AVP, Care Pathways & Patient Engagement Analytics

Blue Cross and Blue Shield of North Carolina; Durham (NC); On-site; USD 210,000 - 336,000; Full time

Job summary

Blue Cross NC seeks a highly analytical, technology-forward healthcare leader who can turn clinical and financial data into actionable care pathways that improve outcomes and affordability. This role blends advanced analytics with healthcare economics, population health, and innovative engagement strategies to influence enterprise decisions.

The ideal candidate will translate complex data into measurable interventions, work across functions, and leverage AI and personalization to drive value.

Qualifications

• Advanced analytics expertise with ability to translate healthcare data into actionable strategies and measurable outcomes.
• Healthcare economics, medical expense/cost of care, utilization, patient populations, or related areas.
• Technology-forward and innovative mindset, energized by AI and data-driven solutions.
• Move beyond reporting to identify opportunities, hypotheses, interventions, and action from insights.
• Experience solving cross-functional problems with distributed ownership and decision rights across teams.
• Strong executive presence and ability to influence senior leaders and align priorities.

Responsibilities

• Develop end-to-end care pathways using advanced analytics and clinical insight to improve outcomes and affordability.
• Translate complex clinical and financial data into actionable interventions with measurable impact across the enterprise.

Skills

Advanced analytics

Healthcare economics

Executive influence

Cross-functional leadership

AI / data-driven innovation

Strategic roadmap development

Education

MD or equivalent clinical credential

Job description

Job Description

This position is a unique opportunity for someone who has the rare combination: advanced analytics + healthcare/clinical insight + technology-forward innovation + enterprise influence. This is not a traditional analytics leader or care management role. The differentiator is someone who can use data and clinical insight to build end-to-end care pathways that improve patient outcomes while directly addressing medical expense and affordability.

We are seeking a highly analytical, technology-forward healthcare leader who can develop innovative, data-driven approaches to care pathways and patient engagement. The ideal candidate will bring deep expertise in healthcare analytics, medical expense/cost-of-care strategy, population health, or related disciplines and demonstrate the ability to translate complex clinical and financial data into actionable interventions and measurable outcomes.

Experience designing end-to-end care pathways, identifying opportunities for earlier intervention, and leveraging advanced analytics, AI, and personalization to improve patient outcomes and affordability is highly preferred. Candidates should demonstrate strong enterprise leadership, executive influence, and the ability to bring strategic clarity to complex initiatives that span multiple functions and stakeholders.

Hiring Preferences / Ideal Candidate Profile

Must-Have Qualifications & Experience

• Advanced analytics expertise with demonstrated ability to translate complex healthcare data into actionable strategies, interventions, and measurable business outcomes.
• Healthcare experience with a strong understanding of healthcare economics, medical expense/cost of care, utilization, patient populations, or healthcare delivery. Payer experience is highly valuable, but candidates with adjacent healthcare experience who can quickly learn the payer environment should be considered.
• Technology-forward and innovative mindset. Must be energized by using emerging technology, advanced analytics, AI, and data-driven approaches to solve complex healthcare problems.
• Proven ability to move beyond reporting and traditional analytics to identify opportunities, develop hypotheses, design interventions, and drive action from insights.
• Experience solving complex, cross-functional problems where ownership and decision rights are distributed across multiple teams or functions.
• Strong executive presence and ability to influence senior leaders and establish clarity across competing priorities, perspectives, and initiatives.
• Demonstrated ability to prioritize high-value opportunities and translate strategy into a roadmap or portfolio of initiatives.

Strongly Preferred

• Clinical credential and/or significant clinical expertise, ideally an MD or equivalent depth of clinical knowledge. Clinical credentials are strongly preferred but should not outweigh exceptional analytics and healthcare capabilities.
• Experience designing or optimizing care pathways, patient journeys, population health strategies, or patient/member engagement interventions.
• Understanding of disease progression and opportunities for earlier intervention or prevention, rather than focusing exclusively on management after a condition has been diagnosed.
• Experience connecting clinical, financial, behavioral, and engagement data to determine where and how interventions will create the greatest value.
• Experience with healthcare affordability, medical expense management, cost-of-care strategies, actuarial analytics, or related disciplines.
• Experience working in environments where analytics informs personalized engagement, intervention timing, channel strategy, or AI-enabled healthcare experiences.

What Will Differentiate the Strongest Candidates

The strongest candidate will be able to demonstrate that they have:

• Built something, not just analyzed something.
  Look for examples where analytics led to a new intervention, program, care model, pathway, or material change in strategy.
• Connected clinical outcomes to financial outcomes.
  Candidates should be comfortable discussing both patient impact and healthcare cost/medical expense implications.
• Thought across the entire patient journey.
  For example, rather than only improving diabetes disease management, they can identify opportunities upstream, such as identifying pre-diabetic populations, determining the appropriate intervention, designing the engagement strategy, and measuring whether the intervention prevented progression.
• Worked successfully across organizational boundaries.
  The role will need to bring coherence across areas that may currently have fragmented strategies, analytics, priorities, or decision rights.
• Used technology as a strategic lever.
  Candidates should be curious and credible around AI, advanced analytics, personalization, predictive modeling, and emerging approaches rather than relying only on traditional healthcare analytics.

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.

$210,268.00 - $336,430.00

Skills

Analytics, Data Visualization, Predictive Modeling, Stakeholder Management, Statistical Analysis, Strategic Planning