Senior Network Strategy Lead — Specialty Pharmacy

Blue Cross and Blue Shield of North Carolina; Columbus (OH); On-site; USD 89,000 - 143,000; Full time

Job summary

Blue Cross NC is seeking a senior strategic professional to lead specialty pharmacy network design and contracting strategy with a focus on affordability and member access in the Columbus area.

The role involves evaluating market opportunities, developing cost-reduction strategies, and communicating results to senior leadership. Collaboration with PBMs, providers, and vendors will be essential to deliver innovative affordability solutions and sustained savings.

Qualifications

• Bachelor's degree or advanced degree is required.
• 5+ years of experience in related field; in lieu of degree 7+ years of experience.

Responsibilities

• Act as a senior member contributing to pharmacy affordability goals through network design, contracting strategy, network optimization, and market-based pricing.
• Identify, analyze, and implement specialty pharmacy network strategies and contracting opportunities.
• Develop network optimization strategies, including design, pricing approaches, and reimbursement methodologies.
• Support strategic planning, financial and qualitative analysis, and business case development for contracting decisions.
• Translate complex market dynamics into strategic recommendations for internal stakeholders.
• Present strategies and impact assessments to executive leadership.
• Collaborate with other departments and external partners to advance affordability solutions.
• Monitor industry trends affecting network performance, reimbursement economics, and cost management.
• Organize progress and outcomes across the portfolio to support decision-making.
• Advance capabilities in network strategy, contracting, and affordability.

Skills

Healthcare Consulting

Healthcare Financial Management

Healthcare Industry

Healthcare Innovation

Healthcare Management

Healthcare Strategic Planning

Health Outcomes

Medical Reimbursement

Performance Metrics

Physician Reimbursement

Project Management

Provider Reimbursement

Reimbursement

Reporting and Analysis

Education

Bachelor's degree

Advanced degree

Job description

Blue Cross NC is seeking a senior strategic professional to lead specialty pharmacy network design and contracting strategy with a focus on affordability and member access in the Columbus area.

The role involves evaluating market opportunities, developing cost-reduction strategies, and communicating results to senior leadership. Collaboration with PBMs, providers, and vendors will be essential to deliver innovative affordability solutions and sustained savings.