Pharmacy Analyst II
About The Position
The Pharmacy Management at BlueCross BlueShield of Tennessee (BCBST) is seeking a motivated, detail-oriented Pharmacy Analyst II to join our team and support pharmacy operations across Commercial and Marketplace lines of business. In this role, you’ll play a critical part in PBM (Pharmacy Benefit Manager) 1/1 readiness by ensuring pharmacy benefits are accurately configured and validated before go-live, while also investigating service disruptions, driving process improvements, and coordinating cross-functional initiatives with clinical, IT, finance, and vendor partners. This position requires strong critical thinking, attention to detail, and the ability to navigate complex environments—helping protect member experience and support regulatory compliance across real-time claims operations.
Requirements
- Bachelor’s degree or equivalent work experience required. Equivalent work experience is defined as 4 years of professional work experience.
- Minimum 4 years Healthcare Industry experience required
- Minimum 3 years of experience in a related field such as operations, technical, project management, product or other related field required.
- Ability to evaluate programs and operational processes
- Skill in issue investigation and structured problem-solving
- Expertise in workflow improvement and efficiency enhancements
- Strength in coordinating initiatives across internal teams
- Capability to ensure compliance with regulatory standards
- Proficient in the Microsoft Office suite, including Microsoft Teams
- Organized and capable of managing multiple assignments or projects simultaneously
- Strong interpersonal abilities
- Strong oral and written communication skills
Nice To Haves
- Demonstrated experience supporting or overseeing healthcare contracts, with the ability to interpret and apply benefit and reimbursement terms.
- Strong analytical capabilities, including running reports, validating data, and researching complex operational issues.
- Prior experience working with a Pharmacy Benefit Manager (PBM), including auditing, benefit validation, or claims review.
Responsibilities
- Implement business strategies aimed at improving processes, ensuring they are completed on time and within scope.
- Lead investigations into service disruptions or inefficiencies, applying structured problem-solving to recommend practical solutions.
- Collaborate across teams to identify and implement workflow enhancements that improve efficiency and accuracy.
- Coordinate with internal teams (e.g., clinical, IT, finance, vendor management) to support pharmacy-related initiatives and program interdependencies.
- Maintain a working knowledge of pharmacy regulations and ensure data and processes align with compliance standards.
- Share knowledge within team learning sessions and onboarding activities.
- Manage various workstreams in strategic projects, ensuring alignment with pharmacy business objectives and stakeholder expectations.
Benefits
- Innovation is encouraged, including the responsible use of AI-enabled tools to support everyday work.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
