Strategic Pharmacy Networks Lead—Affordability & Access

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

Job summary

Blue Cross NC is seeking a senior strategist to lead specialty pharmacy network design and contracting, aiming to improve affordability while preserving member access. You will analyze market dynamics, develop network optimization strategies, and translate complex data into clear recommendations for executives.

The role requires 5+ years in healthcare or related fields, a relevant degree, and the ability to collaborate across departments, PBMs, providers, and vendor partners.

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

• 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.

Skills

Specialty pharmacy network strategy

Contracting

Reimbursement methodologies

Network optimization

Financial analysis

Stakeholder communication

Regulatory compliance

Vendor collaboration

Education

Bachelor's degree or advanced degree

5+ years of experience in related field

In lieu of degree, 7+ years of experience

Job description

Blue Cross NC is seeking a senior strategist to lead specialty pharmacy network design and contracting, aiming to improve affordability while preserving member access. You will analyze market dynamics, develop network optimization strategies, and translate complex data into clear recommendations for executives.

The role requires 5+ years in healthcare or related fields, a relevant degree, and the ability to collaborate across departments, PBMs, providers, and vendor partners.