Senior Strategic Advisor: Pharmacy

Job Description

Acts as a senior member of the strategic function by contributing to the achievement of innovation-based goals through new forms of healthcare reimbursement, healthcare redesign consultation, payer/provider engagement and market offer opportunities. Leverages industry experience and expertise to promote enterprise understanding of the key areas in which the company is seeking to create competitive differentiation and establish sustainable competitive advantage in the marketplace.

What You’ll Do

• Consult with ASO clients on pharmacy benefits, programs, and pricing.

• Analyze client data to identify cost‑savings opportunities and utilization trends.

• Conduct quarterly and annual utilization review meetings with clients.

• Manage relationships with ASO clients, medical sales partners, and external consultants.

• Proactively identify, evaluate, and support implementation of healthcare redesign, provider reimbursement, and partnership strategies that align with BCBSNC’s growth objectives while managing costs and improving member outcomes and experience.

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

• Collaborate on and execute critical activities including strategic planning, complex financial and qualitative analysis, and thought leadership at departmental and enterprise levels.

• Present strategic concepts, planning insights, medical expense and reimbursement data, provider performance metrics, and impact assessments to internal and external audiences, including senior‑level leadership.

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

• Collaborate with cross‑functional partners across the enterprise on shared initiatives and unique ventures, serving as a subject matter expert in healthcare delivery transformation, reimbursement, and strategy.

• Identify, analyze, and monitor industry, regulatory, technology, and market trends impacting divisional operations, provider reimbursement, medical expense strategy, and payer‑provider dynamics.

• Leverage expertise to drive operational improvements through enhanced analytics and reporting capabilities, project management techniques, and consulting or engagement approaches.

Hiring Requirements

• Bachelor’s degree or advanced degree (where required).

• 5+ years of experience in a related field.

• In lieu of a degree, 7+ years of relevant experience.

Great to Have

• PBM or pharmacy experience.

• Client‑facing sales or consultative experience.

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.

$89,174.00 - $142,679.00

Skills

Healthcare Consulting, Healthcare Financial Management, Healthcare Industry, Healthcare Innovation, Healthcare Management, Healthcare Reimbursement, Healthcare Strategic Planning, Health Outcomes, Medical Reimbursement, Performance Metrics, Physician Reimbursement, Project Management, Provider Reimbursement, Reimbursement, Reporting and Analysis

JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC . If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: [email protected] .

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] .

Blue Cross NC is a Hybrid Flex company. Whether the role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in any of our approved states:

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