Senior Strategic Advisor - Specialty Pharmacy Network

Blue Cross and Blue Shield of North Carolina

Wichita (KS)

On-site

USD 89,000 - 143,000

Full time

14 days+

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Benefits offered by this job

Annual incentive bonus

401(k) with employer match

Paid time off

Health benefits

Job summary

Blue Cross and Blue Shield of North Carolina seeks a senior member of the strategic function to drive specialty pharmacy network design, contracting strategy, and cost-reduction initiatives. The role focuses on evaluating market opportunities and implementing affordable network-based solutions while ensuring member access and regulatory compliance.

The position requires 5+ years in a related field and a Bachelor's degree or higher; alternative experience may substitute per policy.

Qualifications

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

Responsibilities

Identify, analyze, evaluate, and implement specialty pharmacy network strategies and contracting opportunities that support affordability while maintaining member access and regulatory compliance.
Develop and execute network optimization strategies including design, performance management, pricing, and market-based reimbursement methodologies.
Support strategic planning and financial/qualitative analysis, business case development, and network evaluations to inform contracting decisions and affordability initiatives.
Translate network, reimbursement, and market dynamics into clear strategic recommendations for internal stakeholders, including senior leadership.
Present network strategies, performance metrics, affordability opportunities, contracting recommendations, and impact assessments to executives.
Collaborate with other departments as a subject matter expert in specialty pharmacy network strategy, contracting, reimbursement methodologies, and affordability solutions.
Monitor industry, regulatory, technology, provider, PBM, and market trends that influence network performance and cost management.
Engage with specialty pharmacies, PBMs, vendors, consultants, providers, and external partners to evaluate opportunities and support affordability solutions.
Organize and communicate progress, recommendations, and outcomes across the portfolio to support alignment and informed decision-making.
Advance network strategy capabilities to continuously improve how network-based solutions are developed and implemented to achieve unit cost reduction.