Blue Cross and Blue Shield Association logo

Business Analyst, Experienced

Blue Cross and Blue Shield Association

  • El Dorado Hills, CA
  • 4 days ago

    Highlights

    In this role you will support day-to-day pharmacy funding and administrative invoice operations by validating payments, coordinating approvals, researching discrepancies, tracking funding activity, and maintaining accurate process documentation. The Pharmacy Finance Support team supports Pharmacy Strategy and Operations in managing impacts to the Pharmacy portfolio budget, ensuring proper approvals, and validating invoices from strategic vendors prior to payment.

    Numbers & Facts

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

    Description

    Your Role

    The Pharmacy Finance Support team supports Pharmacy Strategy and Operations in managing impacts to the Pharmacy portfolio budget, ensuring proper approvals, and validating invoices from strategic vendors prior to payment. The Business Analyst, Experience will report to the Manager of Pharmacy Finance Support. In this role you will support day-to-day pharmacy funding and administrative invoice operations by validating payments, coordinating approvals, researching discrepancies, tracking funding activity, and maintaining accurate process documentation. This role partners with Finance, Data Analytics, external vendor partners, and business stakeholders to resolve discrepancies, helps ensure financial controls, audit readiness, and timely execution across pharmacy payments activities.

    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 in lieu of a degree
    • Requires at least 3 years of prior relevant experience
    • Knowledge of pharmacy benefit claims and pharmacy operations
    • Experience in business analysis, financial operations, payment validation, reconciliation, controls, or audit support
    • Ability to analyze discrepancies, maintain accurate financial tracking, and manage recurring operational deadlines
    • Excellent verbal and written communication skills that exhibit a solution-oriented approach

    Proficient in Microsoft Excel

    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
    • Perform operational validation, approval coordination, payment processing, and discrepancy research for Pharmacy funding and Administrative Invoice activities
    • Track Pharmacy funding expenditures against approved pre-approval amounts and maintain accurate records of dollars received and disbursed
    • Support Archer controls, external audits, and related evidence requests
    • Create and maintain process documents and detailed level procedures for BSC-side Pharmacy
    • Administrative invoice validation
    • Perform other duties as assigned

    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
    • Perform operational validation, approval coordination, payment processing, and discrepancy research for Pharmacy funding and Administrative Invoice activities
    • Track Pharmacy funding expenditures against approved pre-approval amounts and maintain accurate records of dollars received and disbursed
    • Support Archer controls, external audits, and related evidence requests
    • Create and maintain process documents and detailed level procedures for BSC-side Pharmacy
    • Administrative invoice validation
    • Perform other duties as assigned

    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.

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