Hybrid PBM Operations Analyst (Medicare & Vendors)

Stella Resources Co., Inc.; Eagan (MN); Hybrid; USD 69,000 - 114,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Life insurance

401k

Paid Time Off (PTO)

Volunteer Paid Time Off (VPTO)

Job summary

Blue Cross and Blue Shield of Minnesota in Eagan is seeking a PBM Operations Analyst to establish and refine operational processes for CMS and state Medicare products, and to build an oversight structure with KPIs and dashboards.

You will collaborate with internal and external partners, manage member escalations, pharmacy claims analyses, and draft policies; hybrid work with two days onsite, offering comprehensive benefits.

Qualifications

• 3+ years of related health 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.

Responsibilities

• Operational management and oversight of PBM activities and other vendor responsibilities.
• Oversee Medicare Part D requirements and related operational processes.
• Handle member escalation management, pharmacy claims analysis, and reporting.
• Draft and maintain policies related to core job responsibilities.

Skills

Health services experience

Education

Bachelor's degree

Job description

Blue Cross and Blue Shield of Minnesota in Eagan is seeking a PBM Operations Analyst to establish and refine operational processes for CMS and state Medicare products, and to build an oversight structure with KPIs and dashboards.

You will collaborate with internal and external partners, manage member escalations, pharmacy claims analyses, and draft policies; hybrid work with two days onsite, offering comprehensive benefits.