Strategic Pharmacy Network Lead

Blue Cross and Blue Shield of North Carolina

Town of Texas (WI)

On-site

USD 89,000 - 143,000

Full time

14 days+

Application generator

Turn this role into an interview — a resume and cover letter built around what this employer wants.

Get past ATS filters

Benefits offered by this job

Annual Incentive Bonus*

401(k) with employer match

Paid Time Off (PTO)

competitive health benefits and well‑n

Job summary

Blue Cross NC in the United States seeks a senior strategic specialist to lead specialty pharmacy network design, contracting strategy, and market-based pricing to improve affordability while preserving member access.

You will translate market dynamics into actionable plans, present to leadership, collaborate across departments, monitor industry trends, and engage external partners to advance cost-reduction initiatives.

Qualifications

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

Responsibilities

Identify, analyze, evaluate, and implement specialty pharmacy network strategies, reimbursement models, and contracting opportunities that support affordability while maintaining member access and regulatory compliance.
Develop and optimize network design, pricing approaches, participation requirements, and market-based reimbursement methodologies.
Support strategic planning with financial and qualitative analysis, business case development, and network evaluations to inform decisions.
Translate network, reimbursement, and market dynamics into clear strategic recommendations for internal stakeholders and senior leadership.
Present network strategies, performance metrics, affordability opportunities, contracting recommendations, and impact assessments to executive leadership.
Collaborate across departments and external partners to advance specialty pharmacy network strategy and affordability solutions.
Monitor industry, regulatory, technology and market trends affecting network performance and cost management.
Engage with specialty pharmacies, PBMs, vendors, and providers to identify opportunities and resolve strategic challenges.
Organize and communicate progress and outcomes across the portfolio to support alignment and accountability.
Continuously improve to achieve sustainable unit cost reduction through network-based solutions.