Pharmacy Operations Analyst

BCBSM, Inc.; United States; Hybrid; USD 69,000 - 114,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

401k

Paid Time Off

Volunteer Paid Time Off

Job summary

Blue Cross and Blue Shield of Minnesota is seeking a Pharmacy Operations Analyst to establish and refine operational processes across CMS, federal, state, and BCBSA requirements for Commercial, Medicare and Medicaid products. In this role you will support an oversight structure of the departmental and key stakeholder activities.

You will collaborate with internal and external partners, manage inquiries from members and agencies, and perform additional responsibilities as assigned to ensure

Qualifications

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

Responsibilities

• 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.

Skills

Pharmacy services experience

Education

Bachelor's degree

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'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

• 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.

Required Skills & Experience

• 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.

Preferred Skills & Experience

• 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.

Role Designation

Hybrid Role designation definition: Teleworking is working full time remote. Hybrid is a minimum of 2 days onsite. Onsite is full-time onsite.

Anchored in Connection

Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week – most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote.

Compensation and Benefits

$68,900.00 - $91,300.00 - $113,700.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

To discover more about what we have to offer, please review our benefits page.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an affirmative action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic. Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: [e-mail]. Blue Cross and Blue Shield of Minnesota and Blue Plus are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

Physical requirements.

Chartered in 1933 as Minnesota’s first health plan, this company is one of the most recognized and trusted healthcare brands in the world. It has more members, the largest network of doctors, and more products and services than any other health plan in Minnesota. Headquartered in Eagan, Minnesota.