NC Health Affiliates LLC DBA Blue Cross NC is hiring a Senior Strategic Advisor, Healthcare to serve as a senior member of the strategic function. You will drive innovation-based goals by developing new healthcare reimbursement models, consulting on healthcare redesign, engaging payers and providers, and identifying market opportunities. You will leverage your industry experience to promote enterprise understanding of areas for competitive differentiation and sustainable advantage.
What You'll Do
- Proactively identify, evaluate and work to implement healthcare redesign, provider reimbursement and partnership strategies to meet growth objectives, manage healthcare costs, and improve outcomes and member experience.
- Support and manage development efforts related to the enhancement and maintenance of current products and market offer components.
- Collaborate and execute critical activities such as strategic planning, complex financial/qualitative analysis and thought leadership at departmental and enterprise levels.
- Present strategic concepts, planning data, medical expense/reimbursement rates, provider performance metrics and impact assessments to internal and external audiences, including senior leadership.
- Organize, optimize and communicate progress towards completion of overall work portfolio.
- Collaborate with and support other departments across the enterprise, 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 affecting divisional operations, provider reimbursement, medical expense strategy and payer-provider dynamics.
- Utilize expertise to identify operational improvements with new analysis/reporting capabilities, project management techniques and/or consulting/engagement approaches.
What We're Looking For
- Bachelor's degree or advanced degree (where required)
- 5+ years of experience in a related field
- In lieu of a degree, 7+ years of experience in a related field
Nice to Have
- Demonstrated experience working within value‑based care models (ACOs, bundled payments, shared‑savings, 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
Team & Environment
You will join the Value Program Strategy and Operations team.
Benefits & Compensation
- Salary range: $89,174.00 - $142,679.00
- Medical, dental, and vision coverage
- Numerous health and wellness programs
- Parental leave and support plus adoption and surrogacy assistance
- Career development programs
- Tuition reimbursement for continued education
- 401k match including an annual company contribution
- Work-life balance, flexibility, and autonomy
Work Mode
This position offers a hybrid work arrangement.
NC Health Affiliates LLC DBA Blue Cross NC is an equal opportunity employer.
