Business Analyst, Senior

Blue Shield of California•Long Beach, CA
•$81,950 - $138,508•Hybrid

About The Position

The Pharmacy Finance Support team supports Pharmacy Strategy and Operations in managing impacts to the Pharmacy portfolio budget, ensuring proper approvals, and validating invoices from strategic vendors prior to payment. The Business Analyst, Senior will report to the Manager of Pharmacy Finance Support. In this role you will provide ownership and strategic oversight of Pharmacy funding and finance operations. This role partners with Finance, Data Analytics, external vendor partners, and business stakeholders to resolve discrepancies, strengthen processes, analyze and communicate pharmacy funding claim trends and outlier drivers, and ensure the accurate tracking and approval of Pharmacy funding. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Requirements

  • Bachelor’s degree or High School Diploma/GED and 4 years of additional relevant experience in lieu of a degree
  • Requires at least 5 years of prior relevant experience
  • Advanced knowledge in pharmacy benefit claims and pharmacy operations
  • Demonstrated ability to analyze financial discrepancies, improve processes, and coordinate work across multiple teams and external partners
  • Excellent verbal and written communication skills that exhibit a solution-oriented approach
  • Excellent problem-solving and analytical skills
  • Strong proficiency with Microsoft Excel and pharmacy claim data reporting

Responsibilities

  • Provide complex analytical support through the analysis and interpretation of data in support of cross-functional business operations
  • Develop annual operating plans, capital budgets and forecasts, and build business cases for new business initiatives (cost/benefit analysis)
  • Develop, prepare, and analyze reports with complex analysis and data for management review, and present to various levels of management
  • Define business requirements and provide analysis to increase operational efficiency
  • Provide analytical support for multiple, complex cross-functional projects simultaneously; establish work plans and timelines
  • Research funding and payment discrepancies in partnership with Finance, Data Analytics, and service providers; coordinate incident tickets and follow-through as needed
  • Maintain accurate tracking of Pharmacy Funding and Administrative dollars received and disbursed
  • Oversee and enhance the end-to-end Pharmacy funding process to improve accuracy, controls, timeliness, and transparency and provide backup support for Pharmacy Funding reconciliation and Pharmacy Service Provider administrative invoice validation.
  • Prepare and maintain external vendor partner Pharmacy Funding Pre-Approval documentation, annual estimates, and materials for executive approval
  • Perform other duties as assigned
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