PBM Operations Analyst – Medicare & Dashboards

Blue Cross & Blue Shield of Minnesota; Eagan (MN); Ibrido; USD 69.000 - 114.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, and vision insurance

Life insurance

401k

PTO

Volunteer PTO

Descrizione del lavoro

Blue Cross & Blue Shield of Minnesota is seeking a PBM Operations Analyst to establish and refine processes for CMS/state Medicare requirements. You will create an oversight structure with KPIs and dashboards to measure performance, aligning with vendor and internal partners.

In this hybrid role, you will manage member inquiries and drive policy development. You should have 3+ years in health services, a bachelor's degree or equivalent experience, and strong collaboration skills to navigate

Competenze

• 3+ years of related health services professional experience.
• Bachelor's degree; in lieu of a degree, an additional two years of relevant experience may be accepted.

Mansioni

• Establish and refine operational processes for CMS and State requirements for Medicare products.
• Develop an oversight structure of PBM activities with KPIs and program dashboards.
• Oversee Medicare Part D requirements including member escalation management, claims analysis, and reporting.
• Draft and maintain policies related to core job responsibilities.
• Collaborate with internal and external partners, manage inquiries from members, groups, Clients, CMS/DHS.

Conoscenze

Health services experience

Communication

Analytical thinking

Project management

Collaboration

Problem solving

Formazione

Bachelor's degree

Descrizione del lavoro

Blue Cross & Blue Shield of Minnesota is seeking a PBM Operations Analyst to establish and refine processes for CMS/state Medicare requirements. You will create an oversight structure with KPIs and dashboards to measure performance, aligning with vendor and internal partners.

In this hybrid role, you will manage member inquiries and drive policy development. You should have 3+ years in health services, a bachelor's degree or equivalent experience, and strong collaboration skills to navigate