Senior Strategic Advisor, Specialty Pharmacy Networks

Blue Cross NC; Jacksonville (FL); On-site; USD 89,000 - 143,000; Full time

Benefits offered by this job

Annual Incentive Bonus

401(k) with employer match

PTO

Health benefits and wellness programs

Job summary

Blue Cross and Blue Shield of North Carolina seeks a senior member of the strategic function to advance specialty pharmacy network strategy, contracting, and affordability initiatives. You will evaluate market opportunities, lead cost-reduction strategies, and translate market dynamics into actionable plans for senior leadership.

You will collaborate across departments, engage with external partners, and monitor regulatory trends to sustain member access while reducing unit costs.

Qualifications

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

Responsibilities

• Identify, analyze, evaluate, and implement specialty pharmacy network strategies, reimbursement models, and contracting opportunities to support affordability while maintaining access and compliance.
• Develop and execute network optimization strategies including design, performance management, and market-based reimbursement methodologies.
• Support strategic planning, financial and qualitative analysis, business case development, and network evaluations for contracting and affordability initiatives.
• Translate network, reimbursement, and market dynamics into strategic recommendations for senior leadership.
• Present strategies, metrics, and recommendations to internal audiences including executive leadership.
• Collaborate with other departments as a subject matter expert in specialty pharmacy network strategy and affordability solutions.
• Monitor industry and regulatory trends impacting network performance and cost management.
• Engage with specialty pharmacies, PBMs, vendors, and providers to evaluate opportunities and support affordability solutions.

Skills

Healthcare Consulting

Financial Management

Healthcare Industry

Strategy Development

Health Outcomes

Medical Reimbursement

Performance Metrics

Provider Reimbursement

Project Management

Reimbursement

Analysis

Education

Bachelor's degree or advanced degree

Job description

Blue Cross and Blue Shield of North Carolina seeks a senior member of the strategic function to advance specialty pharmacy network strategy, contracting, and affordability initiatives. You will evaluate market opportunities, lead cost-reduction strategies, and translate market dynamics into actionable plans for senior leadership.

You will collaborate across departments, engage with external partners, and monitor regulatory trends to sustain member access while reducing unit costs.