Strategic Advisor, Specialty Pharmacy Network

Blue Cross and Blue Shield of North Carolina; Virginia (IL); On-site; USD 89,000 - 143,000; Full time

Benefits offered by this job

Annual incentive bonus

401(k) with employer match

Paid Time Off (PTO)

Health benefits

Job summary

Blue Cross NC is seeking a senior professional to drive specialty pharmacy network strategy and affordability initiatives. You will shape contracting, network design, and reimbursement models to lower costs while preserving member access and robust provider relationships.

Responsibilities include analyzing market dynamics, presenting strategic recommendations to senior leadership, and collaborating with diverse teams to implement cost-reduction solutions within regulatory guidelines.

Qualifications

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

Responsibilities

• Identify and implement specialty pharmacy network strategies and contracting opportunities.
• Develop network optimization strategies including pricing and reimbursement methodologies.
• Support strategic planning with financial and qualitative analysis.
• Translate market dynamics into strategic recommendations for leadership.
• Present strategies and impact assessments to executive leadership.
• Collaborate with other departments to advance affordability solutions.
• Monitor industry and regulatory trends affecting network performance.

Skills

Healthcare Consulting

Healthcare Financial Management

Healthcare Industry

Healthcare Reimbursement

Performance Metrics

Project Management

Provider Reimbursement

Reimbursement

Strategic Planning

Health Outcomes

Education

Bachelor's degree

Advanced degree

Job description

Blue Cross NC is seeking a senior professional to drive specialty pharmacy network strategy and affordability initiatives. You will shape contracting, network design, and reimbursement models to lower costs while preserving member access and robust provider relationships.

Responsibilities include analyzing market dynamics, presenting strategic recommendations to senior leadership, and collaborating with diverse teams to implement cost-reduction solutions within regulatory guidelines.