Pharmacy Business Segment Analyst

Blue Cross and Blue Shield of Minnesota; Eagan (MN); On-site; USD 75,000 - 100,000; Full time

Job summary

Blue Cross and Blue Shield of Minnesota is seeking a seasoned professional to support the Pharmacy Business Segments with hands-on expertise across clinical, administrative, and operational activities. You will analyze utilization data, collaborate with internal teams and PBM partners, and help implement improvements to processes and data integrity.

The role requires a minimum of five years in health services and a Bachelor's degree, with potential for alternative experience.

Qualifications

• 5+ 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

• Provide hands-on support, consultation, and operational expertise for Pharmacy Business Segments.
• Analyze pharmacy utilization reports and validate data accuracy.
• Collaborate with PBM and vendor clinical teams to review updates and ensure accuracy in systems and lists.
• Develop workflows and drive continuous improvement in process efficiency and data integrity.
• Support program development of clinical pharmacy programs and manage databases and communications to members and providers.

Skills

Analytics

Cross-functional collaboration

Communication

Education

Bachelor's degree

Tools

Microsoft Office Suite

Job description

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 Will Have

In this positions, you will be responsible for supporting all aspects of the Pharmacy Business Segments by working with the Pharmacy Department to provide hands-on support, consultation, technical and operational expertise. You will work closely with cross functional teams and Pharmacy Benefit Manager (PBM) to support pharmacy initiatives and partner with Business Segments to ensure implementation and execution.

What You'll Do

• Support the Pharmacy Business Segments (Self Insured, Fully Insured, and Government Programs), by providing pharmacy technician expertise across clinical, administrative, and operational activities.
• Conduct and analyze pharmacy utilization reports from business database applications, and validate the data for accuracy and consistency.
• Engage and collaborate with internal and external business teams in the business planning process.
• Evaluate and document all current processes and procedures of pharmacy partners.
• Develop workflows/processes, identify gaps and opportunities for improvement of standard operating procedures, support implementation, and drive continuous improvement in process efficiency and data integrity.

How You'll Do It

• Support program development of clinical pharmacy programs; manage databases and develop communications to members and providers.
• Identify opportunities for improvement and develop recommendations to business based on analysis and auditing of standard PBM reports.
• Collaborate with PBM and vendor clinical teams to review updates, verify accuracy, and ensure changes are accurately reflected in systems and lists.
• Support implementation, monitoring, and review of operational workflows for data accuracy and overall efficiency.
• Perform detailed activities requiring pharmacy technician expertise, and upholding data quality, compliance, and operational readiness.
• Manage workflows for clinical consultations.
• Performs additional responsibilities consistent with the scope and level of the role, as assigned

Required Skills & Experience

• 5+ 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.

Preferred Skills & Experience

• Proficient in Microsoft Office Suite, including advanced Excel and Word skills.
• Ability to communicate complex topics clearly and concisely, actively listen to anticipate stakeholder needs, and align others to drive informed decisions.
• Ability to analyze complex information, evaluate options, and work cross-functionally to drive resolution