Healthcare Analytics & Fraud Insights Analyst

Blue Cross and Blue Shield of North Carolina; Virginia Beach (VA); On-site; USD 89,000 - 143,000; Full time

Job summary

Blue Cross and Blue Shield of North Carolina is seeking an analytics-driven professional to serve as a strategic partner to SIU and Payment Integrity, delivering actionable intelligence and robust reporting across healthcare claims and audits.

The role develops dashboards and self-service analytics, identifies trends and opportunities, and supports executive decision-making while measuring program effectiveness and driving measurable savings for the organization.

Qualifications

• Bachelor's degree or advanced degree required; 3+ years in healthcare analytics, SIU, Payment Integrity, or related field.
• In lieu of degree, 5+ years of relevant experience accepted.
• Strong analytical, problem-solving, and communication skills.

Responsibilities

• Serve as analytics partner to SIU and Payment Integrity by delivering actionable business intelligence and reporting.
• Develop dashboards, scorecards, and self-service analytics to track provider risk, savings, recoveries, and cost avoidance.
• Analyze healthcare claims and audit data to identify trends, anomalies, and opportunities for financial/operational improvement.
• Translate complex data into clear insights for leadership and drive measurable savings and efficiencies.

Skills

Analytical skills

Healthcare analytics

Communication

Education

Bachelor's degree or advanced degree

Tools

Snowflake

AI agents

Job description

Blue Cross and Blue Shield of North Carolina is seeking an analytics-driven professional to serve as a strategic partner to SIU and Payment Integrity, delivering actionable intelligence and robust reporting across healthcare claims and audits.

The role develops dashboards and self-service analytics, identifies trends and opportunities, and supports executive decision-making while measuring program effectiveness and driving measurable savings for the organization.