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.

$118,691.00 - $189,906.00

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