Principal Strategic Advisor: Pharmacy

Blue Cross and Blue Shield of North Carolina

1d•Hybrid

About The Position

Leads efforts to achieve innovation-based goals through new forms of healthcare reimbursement, healthcare redesign consultation, payer/provider engagement and market offer opportunities. Leverages extensive 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.

Requirements

Bachelor’s degree or advanced degree (where required), or equivalent experience.
8+ years of experience in a related field.
In lieu of a degree, 10+ years of relevant professional experience.

Nice To Haves

Experience with PBMs or pharmacy operations.
Client‑facing sales or consultative experience.

Responsibilities

Consult with ASO clients on pharmacy benefits, programs, and pricing strategies.
Analyze client data to evaluate cost‑savings opportunities and identify utilization and cost 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 lead healthcare redesign, provider reimbursement, and partnership strategies to support BCBSNC’s growth objectives while managing healthcare costs and improving member outcomes and experience.
Support and manage development efforts for the enhancement and ongoing maintenance of current products and market offer components.
Lead critical activities including strategic planning, complex quantitative and qualitative analysis, and thought leadership at both 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 leadership.
Organize, optimize, and communicate progress toward completion of the overall work portfolio.
Collaborate with cross‑functional partners across the enterprise, 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.
Drive operational improvements through advanced analytics and reporting, project management methodologies, and consulting or engagement approaches.
Serve as a mentor and coach to junior team members and oversee workstreams or deliverables as needed.