Teams at Blue Cross NC

Manage pharmacy utilization management operations and clinical review teams for a business segment. Drive operational and quality targets, oversee vendors and compliance, develop strategy, represent Pharmacy in cross-functional initiatives, support budget and technology roadmaps, and provide clinical consultation on medication therapy and UM programs.

Manage strategic provider engagement and network initiatives for Blue Cross NC Medicare Advantage products. Build and maintain provider partnerships, ensure contractual compliance, analyze financial/reimbursement impacts, reduce administrative burden, deliver provider education and workshops, resolve complex operational issues, support new payment models and emerging care solutions, and collaborate cross-functionally to improve provider satisfaction and network performance.

Provide strategic employment law counsel on hiring, performance management, terminations, benefits, wage-and-hour and regulatory compliance; draft policies; oversee employment litigation and EEOC matters; support corporate transactions and due diligence; select and manage outside counsel; advise senior leadership; mentor legal team and deliver training.