Pharmacy Financial Analytics Specialist

CareFirst BlueCross BlueShield; Baltimore (MD); On-site; USD 55,000 - 110,000; Full time

Job summary

CareFirst BlueCross BlueShield is seeking a Pharmacy Analyst Functional II in Baltimore to support pharmacy financial performance and contract compliance through analytics, reconciliation, and reporting. The role partners with Finance, Account Management, and analytics teams to deliver accurate insights and ensure timely payments and audits.

The position emphasizes documentation, cross-functional collaboration, and support for audits, with a salary range of $55,296–$109,824 and a comprehensive

Qualifications

• Bachelor's degree in Business Administration or related field, or in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required.
• 2 years experience as a Functional Analyst OR 4 years experience in (level 2 or above) operational role.
• 7+ years experience in an analytical role preferred, with pharmacy/healthcare financials experience as a plus.

Responsibilities

• Partner with cross-functional teams to support audit activities and issue resolution while ensuring accuracy and compliance.
• Analyze pharmacy financial, contract, and operational data to identify trends, variances, risks, and improvement opportunities.
• Monitor, reconcile, and validate financial guarantees and performance measures for Plan-to-PBM and client arrangements.
• Support calculation, validation, reconciliation, and documentation of pharmacy-related payments, including rebates and network discounts.
• Validate invoices and payment activity in coordination with Finance and cross-functional partners to ensure accuracy and compliance.
• Prepare reporting, analysis, and documentation for audits, compliance reviews, root cause analysis, and stakeholder requests.
• Partner with analytics teams to develop insights and recommendations that improve visibility into pharmacy financial performance and contract outcomes.
• Support Account Management, Pharmacy leadership and other stakeholders with reporting, analysis, and ad-hoc requests.

Skills

Microsoft Office

Data visualization

Communication skills

Critical thinking

Team collaboration

Deadline management

Customer service

Education

Bachelor's Degree in Business Administration or related field

Job description

CareFirst BlueCross BlueShield is seeking a Pharmacy Analyst Functional II in Baltimore to support pharmacy financial performance and contract compliance through analytics, reconciliation, and reporting. The role partners with Finance, Account Management, and analytics teams to deliver accurate insights and ensure timely payments and audits.

The position emphasizes documentation, cross-functional collaboration, and support for audits, with a salary range of $55,296–$109,824 and a comprehensive