Job Description
We’re hiring a Senior Strategic Advisor to join the Value Based Care Program Strategy and Operations team! You will act act 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
Proactively identify, evaluate and work to implement healthcare redesign, provider reimbursement and partnership strategies to meet Blue Cross NC’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.
Collaborate and execute 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 senior-level 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 subject matter expert for healthcare delivery transformation and/or healthcare reimbursement and strategy.
Identify, analyze and monitor industry, regulatory, technology and market-based trends that affect divisional operations, provider reimbursement, medical expense strategy and overall payer-provider dynamics.
Utilize expertise to identify operational improvements with new analysis/reporting capabilities, project management techniques and/or consulting/engagement approaches.
What You Bring
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.
Bonus Points (Preferred Qualifications)
Demonstrated experience working within Value Based Care models, including ACOs, bundled payments, shared‑savings arrangements, and quality‑based incentive programs.
Strong understanding of cost‑of‑care drivers, care coordination workflows, and performance metrics used in value‑based programs (e.g., HEDIS, Stars, CMS quality measures).
Ability to translate clinical, financial, and operational data into insights that drive improved quality outcomes and reduction in total cost of care.
Experience partnering with providers, clinical teams, payers, or operational stakeholders to improve performance in value‑based contracts.
Familiarity with population health tools, risk stratification models, and patient engagement strategies.
Proven track record of supporting initiatives that enhance patient outcomes, close care gaps, and optimize incentive achievement.
Knowledge of regulatory requirements and evolving industry standards related to value‑based care arrangements.
What You’ll Get
The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community
Where You’ll Work
Our Hybrid Flex approach is built on presence with a purpose – giving you flexibility to work remotely with intentional in-person connection – that supports a workplace that’s flexible, connected, and future focused.
In a Hybrid-Flex role, you’ll work in the office at least two days a week for collaboration and connection. In a Remote Flex role, you’ll work virtually, with a few in-office visits each year for meaningful moments that matter.
Whether your 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 states listed on this job posting. Onsite expectations will be discussed during the interview process.
#LI-Hybrid
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.
Skills
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