Blue Shield Of California

Operations Specialist, Senior - Stellarus

Blue Shield Of California$75K — $95K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree or equivalent experience required.
  • Minimum of 5 years of relevant experience required.
  • Proficient in Excel, including pivot tables and vLookups.
  • Experience collaborating with cross-functional teams essential.
  • Strong organizational skills and attention to detail required.
  • Previous invoice validation experience is preferred.
  • Desire for understanding end-to-end ticket request processing.

Responsibilities

  • Act as subject matter expert to review and improve operational workflows.
  • Maintain essential databases for business operations.
  • Develop tools and materials to enhance operational efficiency and staff competency.
  • Generate and present reports for management, highlighting operational issues.
  • Contribute expertise in developing guidelines and documenting problems.
  • Monitor shared team inbox for Modular Solutions Escalation Triage support.
  • Participate in incident triage through monitoring shared team communication.
  • Cross-train within the team to provide support as needed.

Benefits

  • Flexible work environment, including office and remote options.
  • Opportunities for professional development and cross-training.
  • Participation in managing vendor relationships and agreements.
  • Engagement in operational processes that influence pharmacy services.
Full Job Description
Job Description

Your Role

The Pharmacy Transformation, Vendor Oversight team supports Pharmacy Services in managing vendor relationships, tracking vendor escalations, running operational processes related to vendor management, overseeing vendor performance, and managing vendor contracting. The Operations Specialist, Experienced will report to the Manager of Pharmacy Vendor Oversight. In this role you will support financial oversight of but not limited to; invoice validation and pharmacy funding along with user access request processing.

Responsibilities

Your Work

In this role, you will:
  • Act as subject matter expert and reviews operational workflows, identifying problems and develops improvements, modifications, and enhancements
  • Maintain databases required for business operations
  • Develop and evaluate tools and materials that enhance operating efficiency, accuracy, and technical skill levels of unit staff
  • Develop and generate reports for management review; notify appropriate department mangers about issues and problems in operational workflow requiring immediate attention
  • Participate as a subject matter expert in the development of written guidelines and documents problems as needed
  • Support Modular Solutions Escalation Triage by monitoring shared team inbox
  • Support incident triage by monitoring shared team inbox
  • Cross-Train in areas across the team for support as needed


Qualifications

Your Knowledge and Experience
  • Requires a bachelor's degree or equivalent experience
  • Requires at least 5 years of prior relevant experience
  • Requires experience with pivot tables, vLookups, and formatting within Excel
  • Requires experience working with cross-functional partners and driving work
  • Requires strong organizational skills and attention to detail
  • Previous invoice validation desired
  • Strong understanding of processing ticket requests from end to end desired


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.

About Blue Shield Of California

Blue Shield of California is a not-for-profit health plan provider that has been providing Californians with access to high-quality healthcare for over 80 years. The company offers a range of health insurance products and services to individuals, families, and employers. Blue Shield of California is committed to improving the health and wellbeing of its members and the communities it serves. The company is also committed to sustainability and has implemented a number of initiatives to reduce its environmental impact.
Learn more about Blue Shield Of California
Size
7,000 employees
Industry
Founded
1981

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