Full-Time
Principal Value-Based Care Operations Advisor
Posted on 8/19/2026
Blue Cross and Blue Shield of North Carolina
5,001-10,000 employees
Not-for-profit health insurance provider
Compensation Overview
$130.6k - $208.9k/yr
Kansas, USA + 25 more
More locations: Pennsylvania, USA | Iowa, USA | Wyoming, USA | Texas, USA | Florida, USA | South Carolina, USA | South Dakota, USA | Georgia, USA | Arizona, USA | Mississippi, USA | Tennessee, USA | Virginia, USA | Arkansas, USA | Utah, USA | Kentucky, USA | Wisconsin, USA | North Carolina, USA | Oklahoma, USA | Missouri, USA | Ohio, USA | Indiana, USA | Louisiana, USA | Michigan, USA | Alabama, USA | Idaho, USA
Remote
Bachelor's
 Business & Strategy (1) |
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- A bachelor's degree or advanced degree in healthcare administration, business, public health, or a related field, or 10+ years of directly related healthcare experience in lieu of a degree.
- At least 8 years of experience in healthcare operations, value-based care programs, payer-provider strategy, or healthcare consulting.
- Demonstrated experience supporting or operating value-based care models, including total cost of care or risk-based arrangements.
- Experience working across clinical operations, finance, analytics, and network or provider engagement.
- Strong understanding of healthcare reimbursement and performance measurement concepts.
- Lead end-to-end operational design of value-based care programs, including shared savings, downside risk, and alternative payment models.
- Translate strategic program objectives into operational workflows, governance structures, and execution plans.
- Identify operational gaps across contracting, attribution, performance measurement, reporting, and financial settlement processes.
- Partner with clinical, finance, actuarial, analytics, and network teams to align program design with operational execution.
- Support development and refinement of value-based care operating models and cross-functional processes.
- Evaluate program performance drivers and recommend operational improvements to enhance outcomes and financial sustainability.
- Provide expertise supporting implementation of new reimbursement models and provider partnership strategies.
- Lead complex cross-functional initiatives requiring coordination across enterprise stakeholders and external partners.
- Support provider engagement strategies by ensuring operational readiness and clarity of performance expectations.
- Establish repeatable processes and controls supporting program scalability and measurement integrity.
- Identify risks to program execution and develop mitigation strategies across operational domains.
- Present operational insights, performance implications, and strategic recommendations to senior leadership.
- Serve as a subject matter expert for value-based care operations and enterprise transformation initiatives.
- Mentor and guide team members supporting value-based care program delivery.
- Experience operationalizing Medicare Advantage and Commercial value-based care programs.
- Experience supporting shared savings reconciliation or financial settlement processes.
- Familiarity with attribution methodologies, performance measurement frameworks, and population health analytics.
- Experience working within payer organizations or integrated delivery systems.
- Consulting or enterprise transformation experience supporting healthcare operating model design.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) provides health insurance and health-care services to over 4.3 million members. It uses a not-for-profit model and operates as an independent licensee of the Blue Cross Blue Shield Association, with a focus on improving health and health care across North Carolina. Its products include health insurance plans and related health services designed to help people stay healthier and access care. The company differentiates itself through its not-for-profit status, large regional presence, and commitment to community health, aiming to lead the industry in better health outcomes. Its goal is to make health care better for all by supporting healthier communities and delivering value to its members through quality coverage and services.
Company Size
5,001-10,000
Company Stage
N/A
Total Funding
N/A
Headquarters
Durham, North Carolina
Founded
1933
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Simplify's Take
What believers are saying
- June 2026 MedAssist and July 2026 Carolina HealthWorks expand affordable-access channels statewide.
- Blue Cross NC ranked No. 4 in JD Power's 2026 digital experience study.
- Value-based care savings exceeded $1 billion since 2019, supporting margin and employer wins.
What critics are saying
- Blue Cross NC faces 2026 staffing reductions and voluntary separations after financial-plan misses.
- Proton beam therapy and state-plan litigation continue after March 2026 rulings, sustaining legal costs.
- The 2013 antitrust settlement begins payouts in 2026, reinforcing a long-tail existential overhang.
What makes Blue Cross and Blue Shield of North Carolina unique
- Blue Cross NC controls CuraCor Solutions, pairing insurer scale with care-delivery assets like FastMed.
- Its 2026 board adds legal, policy, and health-system operators: Fletcher, Fork, and Mueller.
- Blue Cross NC secured the 2028 State Health Plan TPA and PBM contracts.
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Benefits
Health Insurance
Dental Insurance
Vision Insurance
Parental Leave
Family Planning Benefits
Fertility Treatment Support
Career Development Programs
Tuition Reimbursement
401(k) Company Match
Flexible Work Hours
Unlimited Paid Time Off
Paid Vacation
Paid Sick Leave
Paid Holidays
Hybrid Work Options
Wellness Program
Company News
Blue Cross NC ranks No. 4 in JD Power 2026 U.S. Healthcare Digital Experience Study. DURHAM, NC - Blue Cross and Blue Shield of North Carolina (Blue Cross NC) ranked No. 4 in the JD Power 2026 U.S. Healthcare Digital Experience Study (SM) in the Commercial Member Health Plan segment. The ranking reflects ongoing investments to make it easier for members to access information, navigate their coverage and manage their care digitally. JD Power evaluated the effectiveness of digital channels in members' overall health care experience. Its findings reveal more members are using Blue Cross NC's mobile app and digital tools to manage their health insurance. Whether checking benefits or finding care, members are relying more on these tools to meet everyday health care needs. Blue Cross NC has invested in several enhancements to ensure that it understands what matters most for members and provides meaningful information and experiences. "We used that data and feedback to help members quickly find what they need and get things done," said Emily Brannen, Vice President of Digital Strategy at Blue Cross NC. "Upgrades to the digital experience reflect what members told us they need to confidently manage their health insurance needs." Blue Cross NC's improvements to help members include: * Improved Member Portal: Simpler login and navigation help members quickly find coverage details and key information. * Digital Form Submission: Members can now submit forms digitally, including requests for nurse support and behavioral health referrals. * Modernized Payments: A streamlined payment experience with payment options like Apple Pay, Google Pay, PayPal and Venmo make it easier for members to manage and make payments. * Direct support: Secure chat with Blue Cross NC pharmacists helps members get answers to medication-related questions. * Faster appointment scheduling: New tools help members schedule care directly through the Find Care directory, including urgent care, primary care and behavioral health providers. "This ranking from JD Power reflects our focus on creating a simpler, more connected experience so members spend less time navigating their plan." said Brannen. About Blue Cross and Blue Shield of North Carolina Blue Cross and Blue Shield of North Carolina (Blue Cross NC), the leading not-for-profit health plan in North Carolina, is committed to improving the health and well-being of its customers and communities. Since 1933, the company has developed programs and initiatives that give North Carolinians the opportunity to live healthier lives. Blue Cross NC serves more than 4.1 million members, including approximately 1.2 million on behalf of other Blue Plans. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross NC online at www.bluecrossnc.com.
Blue Cross NC names Anita Brown-Graham as vice chair of Board of trustees; Eric Fletcher, Brian Fork and Andrew Mueller named to Board of trustees. DURHAM, N.C. - Blue Cross and Blue Shield of North Carolina (Blue Cross NC) announced the appointment of existing board member Anita Brown-Graham to vice chair of the Blue Cross NC board of trustees and CuraCor Solutions board of directors, the parent holding company of Blue Cross NC. Brown-Graham steps into this leadership role supporting Ned Curran, board chair of Blue Cross NC and CuraCor Solutions. Blue Cross NC also welcomes three new members to its board of trustees: Eric Fletcher, Brian Fork and Andrew Mueller, M.D. Fletcher, Fork and Mueller will also serve as members of the board of directors of CuraCor Solutions. These appointments reflect the organization's commitment to strong strategic guidance across its health care initiatives. The boards consist of community leaders with varied backgrounds in health care, education, business, and finance. "Anita's appointment as vice chair reflects her proven leadership and steady guidance during a period of continued transformation," said Blue Cross NC and CuraCor Solutions board chair Ned Curran. "Additionally, we are fortunate to welcome three board members whose backgrounds span health care delivery, public policy, and complex organizations. Together, this group strengthens our board's ability to provide thoughtful oversight and long-term strategic directions." Eric Fletcher Eric Fletcher is a partner at Brooks, Pierce, McLendon, Humphrey & Leonard, where he advises clients on complex litigation and matters at the intersection of law, public policy, and government. He previously served as General Counsel to former North Carolina Governor Roy Cooper, leading the Governor's legal strategy and advising on executive, legislative, and regulatory matters across state government. A North Carolina native, he holds a bachelor's degree with highest honors from the University of North Carolina at Chapel Hill and a Juris Doctor, magna cum laude, from Harvard Law School. Brian Fork Brian Fork is Chief Executive Officer of Hurricanes Holdings, LLC, where he oversees all business operations of the Carolina Hurricanes, Lenovo Center, and the mixed-use sports and entertainment district under development surrounding the arena. Prior to joining the Hurricanes, Fork served as Chief of Staff and General Counsel to North Carolina Senate President Pro Tempore Phil Berger, playing a lead role in negotiations on major state policy issues, economic development initiatives, and complex litigation matters. Fork holds a bachelor's degree from Davidson College and a Juris Doctor with honors from the University of North Carolina School of Law and currently serves on the Executive Committee of the Greater Raleigh Chamber of Commerce Board of Directors. Andrew Mueller Andrew Mueller, M.D., FAAFP, is President and Chief Executive Officer of MaineHealth, a not-for-profit integrated health system, where he leads system-wide strategy, operations, and financial performance across hospitals, physician practices, research, and a Medicare Advantage health plan. A board-certified family physician, Dr. Mueller brings deep experience in care delivery, value-based payment models, and health system transformation, having previously served as CEO of Centra Health and in senior leadership roles at Novant Health. Dr. Mueller earned his medical degree from the University of North Carolina School of Medicine and a bachelor's degree in electrical engineering from North Carolina State University. The governing board of CuraCor Solutions is composed solely of members of the governing board of Blue Cross NC. Blue Cross NC reorganized as a subsidiary of CuraCor Solutions, remaining a North Carolina-based, not-for-profit, mission-driven company, as authorized by the bipartisan Reorganization & Economic Development Act. This structure allows the organization to more quickly partner and invest in new health programs and technologies that benefit members and drive better, more affordable care for North Carolinians. About Blue Cross and Blue Shield of North Carolina Blue Cross and Blue Shield of North Carolina (Blue Cross NC), the leading not-for-profit health plan in North Carolina, is committed to improving the health and well-being of its customers and communities. Since 1933, the company has developed programs and initiatives that give North Carolinians the opportunity to live healthier lives. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross NC online at http://www.bluecrossnc.com. About CuraCor Solutions CuraCor Solutions is a not-for-profit holding company whose family of companies includes Blue Cross and Blue Shield of North Carolina, FastMed LLC, Brighton Healthplan Solutions, ACS Benefit Services (wholly owned subsidiaries), and affiliated entities Echo Health Ventures and Alo Solutions and Avance Care (not wholly owned). CuraCor helps companies nationwide grow and connect to make quality care simpler, more affordable, and easier to access - so that it works better for all. Learn more at www.curacor.com.
NC Chamber, Blue Cross NC partner to help small businesses afford health coverage. RALEIGH, N.C. - With small businesses feeling the impacts of rising health care costs, the NC Chamber has partnered with Blue Cross and Blue Shield of North Carolina (Blue Cross NC) to provide a new, more affordable health plan option for small businesses, their employees and their families. Carolina HealthWorks brings together North Carolina small businesses to access more affordable health care through a multiple employer welfare arrangement (MEWA) model. A MEWA offers an alternative to small businesses that allows them to pool their resources and provide access to the rate advantages and benefits typically only enjoyed by larger groups. "Small businesses are the lifeblood of this state," said North Carolina Insurance Commissioner Mike Causey. "Many small business owners have told me about their struggles to find affordable health care for their employees. I applaud the North Carolina Chamber for partnering with Blue Cross NC to create this new option for its small employer members. I also want to give a special thank you to the review team at the N.C. Department of Insurance for going above and beyond in putting in extra hours to make this approval in record time. We need to continue to look for ways to help get more North Carolinians affordable health care." "North Carolina leads the nation in business - but is one of the most expensive states for health care - a sharp contradiction that hits hardest for small businesses fighting to survive," said Gary Salamido, president and CEO of the NC Chamber. "This moment demands real solutions. The creation of Carolina HealthWorks is a meaningful step in giving small businesses a tangible, more affordable path forward. We appreciate Blue Cross NC's willingness to partner and find an affordable, thoughtful solution designed to help small businesses support their teams, their families, and stay competitive." Carolina HealthWorks will be available starting November 1 to North Carolina small businesses that have 2 to 50 employees and are members of either the NC Chamber or a participating local chamber. Carolina HealthWorks has chosen Blue Cross NC to be the administrator for this health plan, offering access to Blue Cross NC's broad network. Small business owners have opportunities to enroll in the plan throughout the year. "Right now, the health care system is shifting, and our market is experiencing immense volatility. It will take partnerships and new ideas to meet this moment," said Tunde Sotunde, MD, CEO of Blue Cross NC. "Our partnership with the NC Chamber, and the launch of Carolina HealthWorks, is an example of a creative collaboration to solve a real problem: the soaring cost of health care for small businesses. Blue Cross NC stands ready to partner with organizations committed to driving down health care costs in North Carolina." According to a national analysis, small businesses bear higher burdens from health insurance costs, representing a higher percentage of payroll costs when compared to larger businesses.[1] In fact, among small businesses that do not offer health insurance, 65% cited cost as the most important reason.[2] The impact of those decisions is significant since more than 94% of businesses in the United States have fewer than 50 employees and more than 27% of private sector employees work in firms with 1 to 49 employees.[3] Carolina HealthWorks is sold through Blue Cross NC appointed agents, allowing businesses to continue working with their existing Blue Cross NC agent. Direct enrollment is available through Blue Cross NC for those not currently working with an agent. More information about Carolina HealthWorks is available on the Blue Cross NC website or the NC Chamber's website. About Blue Cross and Blue Shield of North Carolina: Blue Cross NC, the leading not-for-profit health plan in North Carolina, is committed to making health care more affordable, easier to navigate and accessible for all. Since 1933, the health insurer has created programs and initiatives to provide North Carolinians the opportunity to be healthy. Blue Cross NC serves its customers and communities of more than 4.2 million members, including approximately 1.1 million on behalf of other Blue Plans. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross NC online at bluecrossnc.com. All other marks are the property of their respective owners. About NC Chamber: The NC Chamber works to research, develop, advocate, and communicate for solutions and policies that produce a nationally competitive business climate in North Carolina. For more information, visit ncchamber.com. Disclaimer: Benefits are provided by the NC Chamber Benefit Trust, with excess coverage from a licensed insurer. The Trust isn't backed by a guaranty association but is regulated by the NC Department of Insurance. The NC Chamber is the sponsor and plan administrator of Carolina HealthWorks, which is a self-insured non-plan Multiple Employer Welfare Arrangement. Third-party administrative services are provided by Blue Cross and Blue Shield of North Carolina. The NC Chamber and Carolina HealthWorks are separate entities and do not provide Blue Cross or Blue Shield products or services. North Carolina leads the nation in business: CNBC. (2025, July 10). America's Top States for Business. www.cnbc.com/2025/07/10/north-carolina-top-states-for-business-ranking.html (Accessed November 2025). North Carolina is one of the most expensive states for health care: Data from comparison of all 50 U.S. states and Washington, D.C. on nine metrics between 2020 and 2022. Advisory Board. (2024, April 1). Mapped: The states with the highest (and lowest) healthcare costs. www.advisory.com/daily-briefing/2024/04/01/healthcare-costs (Accessed November 2025).
Free and Charitable Clinics receive $500,000 grant from Blue Cross NC Foundation to tackle Oral Health crisis for North Carolina's uninsured.
Blue Cross and Blue Shield of North Carolina (Blue Cross NC ) has agreed to acquire all North Carolina-based locations of FastMed.