Blue Cross Blue Shield of North Carolina
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Sr. Strategic Advisor, Healthcare Strategy
at Blue Cross Blue Shield of North Carolina
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.
• Proactively identify, evaluate and work to implement healthcare redesign, provider reimbursement and partnership strategies to meet BCBSNC’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.
• Utilizes expertise to identify operational improvements with new analysis/reporting capabilities, project management techniques and/or consulting/engagement approaches.
• Bachelor’s degree with at least 6 years experience with responsibility for strategic/business development, strategic planning, market or product development, healthcare operations, or business process improvement.
• OR Masters degree with at least 4 years experience as stated above.
• Direct experience leading and implementing business and contractual issues as well as serving as a liaison to business executives, internal and external, and other outside advisors
• Negotiation and/or consultative experience required.
• Experience related to the management and delivery of programs, projects and work efforts in a portfolio-based environment
• Masters in Health Administration, Business Administration or Public Health
• Previous work experience in health insurance or health care industry with multi-faceted knowledge of healthcare delivery systems is strongly preferred.
• Previous Network Management experience and/or other direct experience with provider reimbursement and pay for performance program design.
• Knowledge of ACO/PCMH, bundled payments and HMO payment models
• Understanding of BCBSNC business, systems, and organization preferred (may be specific to Finance, Healthcare, Network Management, Sales and marketing, IS, and/or Operations based on determined need of team)
• Proven leadership skills with the ability to manage goals through collaboration and teamwork.
• Ability to facilitate difficult conversations, build consensus and provide consultation expertise.
• Ability to create and communicate business cases as well as design and implement development programs.
• Proficient in stakeholder management, problem/issue resolution and cross-team collaboration
• Strong planning and portfolio management skills.
• Ability to think creatively and strategically while handling difficult and complex issues
• Excellent oral and written communication skills with ability to present information effectively to both internal and external audiences.
• Ability to meet time deadlines and effectively manage multiple priorities.
• Ability to manage extensive amounts of complex information, connect and interrelate disparate ideas and thoughts, pay attention to detail, and work effectively with varying constituencies
• Strong understanding of logic and causal relationships and with some experience directing and conducting relevant research.
• Ability to work independently and effectively handle changing priorities.
• Excellent initiative and interpersonal skills
• Strong interpretation and translation skills – ability to understand technical / expert jargon and business needs and bridge communication gaps.
• Proficient in working in a Windows-based technical environment, including the ability to use all standard MS Office products, as well as experience working with intranet and internet applications.
It's an exciting time to work at Blue Cross and Blue Shield of North Carolina. 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.
Our company is a not-for-profit with headquarters in Durham and major operations in Winston-Salem and Fayetteville. In all we employ more than 4,900 North Carolinians and serve more than 3.9 million customers.
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.
Third Party Staffing Agencies
Blue Cross NC does not accept unsolicited resumes from any source other than directly from candidates. For the protection of all parties involved in the recruiting process, resumes will only be accepted from recruiters/agencies if a signed agreement is in place at the inception of the recruiting effort and authorized for a specific position. Unsolicited resumes sent to Blue Cross NC from recruiters/agencies do not constitute any type of relationship between the recruiter/agency and Blue Cross NC and do not obligate Blue Cross NC to pay fees if we hire from those resumes.