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Blue Cross and Blue Shield of Minnesota

Nonprofit health insurance provider for Minnesota

Pharmacy Business Segment Analyst

Business AnalysisPosted on Nov 11
Full-timeEagan, MN, USA$79.1k - $130.5k /yr

About the Job

Requirements

  • At least five years of related health services professional experience.
  • A bachelor's degree is required; an additional two years of relevant experience beyond the stated experience qualifications may be accepted in lieu of the degree.
  • A clear and active Pharmacy Technician license in Minnesota is required.

Responsibilities

  • Support the Pharmacy Business Segments (Self Insured, Fully Insured, and Government Programs) by providing pharmacy technician expertise across clinical, administrative, and operational activities.
  • Conduct and analyze pharmacy utilization reports from business database applications, and validate the data for accuracy and consistency.
  • Engage and collaborate with internal and external business teams in the business planning process.
  • Evaluate and document all current processes and procedures of pharmacy partners.
  • Develop workflows and processes, identify gaps and opportunities for improvement of standard operating procedures, support implementation, and drive continuous improvement in process efficiency and data integrity.
  • Support development of clinical pharmacy programs; manage databases and develop communications to members and providers.
  • Identify opportunities for improvement and develop recommendations to the business based on analysis and auditing of standard PBM reports.
  • Collaborate with PBM and vendor clinical teams to review updates, verify accuracy, and ensure changes are accurately reflected in systems and lists.
  • Support implementation, monitoring, and review of operational workflows for data accuracy and overall efficiency.
  • Perform detailed activities requiring pharmacy technician expertise while upholding data quality, compliance, and operational readiness.
  • Manage workflows for clinical consultations.
  • Perform additional responsibilities consistent with the scope and level of the role, as assigned.

Desired Qualifications

  • Proficiency in Microsoft Office Suite, including advanced Excel and Word skills.
  • Ability to communicate complex topics clearly and concisely, actively listen to anticipate stakeholder needs, and align others to drive informed decisions.
  • Ability to analyze complex information, evaluate options, and work cross-functionally to drive resolution and prevent recurrence.
  • Ability to leverage technology to communicate complex topics clearly and concisely, actively listen to anticipate stakeholder needs, analyze complex information, and align others to drive resolution.
  • Ability to effectively organize work, balance competing priorities, and manage time across complex assignments and competing deadlines.
  • Experience and knowledge of pharmacy operations, including PBM, health plan, retail, specialty, or medical pharmacy.
  • Experience triaging and resolving inquiries associated with claims and benefits.
  • Experience working with Commercial, Medicare, and/or Medicaid.
  • Demonstrated project management and strategy development skills.

About the Company

Blue Cross and Blue Shield of Minnesota

Nonprofit health insurance provider for Minnesota

Blue Cross® and Blue Shield® of Minnesota provides health insurance plans in Minnesota. It is a nonprofit organization that helps people access health services by offering coverage to individuals and groups through a broad provider network. Members pay premiums or receive employer-sponsored benefits, and the company processes claims and coordinates care with healthcare providers. The product works by giving members access to a network of doctors, hospitals, and services, with costs covered according to the plan’s benefits and rules. What sets it apart from competitors is its long history since 1933, its nonprofit status, and its operation as an independent licensee of the Blue Cross Blue Shield Association, which provides a large, nationwide network and scale while focusing on affordable access for Minnesotans. The company's goal is to make a healthy difference in people’s lives by expanding economical, timely access to health services for residents of Minnesota.

Company size
1,001-5,000
Company stage
Not listed
Total funding
$5.7M
Headquarters
Eagan, MN
Founded
1933

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