Senior Strategist, Specialty Pharmacy Networks & Affordability

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

Job summary

Blue Cross NC is seeking a senior strategic leader to shape specialty pharmacy network design, contracting strategy, and market-based pricing to improve affordability while preserving member access. You will apply industry experience to identify opportunities and implement cost-reduction programs across the enterprise.

The role requires deep knowledge of network optimization, reimbursement methodologies, and cross-functional collaboration with PBMs, providers, and internal teams, and it presents

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

• Identify and implement specialty pharmacy network strategies to support affordability.
• Develop network optimization strategies and market-based reimbursement methodologies.
• Support financial analysis, business cases, and contracting decisions.
• Translate complex network, reimbursement, and market dynamics into strategic recommendations for internal stakeholders.
• Present network strategies and affordability opportunities to executive leadership.
• Collaborate with other departments as a subject matter expert in specialty pharmacy network strategy.
• Identify and monitor industry trends affecting network performance and cost management.

Skills

Healthcare Consulting

Financial Management

Healthcare Industry

Strategic Planning

Project Management

Provider Reimbursement

Reimbursement Analytics

Reporting & Analysis

Performance Metrics

Health Outcomes

Education

Bachelor's or advanced degree

Job description

Blue Cross NC is seeking a senior strategic leader to shape specialty pharmacy network design, contracting strategy, and market-based pricing to improve affordability while preserving member access. You will apply industry experience to identify opportunities and implement cost-reduction programs across the enterprise.

The role requires deep knowledge of network optimization, reimbursement methodologies, and cross-functional collaboration with PBMs, providers, and internal teams, and it presents