Jobs at Blue Cross Blue Shield Association

Leads strategic digital initiatives and user-centered experience delivery across business, technology, design, testing, and vendor teams. Translates strategy into execution, facilitates stakeholder alignment, manages governance and risks, ensures accessibility and compliance, tracks performance, and drives quality digital solutions. The role also oversees vendor partnerships, workshops, communications, and continuous improvement efforts.

Leads cybersecurity risk and compliance programs, including FedRAMP strategy, continuous monitoring, audit readiness, control implementation, risk registers, and third-party risk assessments. Builds AI-enabled compliance processes, guides multiple projects, manages budgets and resources, advises senior leadership, translates technical risks for business stakeholders, and drives governance, process improvement, and regulatory compliance across the organization.

Provides executive leadership for Federal Employee Program products across medical, dental, vision, postal, and overseas offerings. Owns portfolio strategy, pricing collaboration, product development, marketing, brand positioning, member engagement, and growth initiatives. Leads product launches, market analysis, benefit changes, partnerships, and member experience improvements. Manages and develops a high-performing team while coordinating with actuarial, clinical operations, plans, and strategic partners to achieve enrollment, profitability, quality, and retention goals.

Maintains accurate financial records and supports month-end close, journal entries, reconciliations, payment processing, financial reporting, variance analysis, audits, and internal controls. The accountant also identifies process improvements, collaborates with accounts payable, accounts receivable, and finance teams, and performs ad hoc financial analysis to support business decisions. The role requires accounting expertise, US GAAP knowledge, CPA certification, and experience with accounting software such as PeopleSoft and Workday.

Leads enterprise AI strategy, portfolio management, governance, lifecycle oversight, financial management, and value measurement. Advises teams on AI technology selection, including foundation models, agents, RAG architectures, orchestration platforms, and evaluation tools. Establishes responsible AI processes, approval workflows, model governance frameworks, executive dashboards, and investment prioritization methods. Partners with FinOps, Procurement, Enterprise Architecture, Technology, and business leaders to optimize AI spending, manage risk, drive responsible adoption, and realize measurable business value through influence and cross-functional leadership.

Lead federal advocacy strategy to advance BCBSA legislative and regulatory priorities. Build and sustain relationships with Members of Congress, staff, Administration officials, and stakeholders; monitor congressional activity; provide strategic guidance and executive presentations; coordinate cross-functional and Blue Plan advocacy efforts; leverage political resources and partnerships to influence federal policy affecting the insurance industry.

Lead brand strategy and support customer experience by translating research and consumer insights into strategic direction, creative briefs, and recommendations. Drive system-wide brand initiatives, partner with plans and cross-functional teams, and present strategy to leadership using AI-enabled tools to accelerate analysis and deliver aligned brand and marketing priorities.

Lead the Medicare compliance program by operationalizing CMS requirements across Part C and Part D. Provide subject-matter expertise on claims, pharmacy, UM, appeals; design policies, training, monitoring, audits, investigations, CAPs, and risk assessments. Liaise with operations and FDRs to embed compliance into workflows and support audit-readiness and governance reporting.

Leads the financial and operational internal audit plan, directing concurrent audits, supervising audit staff, reviewing audit quality and findings, and advising senior management. Oversees risk assessments, internal controls, audit reporting, strategic improvement initiatives, and quality programs. Evaluates and deploys AI-enabled audit tools, prepares executive and committee presentations, manages audit issues, and coordinates with enterprise risk, compliance, and information security functions.

Lead product strategy and roadmap for healthcare analytics and AI/agentic products. Own end-to-end product lifecycle, translate market and customer needs into actionable features, ensure compliance (HIPAA, SOC 2), mentor product teams, and partner with engineering, data science, and commercial teams to deliver scalable, AI-enabled solutions for payers, providers, and healthcare stakeholders.

Lead HEDIS data quality strategy and operations, oversee portal and QCR profiling, perform advanced data analyses, coordinate cross-functional partners, ensure NCQA-compliant reporting, and drive continuous improvement in HEDIS processes.

Lead strategy and execution for enterprise data and AI/ML platform as a product. Own roadmap, delivery, adoption, and value tracking for foundational platform products (ingress/egress, data quality, engineering agents, AI/ML platforms). Manage portfolio, build business cases, mentor teams, drive cross-functional alignment, and ensure measurable business outcomes while balancing modernization and technical debt.

Lead Accreditation and Quality operations for FEP, set strategy for QCR measures, ensure compliance with HEDIS/NCQA/URAC, manage cross-functional accreditation projects, develop programs to improve member care, oversee budgets, and lead a department to meet Plan and accreditor requirements.

Lead cross-functional accreditation projects for Federal Employee Program and Blue Plans. Serve as subject-matter expert for NCQA and URAC accreditation, develop submission documentation and tools, provide delegation oversight, conduct mock surveys, present accreditation guidance to plans, and translate trends into strategic action plans to ensure compliance and successful surveys.