• Direct, manage and lead efforts that define and enable strategic and operational priorities for the Pharmacy group. • Lead staff responsible for accomplishing goals related to pharmacy operations, clinical and specialty pharmacy programs, opportunity analysis, solution design, provider/payer integration and vendor evaluation and management. • Provides expertise and insights in drug coverage for provider administered therapy, pharmacy channel specialty drugs, and traditional retail medications. • Champion innovation while identifying pharmacy-related opportunities and collaborations that drive value for Blue Cross NC members. • Evaluate emerging pharmacy industry trends and the strategic needs of the department as it relates to overall business objectives. • Oversee all clinical aspects of drug coverage from formulary management, policy development, and drug channel management. • Develop new strategies to include total cost management, including real-world evidence for lowering total cost of care beyond drug expenditure to patient outcomes. • Develop, in partnership with analytics teams, infrastructure to track drug trends and dissect changes in unit cost, utilization, and drug mix to support new ideation in management. • Participate in the development of departmental strategic plans and objectives to improve achieve medical expense goals while maintaining standards in clinical excellence. • Understand the evolving medication therapy space and develop strategies around traditional, specialty and gene therapies. • Direct the management of formulary and medication policy development and maintenance for the purpose clinical quality and affordability. • Oversee day-to-day operations related to tracking and managing drug expenditure in collaboration with medical economics teams in order to manage emerging trends in cost and clinical quality. • Direct, manage, and/or support implementation of corporate projects that requires input on drug utilization, unit costs, and pricing dynamics in the pharmaceutical supply chain.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description In this role, you’ll proactively partner with our largest customers to identify opportunities for cross-sell and up-sell and seek out brand new customers with your prospecting prowess in your territory. - Identify and engage with the decision makers within an organization to uncover their needs. - Demonstrate the value of our products, win deals, and assist them through the implementation process. - Collaborate with Marketing, Solutions Engineers, Product Specialists, and your sales leader to ensure you have the resources you need to be successful. Qualifications - A bachelor’s degree in business management, marketing or related field, preferred - 8+ years of a successful B2B sales career track and experience targeting Enterprise organizations (6,000+ employee headcount) - Experience selling SaaS based solutions - Familiarity with value selling, strategic selling, formal training or understanding of best practice models such as Challenger, MEDDICC, SPIN, and Solution Selling - A passion for learning – the risk and compliance space is rapidly evolving - Strong prospecting, planning, organizational and time management skills - Technical ability to be proficient with Salesforce and Microsoft Office products - Excellent verbal and written communication skills - Ability to travel 25%-50% within your territory and for on-site sales intensive training Requirements - Ability to approach, recognize and anticipate process and operational problems and effectively identify areas for improvement - Culture Agility: Comfort working in a fast-paced, candid environment that values innovation, healthy debate, and follow-through - AI Readiness: Curiosity and willingness to use AI and emerging technologies to elevate your work and deliver smarter outcomes - Ability to drive results through your job competencies of sales strategy and process, product and industry knowledge (Sales), and persuasive sales engagement while leveraging NAVEX's core values Benefits - Meaningful Purpose: Your work helps organizations operate with integrity and protect their people—at a scale few companies can match. - High-Performance Environment: We move with urgency, set ambitious goals, and expect excellence. - Candid, Supportive Culture: We communicate openly, challenge ideas—not people, and value teammates who embrace bold thinking and continuous improvement. - Growth That Matters: You can count on authentic feedback, strong accountability, and leaders invested in your success. - Rewards for Results: We provide clear, competitive compensation designed to recognize measurable outcomes and real impact.

• By embodying our core purpose of customer obsession, new ideas, and driving innovation, and delivering excellence, you will help ensure that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare • Ensures that Revenue Cycle goals, objectives, and vision are achieved • Working with the senior leadership, develops short and long range plans with a focus on continuous improvement • Establishes and implements policies and procedures and identifies growth opportunities • Direct oversight of daily operations including management of managers, supervisors, and coders • Integral in the development, implementation, and maintenance of efficient processes, coding compliance plan, and coding education for Ensemble and Clients

• The Director, Payment Integrity uses technology and data mining, detects anomalies in data to identify and collect overpayment of claims. • The Director leverages technology and the clinical and coding expertise of their associates to identify potential overpayments to be substantiated via review of medical records. • The Director contributes to the investigations of fraud, waste and abuse. • The Director requires an in-depth understanding of how organizational capabilities interrelate across the function or segment. • The Clinical and Coding Medical Record Review Director of Payment Integrity contributes to overall cost reduction, by increasing the accuracy of provider payments in our payer systems, and by ensuring correct claims payment. • The Director oversees internal teams and stacked vendor operations conducting reviews of inpatient and outpatient services using automation, new innovative technology and expertise. • The Director will make decisions related to the implementation of new/updated programs or large-scale projects. • The Director will lead Operations for technical procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance.