Senior Pharmacy Network Strategy Leader

Blue Cross and Blue Shield of North Carolina; Michigan; On-site; USD 89,000 - 143,000; Full time

Benefits offered by this job

Annual Incentive Bonus*

401(k) with employer match

Paid Time Off (PTO)

Health benefits and wellness programs

Job summary

Blue Cross NC is seeking a senior professional to influence specialty pharmacy network strategy and contracting. You will design, evaluate, and implement network-based affordability solutions while maintaining member access and regulatory compliance.

The role involves collaborating with internal teams, presenting to leadership, and monitoring market dynamics to optimize costs and drive sustainable improvements.

Qualifications

• Bachelor's degree or advanced degree (where required).
• 5+ years of experience in related field.
• In lieu of degree, 7+ years of experience in related field.

Responsibilities

• Act as a senior member advancing specialty pharmacy network strategies and affordability.
• Identify, analyze, and implement network strategies that support affordability while maintaining access and compliance.
• Develop network optimization strategies including design, pricing, and reimbursement methods.
• Support strategic planning with financial and qualitative analyses for contracting decisions.
• Translate complex market dynamics into strategic recommendations for senior leadership.
• Present strategies and impact assessments to executive audiences.
• Collaborate with other departments as a subject matter expert in specialty pharmacy.
• Monitor industry trends affecting network performance and cost management.
• Engage with external partners to evaluate opportunities and affordability solutions.
• Organize and communicate progress across the portfolio to support accountability.

Skills

Healthcare Consulting

Healthcare Financial Management

Healthcare Industry

Healthcare Strategic Planning

Health Outcomes

Performance Metrics

Project Management

Provider Reimbursement

Reimbursement

Education

Bachelor's degree or advanced degree

Job description

Blue Cross NC is seeking a senior professional to influence specialty pharmacy network strategy and contracting. You will design, evaluate, and implement network-based affordability solutions while maintaining member access and regulatory compliance.

The role involves collaborating with internal teams, presenting to leadership, and monitoring market dynamics to optimize costs and drive sustainable improvements.