Job Description

Your Role

The Pharmacist Clinical Program Manager, Provider Partnership team supports the development, implementation, coordination, and assessment of pharmacy initiatives with the goal of providing high quality and affordable care to Blue Shield of California's members. The Business Analyst, Consultant will report to the Senior Pharmacist Manager of the Pharmacist Clinical Program Manager, Provider Partnership team. In this role you will be a subject matter expert for related programs to ensure that business requirements are established and maintained, key performance indicators are defined and monitored, and new ideas are evaluated to support data-driven decisions. You will work with an agile mindset, applying tenets of the Agile framework to drive high performing results for clinical pharmacy programs.

Responsibilities

Your Work

In this role, you will:

• Provide highly complex analytical support through the analysis and interpretation of data in support of cross-functional business operations
• Lead the development of annual operating plans, capital budgets and forecasts, and build business cases for new business initiatives (cost/benefit analysis)
• Develop, prepare, and analyze reports with highly complex analysis and data for management review, and presents to various levels of management
• Define business requirements and provide analysis to increase operational efficiency
• Provide analytical support for multiple, highly complex cross-functional projects simultaneously, establish work plans and timelines, coordinate with internal and external resources
• Improve processes, systems, and products to enhance the performance of the Clinical Pharmacy Program Manager Provider Partnership Team
• Provide business analytic support to inform strategies that help ACO groups achieve risk share and quality targets and Medicare groups meet quality measure goals, including analysis of key performance indicators and risk share models.
• Provide business analytic support to any new technologies or strategies that enable and enhance clinical quality improvement and drug cost affordability.
• Collaborate with other business areas, including Data and Analytics, Digital Experience, I.T. to research, design, build, test, monitor, and enhance clinical pharmacy programs to achieve defined goals.
• Support professional growth and employee engagement for yourself and others by being a key resource to advise and mentor other team members

Qualifications

Your Knowledge and Experience

• Requires a college degree or equivalent experience
• Requires at least 7 years of prior relevant experience
• A minimum of 3 years' experience in managed care pharmacy is preferred
• Requires strong analytic and problem-solving skills with intermediate to advanced knowledge of pharmacy data elements and related technical standards/concepts (e.g. claims, e-prescriptions, e-prior authorization, real time pharmacy benefits, etc.)
• Requires advanced proficiency in Microsoft applications including Word, Excel, Power Point, Power Query, Power BI, OneNote, SharePoint
• Requires excellent written, verbal, and interpersonal communication skills
• Requires experience working independently in a fast-paced environment

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 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.

Physical Requirements:

Office Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office/deskwork - Activity level: Sedentary, frequency most of work day.

Please click here for further physical requirement detail.