><div></div><div>
Salary Range</div><div>
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.</div><div></div><ul><li><i>Based on annual corporate goal achievement and individual performance.</i></li></ul><br>
$73,698.00 - $117,917.00<div></div><div>
Skills</div><div>
_____________________________________________________________________<br>
<br>
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 <div>https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC</div>. 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: <div>HR.Staffing@BCBSNC.com</div>.</div></div>

Compensation Advisor

<div></div><div>Dependent on clinical discipline, the Case Manager / Health Coach coordinates appropriate care, resources and/or services of selected member populations. Provides guidance and promotes effective utilization and monitoring of health care resources to drive quality care for our members. Collaborates as needed with varied members of the healthcare team to achieve optimal clinical and/or resource outcomes.<div></div><div>
What You'll Do</div><div></div><ul><li>Serve as a team member on a multidisciplinary team, coordinating care, resources and/or services for members to achieve optimal clinical and resource outcomes.</li><li>Utilize applicable clinical skillset and perform comprehensive assessments to determine how to best collaborate with members, family, internal partners and external services/providers on plans for treatment, appropriate intervention and/or discharge planning.</li><li>Develop a member-centric plan tailored to members&rsquo; needs, health status, educational status and level of support needs; identify barriers to meeting goals or plan of care</li><li>Utilize community resources and funding sources as needed in the development of the plan of care.</li><li>Perform ongoing monitoring and management of member which may include scheduled follow-up with member, discussion of plan with member, appropriate services/education to address needs, appropriate referrals with supporting documentation, assessment of progress towards goals, modification of plan/goals as needed, with contact frequency appropriate to member acuity.</li><li>Evaluate and facilitate care provided to members through the continuum of care (physician office, hospital, rehabilitation unit, skilled nursing facility, home care, etc).</li><li>Educate members and encourage pro-active intervention to limit expense and encourage positive outcomes</li><li>Effectively document all aspects of the plan from the initial assessment, development of the plan, implementation, monitoring, and evaluating outcome.</li><li>May outreach directly to members identified as high risk, high cost, or high utilization cases.</li><li>May review alternative treatment plans for case management candidates and assess available benefits and the need for benefits exception or flex benefit options, where eligible.</li><li>May evaluate medical necessity and appropriateness of services as defined by department.</li><li>As needed, develop relevant policies/procedures, education or training for use both internally and externally.</li></ul><div><br>
What You'll Bring</div><div></div><ul><li>RN with 3 years of clinical and/or case management experience required</li><li>Must have and maintain a valid and applicable clinical license (NC or compact multi-state licensure) to perform described job duties</li><li>For some roles, additional specialty certification (i.e. CCM, CDCES) may be required. If so, incumbents must obtain relevant certification within 2 years of employment</li></ul><div></div><div>
What You&rsquo;ll Get</div><ul><li>
The opportunity to work at the cutting edge of health care delivery with a team that&rsquo;s deeply invested in the community</li></ul><ul><li>
Work-life balance, flexibility, and the autonomy to do great work</li></ul><ul><li>
Medical, dental, and vision coverage along with numerous health and wellness programs</li></ul><ul><li>
Parental leave and support plus adoption and surrogacy assistance</li></ul><ul><li>
Career development programs and tuition reimbursement for continued education</li></ul><ul><li>
401k match including an annual company contribution</li></ul><div><div>
Learn more</div></div><div></div><div>
Salary Range</div><div>
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.</div><div></div><ul><li><i>Based on annual corporate goal achievement and individual performance.</i></li></ul><br>
$73,698.00 - $117,917.00<div></div><div>
Skills</div><div>
_____________________________________________________________________<br>
<br>
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 <div>https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC</div>. 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: <div>HR.Staffing@BCBSNC.com</div>.</div></div>

Case Manager

<div></div><div>The Senior Treasury Analyst for the Federal Employees Program (FEP) manages treasury operations&mdash;including cash management, liquidity oversight, and funding strategy&mdash;to ensure accurate cash flow, timely funding, and regulatory compliance. The role requires strong analytics, operational discipline, and strategic insight for the FEP business.<div></div><div>
What You&rsquo;ll Do</div><ul><li><div>
Lead all treasury operations for the FEP line of business, including daily cash positioning, funding, payment execution, account reconciliation, and liquidity oversight.</div></li><li><div>
Monitor and optimize working capital by analyzing cash inflows, disbursement timing, and funding requirements.</div></li><li><div>
Develop and manage short-term cash flow forecast and provide actionable insight to support daily operations.</div></li><li><div>
Partner with business areas and the Blue Cross and Blue Shield Association to understand operational drivers impacting cash flow.</div></li><li><div>
Ensure compliance with internal controls, and government standards while mitigating financial and operational risk.</div></li><li><div>
Provide timely support and documentation for required audits.</div></li><li><div>
Recommend and implement solutions to strengthen operational controls.</div></li></ul><div></div><div>
What You Bring</div><ul><li><ul><li>Bachelor's degree or advanced degree</li><li>5+ years of treasury experience</li><li>In lieu of degree, 7+ years of experience in related field.</li></ul></li></ul><div></div><div>
Bonus Points</div><ul><li><div>
Experience working in highly regulated environments or government programs such as FEP</div></li><li><div>
Experience supporting internal and external audits and/or regulatory exams</div></li><li><div>
Experience working with Treasury Management System (Kyriba, GTreasury, FIS, etc.)</div></li><li><div>
Strong attention to detail with a focus on accuracy and controls</div></li><li><div>
CTP Designation</div></li><li><div>
Strong Excel skills</div></li></ul><div></div><div>
What You&rsquo;ll Get</div><ul><li><div>
The opportunity to work at the cutting edge of health care delivery with a team that&rsquo;s deeply invested in the community.</div></li><li><div>
Work-life balance, flexibility, and the autonomy to do great work</div></li><li><div>
Medical, dental, and vision coverage along with numerous health and wellness programs.</div></li><li><div>
Parental leave and support plus adoption and surrogacy assistance</div></li><li><div>
Career development programs and tuition reimbursement for continued education</div></li><li><div>
401k match including an annual company contribution</div></li><li><div><div>
Learn more</div></div></li></ul><div></div><div>
Salary Range</div><div>
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.</div><div></div><ul><li><i>Based on annual corporate goal achievement and individual performance.</i></li></ul><br>
$89,174.00 - $142,679.00<div></div><div>
Skills</div>
Budgeting, Cash Flow, Cash Flow Management, Finance Strategy, Financial Analysis, Financial Data, Financial Modeling, Financial Planning and Analysis (FP&amp;A), Financial Reporting and Analysis, Treasury Analysis, Treasury Management<div>
_____________________________________________________________________<br>
<br>
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 <div>https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC</div>. 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: <div>HR.Staffing@BCBSNC.com</div>.</div></div>

Sr Treasury Analyst (FEP)