Pharmacy Business AnalystBlue Cross Blue Shield of Massachusetts • Hingham, Wisconsin, United States
Pharmacy Business Analyst
Blue Cross Blue Shield of Massachusetts
- Hingham, Wisconsin, United States
- Hingham, Wisconsin, United States
About
Under the leadership of the Clinical Pharmacy Account Relationship Manager, the Pharmacy Business Analyst performs a variety of functions to support the Clinical Pharmacy Market Strategy teams. The role requires a strong background in data manipulation and analysis to meet business and regulatory data/reporting requirements, and involves developing and maintaining business workflows, dashboards, and pharmacist care management support. Responsibilities
Successfully manipulate and analyze pharmacy claims data and performance measurement in Excel and other systems, and interpret findings to assist in project plans, formulary communications, and provider communications. Develop and maintain business workflows and 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 and external meetings related to team projects and take clear and concise meeting notes. Independently perform research to prepare all necessary information for case management pharmacy review, including calling provider offices and 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 and knowledge to drive success of business partners and the enterprise, including through ongoing efficiency reviews of business processes. Special projects as assigned. Education & Experience Requirements
Bachelor’s Degree or equivalent working experience. 3-5 years of experience in managed care and/or pharmacy. Experience in management of business functions and/or project management preferred. Advanced proficiency in standard office‑suite applications, including Microsoft Word, Excel, PowerPoint, and relational database manipulation. Skills & Competencies
Advanced proficiency in standard office‑suite applications, including Microsoft Word, Excel, PowerPoint, and relational database manipulation. Ability to collaborate independently 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‑mindful, and be results‑oriented. Excellent teamwork skills and approach to goal setting and attainment. Employment Details
Location: Hingham Time Type: Full time Salary Range: $89,820.00 – $109,780.00 (variable pay may also apply) The salary range represents the lowest to highest salary we, in good faith, believe we would pay for this role at the time of posting. Pay may be modified in the future and is based on factors such as education, qualifications, certifications, experience, skills, performance, shift, travel requirements, and business needs. Benefits include paid time off, medical, dental, and vision insurance, 401(k), and a suite of well‑being benefits for eligible employees.
#J-18808-Ljbffr
Languages
- English
Notice for Users
This job comes from a TieTalent partner platform. Click "Apply Now" to submit your application directly on their site.