Pharmacy Operations & Improvement Analyst (Hybrid)

HMSA; Honolulu (HI); Hybrid; USD 90,000 - 120,000; Full time

Job summary

HMSA is seeking an experienced professional to lead operational planning and execution within Pharmacy Operations, PBM, and related areas in a hybrid Honolulu setting. The role focuses on improving efficiency, coordinating testing, and driving issue resolution across cross-functional teams.

The position emphasizes collaboration with internal departments and external partners to implement corrective actions and optimize beneficiary and member services in a dynamic health plan environment.

Responsibilities

• Manage projects related to developing and improving Pharmacy Operations, coordinate and/or facilitate planning and completion of quality assurance and monitoring activities within the department, Pharmacy Benefits Manager (PBM) and/or among major functional areas
• Assess compliance with internal policies, procedures and work flows and new and revised business requirements; work with internal and external departments to implement corrective actions as necessary to meet and/or maintain acceptable performance levels
• Support day-to-day execution of pharmacy operational activities within an assigned line of business.
• Coordinate operational tasks, implementations, and follow-up activities across internal teams and external partners.
• Assist in planning and execution of pharmacy-related initiatives, benefit changes, and operational enhancements.
• Monitor operational activities to identify risks, delays, and/or process breakdowns.
• Analyze business problems, including, but not limited to new benefit changes or products, formulary changes, enhancements to add functionality and/or improve efficiencies
• Support benefit setup, validation, testing, and implementation activities.
• Review benefit configuration outcomes and investigate discrepancies or operational concerns.
• Coordinate testing activities with internal stakeholders and external vendors.
• Document implementation results, findings, and required corrective actions.
• Investigate operational issues impacting members, pharmacies, and/or business partners.
• Facilitate & Coordinate issue resolution efforts across Pharmacy Management teams and supporting departments.
• Identify root causes, escalation needs, and opportunities for process improvement.
• Develop recommendations and proposals for resolution for leadership
• Track operational issues through resolution and communicate status updates to stakeholders.
• Independently analyze operational trends, implementation results, issue patterns, and performance indicators.
• Develop reports and summaries that support decision-making and continuous improvement.
• Partner with Pharmacy Performance and Pharmacy Solutions to support operational reviews and initiative tracking.
• Identify opportunities to improve workflow efficiency and service quality.
• Partner with Operations Specialists to ensure operational activities are completed accurately and consistently.
• Collaborate with Operations Pharmacists on clinically complex operational issues.
• Support interactions with internal departments, external vendors, and PBM partners.
• Contribute operational expertise to enterprise initiatives and governance discussions as needed.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.

Job description

HMSA is seeking an experienced professional to lead operational planning and execution within Pharmacy Operations, PBM, and related areas in a hybrid Honolulu setting. The role focuses on improving efficiency, coordinating testing, and driving issue resolution across cross-functional teams.

The position emphasizes collaboration with internal departments and external partners to implement corrective actions and optimize beneficiary and member services in a dynamic health plan environment.