Senior Strategy Advisor - Specialty Pharmacy & Affordability

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

Job summary

Blue Cross NC is seeking a senior professional to lead specialty pharmacy network strategy, partnering with teams to design contracts and optimize networks for affordability and member access across our enterprise. You will influence pricing, reimbursement models, and strategic investments while aligning with regulatory expectations.

The role requires extensive market insight, stakeholder collaboration, and the ability to translate complex dynamics into clear recommendations for executive

Qualifications

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

Responsibilities

• Proactively identify, analyze, evaluate, and implement specialty pharmacy network strategies, reimbursement models, and contracting opportunities that support affordability goals while maintaining member access, provider relationships, and regulatory compliance.
• Develop and execute specialty pharmacy network optimization strategies, including network design, performance management, pricing approaches, participation requirements, and market-based reimbursement methodologies.
• Support strategic planning, structured financial and qualitative analysis, business case development, and network evaluations to inform contracting decisions, network investments, and affordability initiatives.
• Translate complex network, reimbursement, and market dynamics into clear strategic recommendations and actionable plans for internal stakeholders, including senior leadership.
• Present network strategies, performance metrics, affordability opportunities, contracting recommendations, and impact assessments to internal audiences at all levels, including executive leadership.
• Collaborate with and support other departments across the enterprise on both common initiatives and unique ventures, acting as a subject matter expert in specialty pharmacy network strategy, contracting, reimbursement methodologies, and affordability solutions.
• Identify, analyze, and monitor industry, regulatory, technology, provider, PBM, and market trends that influence specialty pharmacy network performance, reimbursement economics, access models, and overall cost management.
• Engage with specialty pharmacies, PBMs, vendor, consultants, vendors, providers, and other external partners to evaluate opportunities, resolve strategic challenges, and support development of innovative affordability solutions.
• Organize, synthesize, and communicate progress, recommendations, and outcomes across the specialty pharmacy network strategy portfolio to support alignment, accountability, and informed decision‑making.
• Utilize expertise to advance network strategy, contracting, reimbursement, and affordability capabilities, continuously improving how network-based solutions are developed, evaluated, and implemented to achieve sustainable unit cost reduction.

Skills

Specialty pharmacy network design

Contracting strategy

Network optimization

Market-based pricing

Affordability initiatives

Stakeholder engagement

Regulatory compliance

Strategic planning

Cost reduction

Industry analysis

Education

Bachelor's degree

Advanced degree

Job description

Blue Cross NC is seeking a senior professional to lead specialty pharmacy network strategy, partnering with teams to design contracts and optimize networks for affordability and member access across our enterprise. You will influence pricing, reimbursement models, and strategic investments while aligning with regulatory expectations.

The role requires extensive market insight, stakeholder collaboration, and the ability to translate complex dynamics into clear recommendations for executive