Job Description
Leads the development, execution, and continuous assessment of pricing strategies across the EBS and CDS portfolio, including designated Blue Cross NC-affiliated products and services within scope. Serves as the organization's subject matter expert in market-based pricing, Target Market Price (TMP) methodologies, competitive pricing intelligence, and portfolio pricing optimization.Owns the development and maintenance of Target Market Price methodologies, ensuring pricing recommendations are informed by customer value, market willingness-to-pay, competitive positioning, financial performance objectives, and long-term portfolio strategy.
Partners closely with Product Management, Sales, Finance, Actuarial, Underwriting, and business P&L leaders to establish pricing strategies that balance market competitiveness, growth objectives, customer value, and financial performance. Develops pricing frameworks, market-informed guardrails, and strategic pricing recommendations that guide product positioning, customer quotations, and portfolio investment decisions.
Provides ongoing monitoring of market conditions, competitive pricing trends, profitability performance, and customer purchasing behaviors to ensure pricing strategies remain aligned with organizational goals and evolving market dynamics.
What You'll Do
Target Market Price (TMP) Strategy & Pricing Leadership
Owns the development, implementation, and continuous refinement of Target Market Price (TMP) methodologies across assigned products and services.
Defines market-based pricing strategies that balance customer value, competitive positioning, growth objectives, and profitability requirements.
Establishes target pricing ranges, acceptable pricing corridors, and pricing thresholds for products, services, and customer segments.
Evaluates willingness-to-pay, customer value drivers, competitor pricing, and market dynamics to inform pricing recommendations.
Develops strategic pricing frameworks that support sustainable growth and portfolio profitability.
Leads initiatives to optimize pricing approaches throughout the product lifecycle.
Recommends pricing actions that align with business objectives, market opportunities, and financial targets.
Market Intelligence & Competitive Analysis
Conducts ongoing analysis of healthcare market pricing trends, competitor pricing strategies, employer purchasing behaviors, and emerging market developments.
Develops and maintains pricing benchmarks across relevant healthcare products and services.
Monitors market shifts, competitive actions, and customer demand signals to proactively identify pricing opportunities and risks.
Evaluates the impact of competitor and market pricing changes on portfolio performance and strategic positioning.
Synthesizes market research, financial performance data, customer insights, and industry trends into actionable recommendations.
Serves as the primary source of pricing intelligence for business and product leaders.
Pricing Governance & Framework Development
Establishes pricing guardrails, approval thresholds, discounting standards, and pricing governance processes across assigned portfolios.
Develops methodologies to ensure consistency in pricing decisions and alignment with market strategies.
Creates pricing decision frameworks that support scalable and repeatable pricing practices.
Reviews pricing exceptions and recommends actions based upon strategic, financial, and market considerations.
Ensures pricing decisions align with organizational objectives while maintaining competitiveness and profitability.
Self-Insured Group Pricing & Quotation Support
Serves as strategic pricing lead for self-insured employer group opportunities.
Collaborates with P& Leaders, Sales, Underwriting, Actuarial, Finance, and Product Management teams to develop pricing strategies for new and renewing employer groups.
Assesses proposed pricing against established TMP methodologies, pricing guardrails, and financial targets.
Provides pricing consultation and recommendations for complex, high-value, or strategically important opportunities.
Supports negotiation strategies through analysis of pricing flexibility, competitive positioning, market conditions, and financial implications.
Identifies trade-offs between growth objectives, profitability requirements, and market competitiveness.
Contributes to development of customer pricing value propositions and pricing-related sales support materials.
Portfolio Performance & Financial Analysis
Partners with business P&L leaders to evaluate pricing effectiveness and overall portfolio performance.
Assesses revenue, margin, retention, growth, and profitability trends associated with pricing decisions.
Conducts scenario modeling and sensitivity analyses to evaluate strategic pricing alternatives.
Identifies opportunities to improve portfolio performance through pricing optimization and market repositioning.
Supports annual planning, forecasting, and strategic growth discussions through pricing and financial analyses.
Develops business cases supporting pricing recommendations and strategic investment decisions.
Cross-Functional Leadership & Influence
Builds and manages strong partnerships across Product Management, Sales, Finance, Underwriting, Actuarial, Network Management, Operations, and business leadership teams.
Influences pricing decisions across multiple products, services, and business areas without direct authority.
Facilitates alignment among stakeholders regarding pricing strategy, competitive positioning, growth objectives, and financial outcomes.
Translates complex pricing concepts into actionable recommendations for executive and business leaders.
Serves as a trusted advisor on pricing strategy, market dynamics, and portfolio profitability.
Reporting, Analytics & Insights
Develops pricing performance dashboards, scorecards, and reporting frameworks.
Tracks and communicates key pricing metrics, including:
Price realization
Market competitiveness
Quote win/loss rates analysis
Margin performance
Retention impacts
Portfolio growth
Pricing variance trends
Competitive positioning
Customer segment performance
TMP effectiveness
Provides recurring pricing assessments and strategic recommendations to leadership.
Identifies trends and opportunities requiring strategic pricing intervention.
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.
Skills
Finance, Finance Strategy, Financial Advising, Financial Analysis, Financial Execution, Financial Planning and Analysis (FP&A), Operational Process Improvements, Portfolio Management, Process Improvements, Resource Management, Strategic Planning, Strategic Thinking, Strategy Development, Wealth 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: [email protected].
Skills Required
- Expertise in Target Market Price (TMP) methodologies and market-based pricing
- Competitive pricing intelligence and market analysis experience
- Financial analysis, scenario modeling, and pricing optimization experience
- Experience partnering with Product Management, Sales, Finance, Actuarial, Underwriting, and P&L leaders
- Developing pricing frameworks, guardrails, and governance processes
- Pricing strategy development for self-insured employer group opportunities
- Experience building pricing performance dashboards, scorecards, and reporting frameworks
- Portfolio management and profitability analysis experience
- Strategic thinking, resource management, and process improvement skills
- Skills listed: Finance, Financial Analysis, FP&A, Portfolio Management, Strategic Planning
What We Do
It's an exciting time to work at Blue Cross and Blue Shield of North Carolina. Health care is changing, and we're leading the way. We offer more than health insurance our customers can count on. We’re committed to better health and better health care − in our communities and beyond. Our employees bring energy and creativity to the workplace, and it shows in our innovative approach to improving the health and well-being of North Carolinians. Our company is a not-for-profit with headquarters in Durham and major operations in Winston-Salem and Fayetteville. In all we employ more than 4,500 North Carolinians and serve more than 3.7 million customers. Help us lead the charge for better health care by joining our award-winning team. Discover tremendous opportunities with us to do challenging and rewarding work. Opportunities that can lead you to a fulfilling career, work that can help others lead healthier, happier lives. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association.
