Job Description

We are hiring a Senior Healthcare Consulting Advisor. This person will develop and present data-driven insights, healthcare consulting, and targeted recommendations to our largest and most complex ASO client groups, insurance brokers/consultants or large and complex provider systems/ACOs. You will independently advise on Blue Cross NC healthcare programs and services, medical policy, provider network/reimbursement strategies, cost drivers and industry best practices.

Also leverage significant employer-group/provider experience and expertise to define and deliver tailored solutions to employer group customers or provider systems through the analysis of relevant metrics and comprehensive customer insight to improve member health, provider quality and positive impact quality and affordability of care. As a senior member of the team, you will also provide subject matter expertise on healthcare industry topics to internal stakeholders and mentor staff.

What You Will Do

• Manage relationships and consults with large (1,000+) and national BCBSNC clients or largest Blue Premier systems/ACOs by developing tailored business plans to positively impact client/provider needs, improve BCBSNC competitive positioning, drive new partnerships/membership and improve retention.
• In coordination with internal stakeholders (i.e. Sales, Network, DNA, Quality), conducts periodic/annual/quarterly meetings with clients/providers to review relevant data, assess programs, advise on various healthcare topics, and suggest solutions to meet client/provider goals and objectives.
• Accesses diverse reporting sources and market intelligence to collect and analyze data, develop custom insights and make recommendations.
• Analyzes client financial, quality and/or utilization data to determine success of current engagement approach and identifies further opportunities to lower healthcare cost, improve quality and/or improve member health.
• Works with organization partners to understand internal capabilities related to current and future service offerings and assists in operationalizing what our clients/providers are requesting; supports responses to client groups/providers involving healthcare programs, operations and policies.
• Participate in relevant updates/calls/presentations with assigned employer groups/providers and/or prospective clients/partners.
• Negotiates client/provider specific engagements and partnerships, and effectively cross sells opportunities and markets programs to best meet current or prospective client/provider needs.
• For sales/client group activities: Supports and participates in finalist meetings for new and renewed groups.
• Assists with the planning and execution of key events for client groups/providers (Healthcare Symposium, Advisory Councils)
• Promotes goodwill and builds relationships with business leaders and providers; projects and maintains the corporate image within the community.
• Represents the department on enterprise workgroups and committees.
• Participates in training and/or initiatives to improve the consultative services offered to client groups/providers.

Who You Bring

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

Bonus Points(Preferred Qualifications)

• Master's degree preferred
• Experience with data analytics and reporting, including advanced Excel skills, pivot tables, and data interpretation.
• Demonstrated stakeholder management experience, with the ability to build relationships and influence cross-functional partners.
• Strong business acumen with the ability to translate data and insights into actionable business recommendations
• Proven client-facing experience with demonstrated success managing client relationships, presentations, and strategic discussions.

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.

$98,092.00 - $156,947.00

Skills

Client Management, Consulting, Health Care, Healthcare Consulting, Healthcare Industry, Healthcare Networks, Healthcare Operations, Healthcare Program Management, Medical Policy, Stakeholder Management

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 https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. 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: HR.Staffing@BCBSNC.com.