Senior Pharmacy Strategy & Network Architect — Remote

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

Benefits offered by this job

Annual Bonus

401(k) match

PTO

Health benefits

Wellness programs

Job summary

Blue Cross and Blue Shield of North Carolina is seeking a senior strategic professional to advance specialty pharmacy affordability through network design, contracting, and market-based pricing.

You will analyze market dynamics, develop cost-reduction strategies, and present actionable plans to senior leadership while ensuring member access and regulatory compliance. This role collaborates across enterprise to drive sustainable affordability improvements.

Qualifications

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

Responsibilities

• Design specialty pharmacy network strategies, contracting opportunities, and reimbursement methodologies.
• Perform network optimization, pricing approaches, participation requirements, and market-based reimbursements.
• Support strategic planning, financial and qualitative analyses, and business case development for contracting decisions.
• Translate network, reimbursement, and market dynamics into strategic recommendations for senior leadership.
• Present strategies, metrics, affordability opportunities, and impact assessments to internal audiences across levels.

Skills

Healthcare Consulting

Healthcare Financial Management

Healthcare Industry

Healthcare Innovation

Healthcare Management

Healthcare Reimbursement

Healthcare Strategic Planning

Health Outcomes

Medical Reimbursement

Performance Metrics

Physician Reimbursement

Project Management

Provider Reimbursement

Reimbursement

Reporting and Analysis

Education

Bachelor's degree or advanced degree

Job description

Blue Cross and Blue Shield of North Carolina is seeking a senior strategic professional to advance specialty pharmacy affordability through network design, contracting, and market-based pricing.

You will analyze market dynamics, develop cost-reduction strategies, and present actionable plans to senior leadership while ensuring member access and regulatory compliance. This role collaborates across enterprise to drive sustainable affordability improvements.