Healthcare Strategy & Reimbursement Leader

Blue Cross NC

Durham (NC)

On-site

USD 131,000 - 209,000

Full time

11 days ago

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Job summary

Blue Cross NC is seeking a Principal Strategic Advisor to lead innovation-based healthcare reimbursement, redesign consultation, and payer/provider engagement to drive differentiated strategies and sustainable competitive advantage.

You will mentor junior staff, oversee cross-functional initiatives, present strategic plans to senior leadership, and translate market trends into actionable improvements across enterprise initiatives.

Qualifications

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.

Responsibilities

Proactively identify, evaluate and lead the implementation of healthcare redesign, provider reimbursement and partnership strategies to meet BCBSNC’s growth objectives, as well as manage healthcare costs while improving outcomes and the healthcare experience for our members.
Support and manage development efforts related to the enhancement and maintenance of our current products and market offer components.
Lead critical activities such as strategic planning, highly complex quantitative/qualitative analysis and thought leadership at a departmental and enterprise level.
Present information such as strategic concepts, planning data, medical expense/reimbursement rates, provider performance metrics and impact assessments to both internal and external audiences at all levels, including senior-level leadership.
Organize, optimize and communicate progress towards the completion of overall work portfolio.
Collaborate with and support other departments across the enterprise on both common initiatives and unique ventures, acting as a subject matter expert for healthcare delivery transformation and/or healthcare reimbursement and strategy.
Identify, analyze and monitor industry, regulatory, technology and market-based trends that affect divisional operations, provider reimbursement, medical expense strategy and overall payer-provider dynamics.
Utilizes extensive expertise to identify and drive operational improvements with new analysis/reporting capabilities, project management techniques and/or consulting/engagement approaches.
Serve as a mentor and coach to more junior team members regarding various skills and approaches and may oversee work of other staff members as needed