Strategic Advisor, Healthcare

Blue Cross and Blue Shield of North Carolina; Oklahoma; On-site; USD 68,000 - 110,000; Full time

Job summary

An established industry player is seeking a Strategic Advisor in Healthcare to drive innovation and enhance healthcare reimbursement strategies. This role involves complex analysis, strategic planning, and collaboration across departments to improve healthcare outcomes and member experiences. The ideal candidate will have a strong background in healthcare reimbursement analysis, underwriting, and strategic consultation. Join a dynamic team dedicated to transforming healthcare delivery and making a meaningful impact on the industry.

Benefits

401(k) with Employer Match

Annual Incentive Bonus

Paid Time Off (PTO)

Competitive Health Benefits

Wellness Programs

Qualifications

• 5+ years of experience in healthcare or related fields.
• 3+ years in healthcare reimbursement analysis or payer/provider engagement.

Responsibilities

• Support healthcare redesign and reimbursement strategies.
• Analyze industry trends affecting operations and reimbursement.

Skills

Healthcare Reimbursement Analysis

Strategic Planning

Financial Analysis

Payer/Provider Engagement

Sales Support

Pharmacy Pricing Concepts

Education

Bachelor's Degree

Advanced Degree

Job description

Job Description

The Strategic Advisor, Healthcare plays a crucial role in assisting with complex analysis, evaluation, and planning to achieve the organization's innovation-based goals. This includes new forms of healthcare reimbursement, healthcare redesign consultation, payer/provider engagement, and market offer opportunities. Underwriting experience is essential for this role, as it supports the promotion of enterprise understanding in key areas where the company seeks to create competitive differentiation and establish a sustainable competitive advantage in the marketplace.

What You'll Do

• Support the implementation of healthcare redesign, provider reimbursement and partnership strategies to meet BCBSNC's growth objectives, as well as manage healthcare costs while improving outcomes and the healthcare experience for our members.

• Support and manage development efforts related to the enhancement and maintenance of our current products and market offer components.

• Assists with critical activities such as strategic planning, complex financial/qualitative analysis and thought leadership at a departmental and enterprise level.

• Present information such as strategic concepts, planning data, medical expense/reimbursement rates, provider performance metrics and impact assessments to both internal and external audiences at all levels, including leadership.

• Organize, optimize, and communicate progress towards the completion of overall work portfolio.

• Collaborate with and support other departments across the enterprise on both common initiatives and unique ventures, acting as a representative for healthcare delivery transformation and/or healthcare reimbursement and strategy.

• Analyze and monitor industry, regulatory, technology and market-based trends that affect divisional operations, provider reimbursement, medical expense strategy and overall payer-provider dynamics.

• Supports efforts for operational improvements with new analysis/reporting capabilities, project management techniques and/or consulting/engagement approaches.

• Provides pharmacy sales support.

• Develops custom pharmacy pricing.

What You'll Bring (Hiring Requirements)

• Bachelor's degree or advanced degree (where required). In lieu of a degree, 5+ years of experience in a related field.

• 3+ years of experience in a related field. For example, experience in healthcare reimbursement analysis or payer/provider engagement.

• Underwriting Experience preferred. Relevant examples include underwriting role in healthcare insurance sectors.

• Experience in sales support and consultation is a plus. Examples might include roles where you provided strategic advice to sales teams or consulted on healthcare redesign projects.

• Familiarity with pharmacy pricing concepts is desirable. Experience could include working with pharmacy benefit managers or analyzing drug pricing strategies.

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$68,200.00 - $109,100.00