Pharmacy Operations Analyst

Blue Cross Blue Shield of Minnesota•Eagan, MN

9d•Hybrid

About The Position

About Blue Cross and Blue Shield of Minnesota At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us. The Impact You'll Have As a Pharmacy Operations Analyst, you will focus on establishing and refining operational processes related to CMS, federal, state, and BCBSA requirements for Commercial, Medicare and Medicaid products. In this position you will support an oversight structure of the departmental and key stakeholder activities. What You'll Do Core responsibilities will involve operational management and oversight of pharmacy operations and support activities. Draft and maintain procedures related to core job responsibilities. How You'll Do It Collaboratively work with internal and external partners, clients, and vendors. Intake, manage, and resolve inquiries, issues, or requests for information received from members, BCBSA, CMS/DHS/DOC/MDH/ERISA and/or any other channel. Performs additional responsibilities consistent with the scope and level of the role, as assigned.

Requirements

3+ years of related pharmacy services professional experience.
Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.

Nice To Haves

Ability to tailor communication to varied audiences, actively listen to uncover requirements, and ensure accurate and timely information exchange.
Ability to analyze information, identify patterns and root causes, and collaborate with partners to implement practical solutions.
Ability to effectively organize work, balance competing priorities, and manage time across multiple responsibilities and deadlines.
Experience and knowledge of pharmacy operations, including PBM, health plan, retail, specialty, or medical pharmacy.
Experience in triaging and resolving inquiries associated to claims and benefits.
Experience working Commercial, Medicare, and/or Medicaid.
Experience working with members/clients/patients on the phone.

Responsibilities

Establish and refine operational processes related to CMS, federal, state, and BCBSA requirements for Commercial, Medicare and Medicaid products.
Support an oversight structure of departmental and key stakeholder activities.
Operational management and oversight of pharmacy operations and support activities.
Draft and maintain procedures related to core job responsibilities.
Collaboratively work with internal and external partners, clients, and vendors.
Intake, manage, and resolve inquiries, issues, or requests for information received from members, BCBSA, CMS/DHS/DOC/MDH/ERISA and/or any other channel.
Performs additional responsibilities consistent with the scope and level of the role, as assigned.