Teams at Blue Cross NC

Principal Learning Solutions Architect serves as a strategic advisor to senior leaders, diagnosing workforce performance gaps and designing enterprise learning and non-learning solutions. Responsibilities include performance consulting, learning architecture, data analysis, executive communication, stakeholder influence, project leadership, and innovation involving digital learning, knowledge management, coaching, change adoption, communications, and AI-enabled learning technologies.

Conducts non-clinical utilization management reviews, communicates determinations to providers and members, documents outcomes, gathers required information, verifies authorization accuracy, supports CMS notification requirements, and refers clinically complex cases to nurses or Medical Directors. Also provides administrative support and serves as a subject matter expert on non-clinical review processes.

Conducts non-clinical utilization management reviews, communicates decisions to providers and members, documents outcomes, obtains required information, verifies authorization accuracy, and refers clinical matters to nurses or Medical Directors. Supports CMS notification requirements, administrative processing, and care management outreach while serving as a subject matter expert on non-clinical review procedures.