Corporate Strategy Senior Consultant - Business Planning & Management
About the job
- A bachelor's degree in a related discipline or equivalent work experience.
- At least 5 years of related business experience.
- Analytical and creative problem-solving skills to lead hypothesis development and integration.
- Ability to generate actionable insights from analytical work.
- Written and verbal communication skills, including facilitation and presentation abilities.
- Ability to work independently.
- Familiarity with the health insurance industry and its concepts.
- Relationship-building and influence skills.
- Ability to mentor junior staff and aid in career development.
- Lead and manage small- to mid-size projects and portions of larger projects addressing critical strategic issues for the Blue System.
- Apply analytical rigor, including data collection and analysis.
- Execute primary and secondary research, including Blue Cross Blue Shield Plan input.
- Identify actionable insights and share them with non-technical audiences, including senior leadership.
- Communicate upward, downward, and across the organization to keep business partners engaged and motivated to act on strategic insights.
- Develop executive deliverables and present findings to inform and influence key decision-makers.
- Conduct primary and secondary research, synthesize findings, and identify strategic recommendations.
- Lead mid-size projects and portions of larger projects.
- Support strategic planning, including Blue Cross Blue Shield Plan engagement.
- Provide coaching and oversight to junior staff.
- AI literacy and understanding of generative artificial intelligence tools, including appropriate business applications and limitations.
- Experience with business or product strategy development and applying analytical methods.
- At least 5 years of related business experience.
- Project-lead experience preparing work plans and leading small- to mid-size projects and portions of larger projects.
About the company
BCBS is a federation of 34 independent member insurers that licenses the Blue Cross Blue Shield brand to those members, and the association itself does not sell insurance but coordinates national marketing, research, advocacy, and brand support. Each member insurer tailors plans to its local market and markets them under the licensed BCBS brand; revenue comes from premiums and investments, while member companies build the provider network. The system is decentralized and community-based, with independent local companies under a single brand, backed by shared marketing, advocacy, and research resources. Its goal is to expand access to health insurance and healthcare by combining local market flexibility with a national brand and support system for broad coverage.
Company Size
1,001-5,000
Company Stage
N/A
Total Funding
N/A
Headquarters
Chicago, Illinois
Founded
1910
Get referred to Blue Cross Blue Shield
See people who can refer or advise you
Simplify's Take
What believers are saying
- Blue Shield of California launched Prior Authorization Reimagined, targeting 80% near-real-time responses by 2027.
- BCBS settlement payments began May 11, 2026, reducing legacy litigation overhang.
- Blue Cross launched new mobile features in 2026, including digital ID cards and claim tracking.
What critics are saying
- Texas AG Ken Paxton opened a September 28, 2026 investigation into BCBSTX.
- BCBSA’s September 24, 2026 AI-coding report invites retaliation from hospitals and regulators.
- Antitrust scrutiny after the 2022 settlement threatens the exclusive-licensing model itself.
What makes Blue Cross Blue Shield unique
- Thirty-four local BCBS licensees combine national brand scale with state-specific networks.
- BCBSA coordinates policy, data science, and advocacy while members run independently.
- The federation’s 2026 prior-authorization pledge spans fifty-plus plans, matching nationwide reach.
Help us improve and share your feedback! Did you find this helpful?
Benefits
Health Insurance
Hybrid Work Options
Company News
Paxton launches investigation into Blue Cross Blue Shield over alleged delays and denials of urgent care as AI healthcare "arms race" Drives costs higher. Texas Attorney General Ken Paxton announced Monday that his office has launched an investigation into Blue Cross Blue Shield of Texas over allegations that the insurer denied or delayed urgent and medically necessary care, as a separate national debate intensifies over the use of artificial intelligence by both hospitals and insurance companies. According to the Texas Attorney General's Office, the investigation covers Blue Cross Blue Shield of Texas, its parent company Health Care Service Corporation, and related entities. Investigators are examining the companies' claim-review procedures and prior-authorization requirements. Paxton's office said it had received reports alleging that medically necessary or urgent procedures were delayed or denied. In one particularly serious allegation, the Attorney General's Office said a newborn needed urgent treatment and a transfer to another medical facility, but administrative denials and potentially improper utilization-review procedures allegedly delayed approval. "Blue Cross Blue Shield has a responsibility to put patients before profits and ensure that Texans receive the care they need," said Attorney General Paxton. "When a newborn baby or any other Texan urgently needs medical treatment, an insurance company's priority should be helping provide that care to the best of its ability - not searching for ways to delay or deny it. I will wage a relentless legal battle against any insurance company that fails to protect health and safety of Texans." Paxton also announced the investigation on X: The Texas investigation comes just days after the Blue Cross Blue Shield Association released its own analysis raising concerns about an entirely different side of the healthcare payment system: hospitals using artificial intelligence to identify additional billable diagnoses. According to Blue Cross Blue Shield Association's September 24 analysis, increasing coding intensity was associated with an estimated $942 million in additional spending for Blue Cross companies between 2023 and 2025. Roughly $653 million was linked to secondary diagnoses that moved patients into higher-reimbursement categories. BCBSA said more than 60% of hospital systems now use AI-enabled technology capable of scanning laboratory results, medical records and clinical documentation for secondary diagnoses. The association's analysis found that the percentage of inpatient cases categorized as medically complex increased from roughly 37% in early 2023 to 40% by the end of 2025. At the same time, BCBSA said it found no corresponding increase in treatment that would indicate patients were actually receiving substantially more complex care. Luke Chalker, BCBSA's senior vice president of product and data science, summarized the group's conclusion: "AI is identifying more billable conditions, not sicker patients." Around the web. But the AI fight cuts both ways. Healthcare industry reporting indicates that insurers are also deploying artificial intelligence to scrutinize medical charts and challenge claims. McLaren Health Care's chief financial officer recently said insurers use AI to scan records for claims they can deny while hospitals examine those same records to maximize reimbursement. "All the insurers are using A.I. to scan our charts to look for claims to deny. For the same reason, we're looking at the same charts today," Dave Mazurkiewicz, the CFO of McLaren Health Care, told the NY Times. That developing technological arms race has created a striking dynamic: hospitals can deploy algorithms to identify diagnoses that generate higher reimbursement, while insurers can use their own automated tools to challenge whether those claims should be paid. Hedgie Markets summarized the controversy on X, arguing that patients ultimately bear the financial consequences through premiums and other healthcare costs. Florida Gov. Ron DeSantis also weighed in, according to the statement provided for this report: "Both Big Hospitals and Big Insurance are using AI tools to either seek more reimbursements or to deny more claims. The result: AI providers make a lot of money, individuals pay higher premiums and have more denials, and nobody gets healthier." BCBSA itself says its estimated $942 million increase ultimately puts upward pressure on premiums and out-of-pocket costs for families, employers and taxpayers. Jim Hᴏft is the founder and editor of The Gateway Pundit, one of the top conservative news outlets in America. Jim was awarded the Reed Irvine Accuracy in Media Award in 2013 and is the proud recipient of the Breitbart Award for Excellence in Online Journalism from the Americans for Prosperity Foundation in May 2016. Ad block users: Some site features may not work correctly while an ad blocker is enabled, because they break scripts and content this website depends on. If you can't see comments below, for example, please disable your ad blocker.
Texas to investigate Blue Cross Blue Shield over prior authorization delays. Posted: Sep 28, 2026 / 01:13 PM CDT Updated: Sep 28, 2026 / 01:13 PM CDT AUSTIN (KXAN) - The Texas Office of the Attorney General announced Monday an investigation into the health insurance company Blue Cross Blue Shield of Texas over "potentially burdensome prior authorization requirements" that could delay "urgent and medically necessary care," according to an agency press release. Prior authorization policies require a patient's insurance company to approve covered treatments or medications before medical providers can provide care. These are often done as a cost-saving step for insurers, as preemptively rejecting a claim means less that it has to pay, or so the logic goes. "Reports received by the OAG indicate that BCBSTX may have denied or delayed coverage for procedures deemed medically necessary or urgent," it said. "Such delays can worsen a patient's condition, increase the risk of complications, allow disease progression, cause disability or death, and increase administrative costs." BCBSTX declined to comment on the investigation. The company said in April it had made "meaningful" progress towards streamlining the process. It touted an 11% reduction in the number of services that need prior authorization. "Moving forward, we will focus on our commitment to address 80% of electronic prior authorization requests in real-time, at the speed of care. We share CMS' urgency to modernize the infrastructure of health care and understand that all of us - policymakers, payers and care providers - have a role to play in activating change," said Kim Keck, Blue Cross Blue Shield Association CEO, in April. The OAG also said it brought the investigation for alleged violations of the Texas Deceptive Trade Practices Act. It'll have to determine if the company failed to "adequate[ly] review" claims.
Blue Cross launches new app. Blue Cross Blue Shield has launched a new app designed to make managing everyday health care needs more convenient, especially for users on the go. The app allows users to access a digital ID card at any time and add it to Apple Wallet or Google Wallet. It also provides real-time updates on claims and prior authorization status. Additional features include biometric login for enhanced security and a doctor finder tool that helps users locate in-network providers. More information is available online.
Tim O'Brien to lead Health Plans, Inc. (HPI) as president. Jun 23, 2026, 12:00 ET Health Plans, Inc. (HPI) is excited to announce the appointment of industry veteran Tim O'Brien as its new President. With Tim at the helm, HPI is poised to enhance its commitment to operational excellence and deliver outstanding results in the healthcare sector. WESTBOROUGH, Mass., June 23, 2026 /PRNewswire-PRWeb/ - HPI, a leading national third-party administrator (TPA) of self-funded benefits and subsidiary of Point32Health, has announced the appointment of Tim O'Brien as president. O'Brien brings more than 25 years of experience across payer, third-party administration, PBM, care delivery, and surgical network organizations. Interim President Glenn MacFarlane worked closely with O'Brien to ensure a smooth leadership transition. "Tim is an accomplished leader with deep experience across the healthcare ecosystem and a proven track record of driving growth and innovation. His expertise in building high-performing organizations and delivering client-focused solutions makes him the right leader for HPI's next chapter," said Marti Lolli, executive vice president of markets & chief growth officer at Point32Health. "We're excited to welcome Tim and confident that he'll further strengthen HPI's position as a trusted partner to brokers and employers nationwide." "I'm excited to join HPI and build on the strong foundation already in place," said O'Brien. "The organization has established a reputation for delivering flexible, outcome-focused solutions. I look forward to working with the team to advance operational excellence, accelerate growth, and expand our impact across the healthcare ecosystem." O'Brien joins HPI from Vitori Health, a vertically integrated health plan platform, where he served as chief executive officer. He led the company through a period of significant growth, culminating in a successful exit to Global Excel Management in 2025. Prior to joining Vitori Health, O'Brien served as division president at Blue Cross Blue Shield of Kansas City and as president and COO of Nueterra Companies. His operating experience includes large-scale technology transformations, international business operations in the United Kingdom and the Middle East, and building high-performing teams across complex, multi-line healthcare organizations. The appointment of O'Brien follows a thorough national recruitment process that interviewed candidates from across the United States. HPI redefines what is possible with self-funded health plans. As a leading national third-party administrator, HPI partners with health plan brokers and employers to deliver innovative self-funding strategies and customized plans tailored to each client's needs and population. HPI's solutions give employers greater cost transparency and control while elevating the member experience. Its entrepreneurial spirit, flexible approach, and personalized service have helped to serve clients of all sizes across all industries, delivering forward-thinking strategies that make the most of every healthcare dollar. About Point32Health Point32Health, the parent company of Harvard Pilgrim Health Care and Tufts Health Plan, is a leading not-for-profit health and well-being organization dedicated to delivering high-quality, affordable health care. Serving nearly 2 million members, its purpose is to guide and empower healthier lives. Media Contact SOURCE HPI
IRS announces increased ACA employer shared responsibility penalties for 2027. Posted by BAS - 04 June, 2026 The IRS has released updated Affordable Care Act ("ACA") employer shared responsibility penalty amounts for the 2027 calendar year. The new indexed amounts reflect another increase in potential penalties for applicable large employers ("ALEs") that fail to comply with ACA employer mandate requirements. Under the ACA, ALEs, generally employers with 50 or more full-time and full-time equivalent employees, may face penalties if they do not offer qualifying health coverage to eligible full-time employees and their dependents. For 2027, the IRS adjusted the penalties as follows: * The Code § 4980H(a) penalty, often referred to as the "A penalty," will increase to $3,780 per full-time employee, after excluding the first 30 employees. This penalty may apply if an ALE fails to offer minimum essential coverage to at least 95% of its full-time employees and their dependent children, and at least one employee receives subsidized coverage through a Health Insurance Marketplace. * The Code § 4980H(b) penalty, often referred to as the "B penalty," will increase to $5,670 per full-time employee who receives subsidized Exchange coverage because the employer's offered coverage was either not affordable or did not provide minimum value. These updated amounts represent significant increases from the 2026 penalty levels and highlight the continuing financial exposure associated with ACA compliance failures. HR and benefits teams should use this as a reminder to review ACA compliance procedures regularly, including: * Proper identification of full-time employees * Measurement and tracking of employee hours * Timely offers of coverage * Affordability testing under ACA safe harbors * Verification that plan options continue to meet minimum value requirements * Accurate ACA reporting and documentation practices With penalties continuing to rise, maintaining consistent ACA administration and documentation processes remains an important part of reducing compliance risk for employers. For information about BAS' ACA data collection and compliance services, contact your account manager or [email protected]. Benefit Allocation Systems (BAS) provides best-in-class, online solutions for: Employee Benefits Enrollment; COBRA; Flexible Spending Accounts (FSAs); Health Reimbursement Accounts (HRAs); Leave of Absence Premium Billing (LOA); Affordable Care Act Record Keeping, Compliance & IRS Reporting (ACA); Group Insurance Premium Billing; Property & Casualty Premium Billing; and Payroll Integration. MyEnroll360 can Integrate with any insurance carrier for enrollment eligibility management (e.g., Blue Cross, Blue Shield, Aetna, United Health Care, Kaiser, CIGNA and many others), and integrate with any payroll system for enrollment deduction management (e.g., Workday, ADP, Paylocity, PayCor, UKG, and many others). This article is for informational purposes only and is not intended as legal, tax, or benefits advice. Readers should not rely on this information for taking (or not taking) any action relating to employment, compliance, or benefits. Always consult with a qualified professional before making decisions based on this content. About BAS' Newsletter Join its free, weekly blog email list to be the first to learn about the hottest HR Issues, MyEnroll360 Features, Systems Security, and Weekly Topics of Interest. "The News to Use that BAS/CCS sends every Thursday always has great info, but particularly the Question of the Week is a great resource!" Account Manager / Employee Benefits PA Insurance Broker