PBM Operations Analyst Sr

About Blue Cross Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you'll join us. How Is This Role Important to Our Work? The PBM Operations Analyst Sr. will focus on establishing and refining operational processes related to Commercial products, audits for all lines of business and pharmacy projects. This position will develop a Service/Claims structure to address member/client issues, ensure compliance and regulatory issues are resolved and lead projects/programs as requested. A Day in the Life: Core responsibilities will involve operational management and oversight of the Pharmacy Benefit Manager(s) (PBM) relating to Service, Claims and RFPs. Management and oversight of PBM audit resolution. Project/Program management for the pharmacy department. Establish PBM KPIs to manage and measure outcomes. Draft and maintain policies 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, groups, Clients, CMS/DHS and/or any other channel. Help prepare and disseminate reporting associated with PBM oversight. Nice to Have: Previous experience in pharmacy technician role, with or without certification Analytical and project management skills preferred Bachelor’s degree or equivalent experience Role Designation: Hybrid Remote Role designation definition: Teleworking is working full time remote. Hybrid is a combination of working onsite and remotely. Onsite is full-time onsite. Make a difference Blue Cross is an Equal Opportunity and Affirmative Action employer that values diversity. All qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national origin, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic. Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to talent.acquisition@bluecrossmn.com. All roles require a high school diploma (or equivalency) and legal authorization to work in the U.S. Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association. Chartered in 1933 as Minnesota’s first health plan, this company is one of the most recognized and trusted health care 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 with offices in North Minneapolis and Virginia and retail centers in Edina, Roseville and Duluth. Affiliate Companies' Jobs