Business Analyst, Consultant - Pharmacy Network - Blue Shield of CA : Job Details

Your Role

The Pharmacy Operations team oversees the build, implementation and maintenance of pharmacy benefits and pharmacy networks in a multi-vendor collaborative partnership. The Business Analyst, Consultant will report to the Senior Manager, Pharmacy Benefit Implementation. In this role you will support and be a subject matter expert in Pharmacy Network setup and maintenance.

Your Knowledge and Experience

• Requires a bachelor's degree or equivalent experience
• Requires at least 7 years of prior relevant experience, including in a pharmacy network composition and rates related role
• Requires knowledge of pharmacy operations and healthcare systems
• Familiarity with regulatory requirements in the healthcare industry
• Strong understanding of the Pharmacy Benefit Management (PBM) industry and the financial levers of a PBM highly desired
• Knowledge of pricing inputs and services (e.g. plan design, prescription history, retail pharmacy network models, rebate assumptions, specialty, mail pharmacy, brand/generic, and more) for contracted PBM services across multiple pricing methodologies strongly preferred