**Job Description** Healthy Blue Care Together (HBCT) is partnering with the North Carolina Department of Health and Human Services to operationalize the Children and Families Specialty Plan (CFSP). CFSP is a single, statewide Medicaid Plan designed to provide seamless, integrated, and coordinated care to enrolled infants, children, youth, young adults, and families served and previously served by the child welfare system. HBCT is outcomes-driven and focused on ensuring that all members have access to quality services and benefits across North Carolina, addressing their physical health, behavioral health, pharmacy, intellectual/developmental, long-term services and supports, unmet health-related resource, and care management needs. The Principal Business Operations Advisor (OA), in collaboration with Plan-level leadership and support staff, will oversee monitoring and evaluation of key aspects of HBCT Plan execution, focusing on: Plan-based and delegated staffing and performance; clinical, care management, medication monitoring, psychosocial, and specialty program implementation; and provider network and service access equity and quality. The OA will lead the development of data management and reporting strategies aligned with our Continuous Quality Improvement framework and Monitoring and Evaluation plan. The OA will collaborate with the Outcomes Monitoring and Evaluation Team to support population- and member-level outcomes monitoring and evaluation. **What You'll Do** Business and Strategic Planning + ​Develop and implement Continuous Quality Improvement framework and Monitoring and Evaluation plan. + Build and facilitate repeatable and Plan-focused strategic planning processes that include confirmation of continued relevance, progress evaluation and communication to affected stakeholders. + Advise and communicate with Plan leadership and external stakeholders, including senior leadership, regarding programs, projects, initiatives, emerging issues and challenges within the child welfare systems. + Develop and use key improvement metrics, such as dashboards, team reporting, regulatory reports and scorecards to review program data and results in comparison with benchmark metrics and expected outcomes. + Monitor and evaluate delegated staff functions activities for compliance and effectiveness. + Proposes a variety of solutions to business issues/problems utilizingappropriate analysis tools (ie Cost/Benefit Analysis, Flowcharting, etc). + Leadthedevelopment of a Monitoring and Evaluation Plan, focused on Plan execution and achievement of objectives and goals. + Lead the coordination, planning, and facilitation of various Plan-level monitoring and evaluation workgroups to make them more effective, data-driven, and outcomes based. + Lead monitoring and evaluation strategy development and activities addressing staffing, staff to member rations, and staff performance + Support development of business plans and analysis under guidance from Plan leadership. + Facilitate the adoption of CQI-driven Plan operating procedures and processes for the Plan and assist with the communication to and education of external stakeholders and delegated partners. + Provide input and recommended strategy for Plan leadership’s public speaking engagements and/or Board or committee meetings. + Facilitate change management work to support business and process improvements and overall Plan effectiveness. Project/Initiative Management + Lead and coordinate work for special projects or initiatives for thePlanas assigned. Possible dutiescould include: + Evaluation of potential opportunities and recommendations to reduce costs/improve efficiencies + Review and evaluation of best or next practice opportunities for potential adoption + Develop recommendations based on important industry literature and ensure leadership is briefed on current and emerging issues of importance to the organization. + Serve as lead on engagements with external entities (i.e.consultants, external stakeholders, delegated partners) and coordinate data gathering and research efforts based on the direction ofPlanleadership. + Manage tracking of initiatives/projects for the division and independently create presentations of initiative/project progress for varied audiences, which may includeSeniorPlanLeadership. Data Analysis/Reporting + Lead the consolidation and standardization of data analysis and reporting for relevantPlanoperations. + Provide analysis and insights for proposed strategic initiatives byleveraginga uniqueperspective on the end-to-end operations of thePlan. + SupportPlanbudget analysis, provide inputintoandmonitorbudget forecasts,and review progress against administrative cost reduction goals + Track and evaluate goal progress, including data collection and analysis of key performance metrics (KPIs). **What You Bring** + Bachelor's degree or advanced degree (where required) + 8+ years of experience in related field. + In lieu of degree, 10+ years of experience in related field. **Bonus Points** + Continuous quality improvement experience within a Managed Care Organization + Experience with Child Welfare systems, data analytics, KPIs, and metrics + Expert in excel, tableau and/or other data management tools + Experience in working in a matrixed environment,facilitatingwork across multiple teams and priorities **What** **You’ll** **Get** + The opportunity to work at thecutting edgeof health care delivery with a teamthat’sdeeply invested in the community  + Work-life balance, flexibility, and the autonomy to dogreat work  + Medical, dental, and vision coverage along withnumeroushealth and wellness programs   + Parental leave and support plus adoption and surrogacyassistance   + Career development programs and tuition reimbursement for continued education   + 401k match including an annual company contribution   + Learn more (https://careers.bluecrossnc.com/global/en/benefits)    **Salary Range** At 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. _*Based on annual corporate goal achievement and individual performance._ $118,691.00 - $189,906.00 **Skills** **About Us** It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians. Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all. Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives. **Authorization to Work in the United States** We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español. **Request Accommodations** Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please notify HR at HR.Staffing@bcbsnc.com . **For most roles, you can choose where to work - fully remote in one of the states listed below, in the office, or a hybrid of the two:** Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming