Care Pathway & Patient Engagement Analyst

NC Health Affiliates LLC DBA Blue Cross NC; North Carolina; Híbrido; USD 89.000 - 143.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, and vision coverage

Parental leave and adoption/surrogacy"

Tuition reimbursement

401k match

Descripción de la vacante

Blue Cross NC is seeking a Care Pathway & Patient Engagement Analyst to advance affordability initiatives through analytics, engagement insights, and care pathway optimization. You will partner across Utilization Management, Care Management, Network, Pharmacy, Actuarial, Finance, Technology, and Clinical teams to translate data into actionable recommendations.

The role emphasizes predictive modeling, segmentation, and impact evaluation to improve affordability, patient engagement, and outcomes.

Formación

• Bachelor's degree or advanced degree in a related field.
• 5+ years of healthcare analytics or related quantitative discipline.
• Experience with SQL and modern analytics tools.
• Experience with statistical analyses and modelling.
• Ability to translate data into actionable recommendations.

Responsabilidades

• Conduct analyses on care pathways, patient engagement, utilization patterns, provider performance, affordability opportunities, and healthcare consumer behavior.
• Develop analytic frameworks to identify where members benefit from interventions.
• Develop predictive models, segmentation approaches, and targeting methodologies for outreach and engagement.
• Execute rigorous evaluations including A/B testing and quasi-experimental methods.
• Analyze longitudinal healthcare journeys to identify utilization patterns and care gaps.
• Apply episode-of-care methodologies and pathway analytics to understand drivers of cost and quality.
• Support financial-impact measurement with actuarial and finance teams.
• Translate findings into clear recommendations for leadership.

Conocimientos

SQL

Python

R

Statistics

Data Visualization

A/B Testing

Educación

Bachelor's degree or advanced degree in related field

Herramientas

Tableau

SQL Server

Descripción del empleo

Job Description We are seeking a Care Pathway & Patient Engagement Analyst to serve Curacor Solutions’ (CCS) Affordability function in advancing the organization's "right care, right time, right place" strategy through innovative analytics, consumer engagement insights, and care pathway optimization. Working closely with leadership, this individual will help develop analytic solutions that improve affordability, enhance patient engagement, and strengthen healthcare outcomes. This role is ideal for a highly analytical, intellectually curious, and execution-oriented professional who enjoys solving complex problems and translating data into actionable recommendations. The successful candidate will partner across Utilization Management, Care Management, Network, Pharmacy, Actuarial, Finance, Technology, and Clinical teams and will contribute to the design, execution, and implementation of key affordability initiatives.

What You’ll Do

• Conduct claims and other analyses focused on care pathways, patient engagement, utilization patterns, provider performance, affordability opportunities, and healthcare consumer behavior.
• Support the development of analytic frameworks that identify where members are most likely to benefit from interventions, including opportunities to improve care quality, increase engagement, reduce unnecessary utilization, and optimize site-of-care decisions.
• Develop predictive models, segmentation approaches, and targeting methodologies that support member outreach, affordability initiatives, care navigation programs, and engagement strategies.
• Execute analyses that evaluate engagement strategies, outreach programs, and affordability initiatives using rigorous measurement approaches, including A/B testing, quasi-experimental methods, and other impact evaluation techniques.
• Analyze longitudinal healthcare journeys to identify utilization patterns, care gaps, clinical variation, and opportunities for intervention.
• Apply episode-of-care methodologies, pathway analytics, and healthcare grouping approaches to understand drivers of medical cost, utilization, quality, and patient experience.
• Support financial-impact measurement efforts by partnering with actuarial, finance, and affordability teams to quantify opportunities, intervention impact, and realized savings.
• Build analyses that incorporate patient risk, disease burden, social determinants of health, clinical complexity, benefit design, and engagement propensity to better understand member behavior and intervention opportunities.
• Leverage provider, network, referral, access, and site-of-care analytics to identify opportunities for network strategy, provider enablement, and member navigation improvements.
• Apply geospatial analytics to understand how provider availability, travel burden, appointment access, and network characteristics influence healthcare utilization and consumer decision-making.
• Partner with technology and data teams to support the development of integrated healthcare data assets spanning claims, pharmacy, EHR, provider, member, care management, and operational data sources.
• Develop dashboards, reports, decision-support tools, and analytical products that enable affordability teams to identify and act on emerging opportunities.
• Explore practical applications of AI, machine learning, natural language processing, and generative AI to improve pathway analytics, patient engagement, prioritization, and decision support.
• Translate analytical findings into clear, concise recommendations and presentations for business leaders and operational stakeholders.
• Contribute to a high-performing team culture by sharing knowledge, supporting colleagues, and maintaining high standards for analytical rigor and business impact.

What You Bring

• Bachelor's degree or advanced degree (where required) 5+ years of experience in related field.
• In lieu of degree, 7+ years of experience in related field.
• Experience in healthcare analytics, health plan analytics, healthcare data science, clinical informatics, health economics, management consulting, actuarial analytics, or a related quantitative discipline.
• Experience working with healthcare data, including medical and pharmacy claims, provider data, eligibility data, care management data, or related healthcare datasets.
• Proficiency in SQL and familiarity with modern analytics tools such as Python, R, or comparable analytical technologies.
• Experience conducting statistical analyses, developing analytical models, and working with large healthcare datasets.
• Experience developing analyses, dashboards, reports, or decision-support tools that support operational decision-making and business strategy.
• Familiarity with episode-based analytics, care pathway analyses, clinical grouping methodologies, or healthcare journey analytics is preferred.
• Experience using modern business intelligence platforms, cloud-based analytics environments, and data visualization tools.

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 state listed on this job posting. Onsite expectations will be discussed during the interview process.

Blue Cross NC is a Hybrid Flex company. Whether the 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 of our approved states: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.

About CuraCor Solutions Blue Cross NC

Blue Cross NC is part of CuraCor Solutions, a larger health care organization that brings together Blue Cross NC, our Corporate Center teams, and other health care businesses and affiliates – all connected by a shared purpose of making health care better for all. To learn more, visit curacor.com.

Salary Range

$89,174.00 - $142,679.00

Authorization to Work in the United States

We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview for English or Visión General de E-Verify for Español.

Request Accommodations Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application, hiring process, or have technical issues that prevent you from completing your application please notify HR at [e-mail]. Blue Cross NC is a Hybrid Flex company. Whether the 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 of our approved states: Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming.

About Us

It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians. Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all. Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.