What are the responsibilities and job description for the Business Analyst, Consultant - Pharmacy Network position at Blue Shield of CA?
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
