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.
- Consult with ASO clients on pharmacy benefits, programs, and pricing.
- Analyze client data to identify cost-savings opportunities and utilization 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 support implementation of healthcare redesign, provider reimbursement, and partnership strategies that align with BCBSNC's growth objectives while managing costs and improving member outcomes and experience.
- Support and manage development efforts related to the enhancement and maintenance of current products and market offer components.
- Collaborate on and execute critical activities including strategic planning, complex financial and qualitative analysis, and thought leadership at 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-level leadership.
- Organize, optimize, and communicate progress toward completion of the overall work portfolio.
- Collaborate with cross-functional partners across the enterprise on shared initiatives and unique ventures, 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.
- Leverage expertise to drive operational improvements through enhanced analytics and reporting capabilities, project management techniques, and consulting or engagement approaches.
Skills Healthcare Consulting, Healthcare Financial Management, Healthcare Industry, Healthcare Innovation, Healthcare Management, Healthcare Reimbursement, Healthcare Strategic Planning, Health Outcomes, Medical Reimbursement, Performance Metrics, Physician Reimbursement, Project Management, Provider Reimbursement, Reimbursement, Reporting and Analysis _____________________________________________________________________
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This posting was published by Blue Cross and Blue Shield of North Carolina on their own careers system and is shown here with a direct link to apply there. Employers: for corrections or removal, contact jobs@veritahire.com.