Blue Cross and Blue Shield Association logo

Manager, Pharmacy Business Analysis

Blue Cross and Blue Shield Association
  • El Dorado Hills, CA
    1 day ago

    Job Description

    Your Role

    The Pharmacy Operations and Stabilization team provides end-to-end oversight of all Pharmacy benefit intent, quality assurance, testing, and production stabilization activities ensuring benefit changes are clearly defined, accurately validated, and effectively managed from issue identification through resolution within a matrixed environment. The Manager, Business Analysis will report to the Sr Manager, Operations and Stabilization. In this role you will manage the team who owns the end-to-end translation of pharmacy benefit intent into business requirements, operational frameworks, and quality validation strategies; provide consultative leadership across quality assurance (QA), testing, and production stabilization activities; and influence cross-functional decisions to resolve complex issues and improve benefit accuracy, operational performance, and governance across matrixed business, clinical, technical, and vendor teams.

    Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

    Your Knowledge and Experience

    • Bachelor's degree or High School Diploma/GED and 4 years of additional relevant experience

    • Requires at least 7 years prior relevant experience, including 3 years of management experience gained as a team leader, supervisoror project/program manager

    • Requires extensive experience with healthy plan pharmacy operations

    • Requires experience translating business intent into business requirements, acceptance criteria, test scenarios, and operational validation plans

    • Requires experience supporting quality assurance, user acceptance testing, regression testing, defect management, and post-implementation validation for pharmacy benefit or healthcare operations initiatives

    • Preferred experience supporting large-scale pharmacy benefit implementations, annual benefit changes, product launches, client implementations, or system migration efforts

    Hybrid

    This role requires employees to be in-office based on our hybrid workplace model, balancing purposeful in-person collaboration with flexibility. For most teams, this means coming into the office two days each week.

    Employees living more than 50 miles from an office location will work with their manager to determine in-office time based on business need.

    Your Work

    In this role, you will:

    • Provide analytical support through the analysis and interpretation of data in support of cross-functional business operations

    • Contribute to annual operating plans, capital budgets and forecasts, and build business cases for new business initiatives (cost/benefit analysis)

    • Develop, prepare and analyze reports for management review, and present to various levels of management

    • Define business requirements and provide analysis to increase operational efficiency

    • Analyze actual results against plan and forecast and recommend interventions where appropriate

    • Translate pharmacy benefit intent, business needs, and operational inputs into clear requirements, process flows, test scenarios, and supporting documentation

    • Support quality assurance and user acceptance testing by validating benefit configuration, documenting results, and coordinating defect resolution

    • Analyze production issues, trends, and root cause indicators to support timely triage, escalation, remediation, and prevention efforts

    • Partner with business, clinical, technical, and vendor teams to clarify requirements, resolve questions, and ensure alignment across implementation and stabilization activities

    • Maintain dashboards, trackers, reports, and issue documentation to support operational visibility, leadership updates, and decision-making

    Your Work

    In this role, you will:

    • Provide analytical support through the analysis and interpretation of data in support of cross-functional business operations

    • Contribute to annual operating plans, capital budgets and forecasts, and build business cases for new business initiatives (cost/benefit analysis)

    • Develop, prepare and analyze reports for management review, and present to various levels of management

    • Define business requirements and provide analysis to increase operational efficiency

    • Analyze actual results against plan and forecast and recommend interventions where appropriate

    • Translate pharmacy benefit intent, business needs, and operational inputs into clear requirements, process flows, test scenarios, and supporting documentation

    • Support quality assurance and user acceptance testing by validating benefit configuration, documenting results, and coordinating defect resolution

    • Analyze production issues, trends, and root cause indicators to support timely triage, escalation, remediation, and prevention efforts

    • Partner with business, clinical, technical, and vendor teams to clarify requirements, resolve questions, and ensure alignment across implementation and stabilization activities

    • Maintain dashboards, trackers, reports, and issue documentation to support operational visibility, leadership updates, and decision-making

    Numbers & Facts

    LocationEl Dorado Hills, CA
    IndustryInsurance
    Company Size2,000 to 2,499 employees
    Websitehttps://www.bcbs.com/about-us/careers

    About Company

    At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry. We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

    Skills

    • Acceptance Testingunmatched
    • Analysis Skillsunmatched
    • Budget Managementunmatched
    • Bug Tracking/Defect Managementunmatched
    • Business Analysisunmatched
    • Business Caseunmatched
    • Business Operationsunmatched
    • Capital Budgetingunmatched
    • Cost Benefit Analysisunmatched
    • Cross-Functionalunmatched
    • Data Analysisunmatched
    • Documentationunmatched
    • Forecastingunmatched
    • Healthcareunmatched
    • High School Diplomaunmatched
    • Identify Issuesunmatched
    • Leadershipunmatched
    • Operational Auditunmatched
    • Operational Supportunmatched
    • Operations Planningunmatched
    • Pharmacyunmatched
    • Problem Solving Skillsunmatched
    • Process Flowunmatched
    • Product/Service Launchunmatched
    • Project/Program Managementunmatched
    • Quality Assuranceunmatched
    • Regression Testingunmatched
    • Reporting Dashboardsunmatched
    • Requirements Managementunmatched
    • Support Documentationunmatched
    • System Migrationunmatched
    • Team Lead/Managerunmatched
    • Test Scenariounmatched
    • Testingunmatched
    • Time Managementunmatched
    • Trend Analysisunmatched
    • Validation Planunmatched

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