Senior Strategic Advisor, Value Based Care

🔥 0 minutes ago

🌲 North Carolina, South Carolina, +1 more states – Remote

🌲 North Carolina – Remote 🌴 South Carolina – Remote ⚔️ Virginia – Remote

💵 $89.2k - $142.7k / year

⏰ Full Time

🟠 Senior

🧐 Strategy

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Blue Cross NC

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Blue Cross NC is a health insurance provider that offers a range of health plans and services to individuals and groups. The company focuses on delivering quality healthcare coverage and improving health outcomes for its members through innovative health programs and services. Blue Cross NC is committed to enhancing access to affordable healthcare while supporting the health and wellness of the communities it serves.

📋 Description

• Contribute to innovation-based goals through new forms of healthcare reimbursement, healthcare redesign consultation, payer/provider engagement, and market offer opportunities • Promote enterprise understanding of areas in which the company seeks competitive differentiation and sustainable competitive advantages • Identify, evaluate, and implement healthcare redesign, provider reimbursement, and partnership strategies to meet Blue Cross NC’s growth objectives, manage healthcare costs, and improve outcomes and member experience • Support and manage development efforts related to enhancing and maintaining current products and market offer components • Collaborate on strategic planning, complex financial and qualitative analysis, and thought leadership at departmental and enterprise levels • Present strategic concepts, planning data, medical expense/reimbursement rates, 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 and support departments across the enterprise on common initiatives and unique ventures as a subject matter expert for healthcare delivery transformation and/or healthcare reimbursement and strategy • Identify, analyze, and monitor industry, regulatory, technology, and market trends affecting divisional operations, provider reimbursement, medical expense strategy, and payer-provider dynamics • Identify operational improvements using 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 • Demonstrated experience working within Value-Based Care models, including ACOs, bundled payments, shared savings arrangements, and quality-based incentive programs (preferred) • Strong understanding of cost-of-care drivers, care coordination workflows, program/project management, and performance metrics used in value-based programs, such as HEDIS, Stars, and CMS quality measures (preferred) • Ability to translate clinical, financial, and operational data into insights that drive improved quality outcomes and reduction in total cost of care (preferred) • Experience partnering with providers, clinical teams, payers, or operational stakeholders to improve performance in value-based contracts (preferred) • Familiarity with population health tools, risk stratification models, and patient engagement strategies (preferred) • Proven track record of supporting initiatives that enhance patient outcomes, close care gaps, and optimize incentive achievement (preferred) • Knowledge of regulatory requirements and evolving industry standards related to value-based care arrangements (preferred)

🏖️ Benefits

• The opportunity to work at the cutting edge of health care delivery with a team that’s deeply invested in the community • Work-life balance, flexibility, and the autonomy to do great work • Medical, dental, and vision coverage • Numerous health and wellness programs • Parental leave and support • Adoption and surrogacy assistance • Career development programs • Tuition reimbursement for continued education • 401k match • Annual Incentive Bonus • Paid Time Off (PTO) • Competitive health benefits and wellness programs