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Pharmacy Business AnalystBlue Cross and Blue Shield of Massachusetts Inc. • Hingham, Wisconsin, United States
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Pharmacy Business Analyst

Blue Cross and Blue Shield of Massachusetts Inc.
  • US
    Hingham, Wisconsin, United States
  • US
    Hingham, Wisconsin, United States
Jetzt Bewerben

Über

Overview
Ready to help us transform healthcare? Bring your true colors to Blue. Under the leadership of the Clinical Pharmacy Account Relationship Manager, the Pharmacy Business Analyst supports the Clinical Pharmacy Market Strategy teams to work efficiently, achieve team goals and deliverables. Responsibilities
Successfully and independently manipulate and analyze pharmacy claims data and performance measurement in Excel and other systems, and interpret findings to assist in the creation and execution of project plans, formulary communications, and provider communications. Develop and maintain business workflows, related documentation, and team dashboards to measure leading and lagging performance metrics. Ensure accuracy in manipulating and maintaining data for projects to mitigate risk of errors and ensure data integrity. Learn and maintain knowledge of BCBSMA systems including CVS CCA, ADT, IPRO, MHK, and other necessary systems. Independently develop, support, and track progress for quality initiatives designed to improve overall health outcomes of commercial members as measured by NCQA HEDIS 5-Star ratings. Manage end‑to‑end data process for quarterly formulary change communications, including quality assurance and coordination with PBM and internal business areas. Manage end‑to‑end data process for monthly formulary file submissions to MA Health Connector for exchange business. Lead and facilitate internal/external meetings related to team projects and take clear and concise meeting notes. Independently perform research to prepare all necessary information needed for case management pharmacy review, including calling provider offices, pharmacies, and reviewing claims and clinical information in available systems. Provide support to clinical pharmacy sales support team including reporting, issue management/research, RFP data analysis, quality assurance, account‑specific marketing material data files, and presentation development. Understand pharmacy business processes, drivers, and goals and use business acumen to drive success of business partners and the enterprise, including through ongoing efficiency reviews of business processes. Execute special projects as assigned. Education & Experience Requirements
Bachelor’s Degree or equivalent working experience. 3‑5 years’ experience in managed care and/or pharmacy. Experience in management of business functions and/or project management is preferred. Advanced proficiency in Microsoft Word, Excel, PowerPoint, and relational database manipulation. Skills & Behavioral Competencies
Advanced proficiency in Microsoft Word, Excel, PowerPoint, and relational database manipulation. Ability to independently collaborate across internal and external teams. Strong planning, prioritizing, and execution skills, and ability to work independently to meet deadlines. Excellent organizational, problem‑solving, and communication skills. Demonstrated strength in analysis, identification of problems, and issue resolution. Ability to multitask, be detail‑minded, and results‑oriented. Excellent skills in teamwork and team‑oriented goal setting and attainment. Salary and Benefits
Full‑time salary range: $89,820.00 - $109,780.00. The job is also eligible for variable pay. A comprehensive benefits package including paid time off, medical/dental/vision insurance, 401(k), and well‑being benefits is offered. Equal Employment Opportunity
Blue Cross Blue Shield of Massachusetts is an Equal Employment Employer - veterans/disability. Applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or expression, or any other characteristics protected by law. Blue Cross Blue Shield of Massachusetts will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with Blue Cross Blue Shield of Massachusetts's legal duty to furnish information.
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  • Hingham, Wisconsin, United States

Sprachkenntnisse

  • English
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