Job Description

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

The Impact You'll Have

In this positions, you will be responsible for supporting all aspects of the Pharmacy Business Segments by working with the Pharmacy Department to provide hands-on support, consultation, technical and operational expertise. You will work closely with cross functional teams and Pharmacy Benefit Manager (PBM) to support pharmacy initiatives and partner with Business Segments to ensure implementation and execution.

What You'll Do

• Support the Pharmacy Business Segments (Self Insured, Fully Insured, and Government Programs), by providing pharmacy technician expertise across clinical, administrative, and operational activities.
• Conduct and analyze pharmacy utilization reports from business database applications, and validate the data for accuracy and consistency.
• Engage and collaborate with internal and external business teams in the business planning process.
• Evaluate and document all current processes and procedures of pharmacy partners.
• Develop workflows/processes, identify gaps and opportunities for improvement of standard operating procedures, support implementation, and drive continuous improvement in process efficiency and data integrity.

How You'll Do It

• Support program development of clinical pharmacy programs; manage databases and develop communications to members and providers.
• Identify opportunities for improvement and develop recommendations to business based on analysis and auditing of standard PBM reports.
• Collaborate with PBM and vendor clinical teams to review updates, verify accuracy, and ensure changes are accurately reflected in systems and lists.
• Support implementation, monitoring, and review of operational workflows for data accuracy and overall efficiency.
• Perform detailed activities requiring pharmacy technician expertise, and upholding data quality, compliance, and operational readiness.
• Manage workflows for clinical consultations.
• Performs additional responsibilities consistent with the scope and level of the role, as assigned

Required Skills & Experience

• 5+ years of related health services professional experience.
• Bachelor’s degree; in lieu of a degree, an additional two years of relevant experience beyond the qualifications listed above may be accepted.

Preferred Skills & Experience

• Proficient in Microsoft Office Suite, including advanced Excel and Word skills.
• Ability to communicate complex topics clearly and concisely, actively listen to anticipate stakeholder needs, and align others to drive informed decisions.
• Ability to analyze complex information, evaluate options, and work cross-functionally to drive resolution and prevent recurrence.
• Ability to leverage technology to communicate complex topics clearly and concisely, actively listen to anticipate stakeholder needs, analyze complex information, and align others to drive resolution.
• Ability to effectively organize work, balance competing priorities, and manage time across complex assignments and competing deadlines.
• Experience and knowledge of pharmacy operations, including PBM, health plan, retail, specialty, or medical pharmacy.
• Experience in triaging and resolving inquiries associated to claims and benefits.
• Experience working Commercial, Medicare, and/or Medicaid.
• Demonstrated project management and strategy development skill set.

Licensure/Certifications

Required:

Clear and active Pharmacy Technician license in the state of Minnesota.

Role Designation

Hybrid

Role designation definition:

• Teleworking is working full time remote.
• Hybrid is a minimum of 2 days onsite.
• Onsite is full-time onsite.

Anchored in Connection

Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week – most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote.

Compensation and Benefits

$79,100.00 - $104,800.00 - $130,500.00 Annual

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

To discover more about what we have to offer, please review our benefits page.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.

Physical requirements.