Your Role (This is a Short-Term Employment)

The Pharmacy Benefits and Compliance Implementation team works in collaboration with internal and external vendor resources to build and validation pharmacy plan benefit details for all Blue Shield members who enroll in plans that have an online pharmacy benefit administered by Blue Shield of California. The Pharmacy Benefits and Compliance Implementation Specialist will report to the Supervisor, Pharmacy Benefits and Compliance Implementation. In this role you will be responsible for gathering requirements, accurate build and deployment of Commercial and Medicare online pharmacy benefits.

Your Work

In this role, you will:

• Act as a subject matter expert to review operational workflows of high degree of complexity and/or for multiple departments, identifying problems and developing improvements, modifications, and enhancements
• Develop and evaluate tools and materials that enhance operating efficiency, accuracy, and technical skill levels of unit staff
• Develop processes used by others to track and communicate workflow and system changes
• Develop and generate reports ranging from routine to moderately complex for management review
• Participate as a subject matter expert in the development of written guidelines and documents problems
• Collaborate with internal BSC Sales and Product resources to evaluate feasibility of pharmacy product design
• Work with aligned pharmacy claims processing, network, contracting and other external vendors to build and deploy pharmacy benefit packages that pair to Blue Shield product offerings
• Track and support benefit build details and work as a subject matter expert for benefit build inquiries as part of audit or compliance related tasks
• Support validation efforts completed by other resources as part of benefit build process

Your Knowledge and Experience

• Requires a bachelor's degree or equivalent experience
• Requires at least 5 years of prior relevant experience
• Requires core understanding of pharmacy benefit composition
• Desired: 3 years previous experience in a pharmacy benefit facing position

Pay Range:

The pay range for this role is: $ 77990.00 to $ 116930.00 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.