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Job Description
We're seeking a Strategic Advisor to join the Reimbursement Policy team in our Payment Integrity department! You will assist with complex analysis, evaluation, and planning needed to achieve the organization's innovation based goals through healthcare reimbursement and payer/provider engagement. Supports reimbursement policy development by assisting with policy interpretation, stakeholder alignment, and application across Commercial and Medicare Advantage lines of business.
You will also promote enterprise understanding of reimbursement policy positions and provides analysis and decision support that helps translate policy direction into clear documentation for governance, implementation readiness, and leadership decision making.
What You'll Do
Support the development, writing and refinement of Commercial and Medicare Advantage reimbursement policies to meet BCBSNC's growth objectives and manage healthcare costs while improving outcomes and the healthcare experience for our members. Support implementation of healthcare reimbursement strategies by translating reimbursement policy direction into clear policy intent, application, rationale, and documentation, including identification and articulation of policy and strategy considerations. Assist with critical strategic planning and thought leadership at a departmental and enterprise levelby developing policy summaries, briefing materials, and supporting documentation. Present reimbursement policy concepts, strategic considerations, and impact assessments in a clear, structured manner to internal and external audiences, including leadership and governance forums. Organize, optimize and communicate progress towards the completion of the overall reimbursement policy work portfolio, including tracking development milestones, dependencies, and readiness for governance consideration. Coordinate, collaborate and integrate input from clinical, legal, compliance, strategy, provider, and operational partners to support the development of reimbursement policies and ensure crossfunctional alignment prior to governance review. Analyze and monitor regulatory, industry, and marketbased trends that affect reimbursement policy, provider reimbursement approaches, medical expense strategy, and payerprovider dynamics. Support efforts of operational improvements by enhancing policy analysis and reporting capabilities, when applicable.
What You Bring
Bachelor's degree or advanced degree (where required) 3+ years of experience in related field. In lieu of degree, 5+ years of experience in related field.
Bonus Points (preferred qualifications)
Bachelor's degree in Public Policy, Public Health, Healthcare Administration, Business, or a related field. 3+ years of experience in policy analysis, healthcare policy support, reimbursement, or related analytical roles. Strong written communication skills with experience drafting structured policy or briefing materials. Ability to analyze complex information and synthesize it into clear recommendations. Experience working in cross-functional, matrixed environments. Familiarity with healthcare reimbursement concepts, payment policy, or provider reimbursement models. Experience supporting policy review, governance, or structured approval processes. Strong organizational skills and ability to manage multiple workstreams concurrently.
What You'll Get
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 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 401k match
WhereYou'llWork Our Hybrid Flex approach is builton presencewith a purpose - giving you flexibility to work remotely with intentional in-person connection - that supports a workplacethat'sflexible, connected, and future focused. In a Hybrid-Flex role,you'llwork in the office at least two days a week for collaboration and connection. In a Remote Flex role,you'llwork virtually, with a few in-office visits each year formeaningfulmoments that matter. Whether your role is Hybrid Flex or Remote Flex depends on the nature of the work and distance from our Durham headquarters. We welcome candidates from outside the local area and in anystateslistedonthis job posting. Onsite expectations will be discussed during the interview process. 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. $73,698.00 - $117,917.00
Skills Data Analysis, Healthcare Industry, Healthcare Management, Healthcare Reimbursement, Healthcare Strategic Planning, Healthcare Strategy, Medical Reimbursement, Operational Process Improvements, Performance Metrics, Pharmacy, Pharmacy Operations, Physician Reimbursement, Project Management, Provider Reimbursement, Reimbursement
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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.
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Blue Cross and Blue Shield of North Carolina
$73,698.00 - $117,917.00
parental leave, paid time off, tuition reimbursement, 401(k)
May 18, 2026