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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

About Us

It's an exciting time to work at Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians.

Blue Cross NC is a fully taxed, not-for-profit company headquartered in Durham, North Carolina. We serve more than 4.3 million members, and we employ more than 5,000 people across the country who are passionate about making health care better for all.

Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives.

Authorization to Work in the United States

We use E-verify to confirm authorization to work in the United States. To learn more about E-Verify, including your rights and responsibilities, please visit E-Verify Overview (https://www.e-verify.gov/employees/e-verify-overview) for English or Visión General de E-Verify (https://www.e-verify.gov/es/empleados/vision-general-de-e-verify) for Español.

Request Accommodations

Blue Cross NC provides reasonable accommodations to applicants with disabilities. If you need a reasonable accommodation for any part of the application or hiring process, please notify HR at [email protected] .

For most roles, you can choose where to work - fully remote in one of the states listed below, in the office, or a hybrid of the two:

Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, and Wyoming