Senior Strategic Advisor, Value Based Care

Job Description

We’re hiring a Senior Strategic Advisor to join the Value Based Care Program Strategy and Operations team! You will 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 advantages in the marketplace.

What You'll Do

• Proactivelyidentify, evaluate and work to implement healthcare redesign, providerreimbursementand partnership strategies to meet Blue Cross NC’s growthobjectives, 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/qualitativeanalysis,and thought leadership at a departmental and enterprise level.?

• Present information such as strategic concepts, planning data, medical expense/reimbursement rates, provider performancemetricsand impact assessments to both internal and external audiences at all levels, including senior-level leadership.

• Organize,optimize,and communicate progress towards the completion ofthe overallwork 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,analyzeandmonitorindustry, regulatory, technology and market-based trends that affect divisional operations, provider reimbursement, medical expensestrategy,and overall payer-provider dynamics.

• Utilizeexpertisetoidentifyoperational improvements with new analysis/reporting capabilities, project managementtechniques,and/or consulting/engagement approaches.

What You Bring

• Bachelor's degree or advanced degree (whererequired)

• 5+ years of experience in relatedfields.

• In lieu of degree, 7+ years of experience in related field.

Bonus Points (Preferred Qualifications)

• Demonstrated experience working withinValue-Based Caremodels, including ACOs, bundled payments,shared savingsarrangements, and quality?based incentive programs.

• Strong understanding of cost?of?care drivers, care coordination workflows,program/project management,and performance metrics used invalue-basedprograms (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 invalue?basedcontracts.

• Familiarity with population health tools, risk stratification models, and patient engagement strategies.

• Proventrack recordof supporting initiatives that enhance patient outcomes, close care gaps, andoptimizeincentive achievement.

• Knowledge of regulatory requirements and evolving industry standards related tovalue?basedcare arrangements.

WhatYou’llGet

• The opportunity to work at thecutting edgeof health care delivery with a teamthat’sdeeply invested in the community

• Work-life balance, flexibility, and the autonomy to dogreat work

• Medical, dental, and vision coverage along withnumeroushealth and wellness programs

• Parental leave and support plus adoption and surrogacyassistance

• Career development programs and tuition reimbursement for continued education

• 401k match

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.

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

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 . 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: .

Originally posted on Himalayas