{"id":2055115,"url":"https://alion.io/job/blue-cross-nc-bi-analyst","title":"BI Analyst","company":{"id":3139,"name":"Blue Cross NC","domain":"bluecrossnc.com","url":"https://alion.io/company/blue-cross-nc","size_band":null,"is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":null,"truth_index":null},"role":"Analytics","role_family":"Analytics","seniority":"senior","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"inferred_payroll_markers","remote_working_hours":null,"hiring_geo_confidence":"inferred","locations":[],"countries":[],"hiring_countries":["US"],"hiring_countries_total":1,"salary":{"min":89174,"max":142679,"currency":"USD","period":"year","gross":null,"usd_annual":142679},"salary_estimate":null,"experience_years_min":5,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"AI Agents","optional":false},{"name":"Snowflake","optional":false}],"status":"live","first_seen_at":"2026-10-07T20:29:01Z","employer_posted_date":null,"last_verified_at":"2026-10-07T20:29:01Z","board_verified":false,"closed_at":null,"days_open":6,"trust":{"level":"not_scored","repost_count":null,"flags":[],"days_open":6},"description":"Job DescriptionServes as a strategic analytics partner to the Special Investigations Unit (SIU) and Payment Integrity teams by delivering actionable business intelligence, financial reporting, operational insights, and statistically sound audit support. This role combines advanced data analysis, dashboard development, healthcare claims expertise, and stakeholder engagement to identify fraud, waste, abuse, payment accuracy opportunities, and operational improvement initiatives.\n\nThe analyst develops reporting and analytical solutions that support provider investigations, overpayment recovery efforts, prepayment and post-payment audit programs, and executive decision-making. This role is responsible for translating complex healthcare data into meaningful insights, measuring program effectiveness, supporting statistically valid sampling methodologies, and driving measurable savings and operational efficiencies across the organization.\nPartner with Special Investigations Unit (SIU), Payment Integrity, Clinical, Finance, and operational stakeholders to identify business needs and develop analytical solutions that support fraud, waste, abuse detection, payment accuracy, and operational performance management.\n\nDesign, develop, and maintain dashboards, scorecards, reports, and self-service analytics solutions that provide actionable insights into investigation outcomes, provider risk, savings, recoveries, cost avoidance, inventory management, and key performance indicators.\n\nAnalyze healthcare claims, provider, member, audit, and investigation data to identify trends, anomalies, emerging risks, and opportunities for financial and operational improvement.\n\nDevelop recurring and ad hoc financial and operational reporting used by leadership to measure program effectiveness, resource utilization, productivity, return on investment, and strategic objectives.\n\nDesign, execute, validate, and document statistically valid random sampling methodologies to support provider audits, overpayment identification, error rate measurement, and extrapolation activities.\n\nCollaborate with business partners, BI Analysts, Data Scientists, and others to define data requirements, improve data quality, and operationalize advanced analytical solutions.\n\nFacilitate requirements gathering, solution design, and stakeholder review sessions to ensure reporting and analytical solutions meet business objectives and deliver measurable value.\n\nValidate data accuracy, reconcile reporting outputs, and ensure consistency of financial, operational, and analytical metrics across multiple systems and audiences.\n\nCommunicate analytical findings, insights, risks, and recommendations to business partners and leadership through effective visualizations, presentations, and written summaries.\n\nEstablish and maintain reporting standards, documentation, governance practices, and development methodologies to ensure scalable, reliable, and sustainable analytical solutions.\n\nManage multiple projects and priorities simultaneously while proactively communicating status, risks, dependencies, and opportunities to stakeholders and leadership.\n\nWhat You Bring\nRequired\n\nBachelor's degree or advanced degree (where required)\n\n3+ years of experience in healthcare analytics, SIU, Payment Integrity, or a related field\n\nIn lieu of degree, 5+ years of experience in related field.\n\nStrong analytical, problem-solving, and communication skills.\n\nPreferred\nExperience supporting Special Investigations Unit (SIU), Fraud, Waste & Abuse (FWA), Payment Integrity, claims auditing, or provider payment review functions.\n\nKnowledge of healthcare claims processing, reimbursement methodologies, CPT, HCPCS, ICD-10, DRG, and provider billing practices.\n\nExperience with statistical sampling methodologies, confidence intervals, extrapolation, and audit-related analytics.\n\nExperience measuring healthcare savings, recoveries, cost avoidance, and operational performance metrics.\n\nExperience with Snowflake\n\nExperience building AI agents\n\nSalary RangeAt 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. \n*Based on annual corporate goal achievement and individual performance.\n$89,174.00 - $142,679.00Skills\nJOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on . If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: .\nOriginally posted on Himalayas","description_format":"text","description_chars":5348,"description_truncated":false,"requirements":{"experience_years_min":5,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":["Wellness"],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Health Insurance & Benefits"],"lifecycle":[{"event":"open","at":"2026-10-07T23:28:15Z"}],"visa":[],"liveness":{"score":86,"band":"hot","label":"Hiring now","p_open":1,"p_active":0.86,"p_room":1,"age_days":6,"expected_fill_days":29,"reasons":["seen:6","win:early"],"computed_at":"2026-10-14T06:34:16Z"},"pay":{"stated_usd_annual":142679,"is_top_pay":true},"html_url":"https://alion.io/job/blue-cross-nc-bi-analyst","json_url":"https://alion.io/job/blue-cross-nc-bi-analyst.json","meta":{"generated_at":"2026-10-14T19:12:44Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":25192,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-15T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":3139},"rest":"https://alion.io/mcp/rest/get_company?id=3139"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fblue-cross-nc-bi-analyst"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fblue-cross-nc-bi-analyst"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fblue-cross-nc-bi-analyst"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/blue-cross-nc-bi-analyst\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fblue-cross-nc-bi-analyst"}]}