Care Pathways Intelligence & Engagement Analyst

Blue Cross and Blue Shield of North Carolina; North Carolina; Hybrid; USD 89,000 - 143,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

401k match

Paid time off

Job summary

Blue Cross NC seeks a Care Pathway & Patient Engagement Analyst to advance affordability and engagement strategies using analytics, insights, and care pathway optimization. You’ll collaborate across departments to design analytic solutions that improve care access, reduce costs, and enhance patient outcomes.

The role requires strong analytical skills, experience with claims data, and the ability to translate data into actionable recommendations for leadership and operations.

Qualifications

• 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.

Responsibilities

• 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.

Skills

SQL

Python

R

Analytical thinking

Education

Bachelor’s degree or advanced degree

Job description

Blue Cross NC seeks a Care Pathway & Patient Engagement Analyst to advance affordability and engagement strategies using analytics, insights, and care pathway optimization. You’ll collaborate across departments to design analytic solutions that improve care access, reduce costs, and enhance patient outcomes.

The role requires strong analytical skills, experience with claims data, and the ability to translate data into actionable recommendations for leadership and operations.