Senior Strategic Advisor, Value Based Care

About the role

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.

Responsibilities

• 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 the 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.

Requirements

• Bachelor's degree or advanced degree (where required)
• 5+ years of experience in related fields. In lieu of degree, 7+ years of experience in related field.

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, program/project management, 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.

Skills

• Skills not specified

Benefits

• Medical, dental, and vision coverage along with numerous health and wellness programs
• Parental leave and support plus adoption and surrogacy assistance
• Career development programs and tuition reimbursement for continued education

Pay

• $89,174.00 - $142,679.00

Schedule

• Hybrid Flex or Remote Flex depending on the nature of the work and distance from our Durham headquarters.