AVP, Care Pathways & Patient Engagement Analytics

Blue Cross NC; North Carolina; On-site; USD 180,000 - 290,000; Full time

Job summary

Blue Cross NC is seeking an analytics-forward leader who combines advanced analytics, clinical insight, and technology-driven innovation to shape end-to-end care pathways. The role focuses on translating clinical and financial data into interventions that improve patient outcomes while addressing medical expense and affordability.

The ideal candidate brings deep expertise in healthcare analytics, population health, and cost-of-care strategy, with the ability to influence enterprise decisions

Qualifications

• Advanced analytics translating complex healthcare data into actionable strategies and measurable outcomes.
• Healthcare economics understanding including medical expense and cost of care.
• Ability to translate clinical and financial data into interventions and drive action from insights.
• Executive presence to influence senior leaders and align multiple stakeholders across functions.
• Experience solving cross-functional problems with distributed ownership and accountability.
• Ability to prioritize high-value opportunities and translate strategy into a roadmap of initiatives.
• Familiarity with AI, personalization, and predictive modeling in healthcare analytics.

Skills

Advanced analytics

Healthcare economics

Technology-forward

Cross-functional leadership

Executive influence

Strategic roadmapping

Intervention design

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.