Health Care Analyst - Pharmacy Vendor Contracting

With more than 7,000 employees, we are the largest health insurance company in Michigan. We offer an exciting work environment with a diverse group of employees. Our goal is to make health insurance easier for our members. We want to transform the industry and become a resource that people can trust.

Detroit, MI

Blue Cross Blue Shield of Michigan

When you think of <a href="" target="_blank" rel="noopener noreferrer">Blue Cross Blue Shield of Michigan</a> for health insurance, you can know you&rsquo;re getting much more. We're a company founded on a tradition of affordable, quality health care for everyone, improving the present and investing in the future.&nbsp;<br /><br />We offer:<br />Plans for employers and individuals that meet today&rsquo;s needs, budgets and lifestyle<br />The largest network of doctors and hospitals in the state<br />Lower health care costs Higher quality health care<br />Award-winning diversity practices<br />Grants and programs that promote better health throughout Michigan<br /><strong><br />Mission:&nbsp;</strong>We commit to being our members&rsquo; trusted partner by providing affordable, innovative products that improve their care and health.<br /><br /><a href="" target="_blank" rel="noopener noreferrer"><strong>Click here</strong></a> to learn more about our commitment to our Social Mission, view company updates and reviews, and view our awards &amp; accolades.<br /><br />For Application Timeline &amp; Selection Process:&nbsp;<a href="" target="_blank" rel="noopener noreferrer">Click Here</a>. Learn more about your options as an external candidate. <a href="" target="_blank" title="BCBSM" rel="noopener noreferrer">Click here</a> to view open positions.

keywords: analysis,teamwork,consulting,organization,communication,support,research,support,knowledge,degree,skills,project management,teamwork,experience


Competitive Total Compensation Package

Overview: Responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions. Coordinate projects for senior management.
Responsibilities: <ul> <li>Research, analyze, identify, and evaluate data from assigned problems to evaluate existing and potential trends and issues.</li> <li>Possess and maintain a comprehensive understanding and knowledge of BCBSM business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and basic research principles/methodologies.</li> <li>Assist in the management and monitoring of multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters.</li> <li>Communicate results of the analysis to management via reports/presentations and assist management in implementing programs that provide solutions.</li> <li>Recommend, communicate, and implement solutions to identified problems/root causes of issues.</li> <li>Provide expertise and guidance to unit and corporate staff as required.</li> <li>Represent and participate in group or committee discussions.</li> </ul>
Requirements: <ul> <li>Knowledge of pharmacy business and data. Be able to support the resolution of pharmacy claim adjudication discrepancies related to vendor contracts. May be requested to participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.&nbsp; Assist in the business process redesign and documentation as needed.</li> <li>Vendor Management contracting.&nbsp; Health Care Analyst will assist the manager in large-scale enterprise procurement activities such as Request for Proposals (RFP) but with limited direction may lead to smaller procurement projects on their own. May be requested to assist in the development of support documentation</li> <li>Provide project management support for enterprise-wide pharmacy projects.&nbsp; Assist manager in implementing corporate-wide pharmacy projects that interact with other business areas, multiple IT areas, and with multiple pharmacy vendors.&nbsp; May act as a liaison between pharmacy and other BCBSM departments or vendors.&nbsp; Assist in leading group or committee discussions. Develop project documentation using Microsoft Office Suite (Word, Excel, PowerPoint, Visio).&nbsp;</li> </ul> "&nbsp;<strong>Qualifications</strong>" <ul> <li>Bachelor's Degree in Business Administration, Economics, Health Care, Information Systems, Statistics, or other related field is required.&nbsp; Master's Degree in related field preferred.</li> <li>Four (4) or more years of experience in a related fields required.</li> <li>Strong communication skills are required to understand, interpret, and communicate ideas.</li> <li>Strong knowledge and use of existing software packages (PowerPoint, Excel, Word, etc).</li> <li>Working knowledge of data languages such as SAS or SQL.</li> <li>Strong analytical, organizational, planning and problem solving skills.</li> <li>Ability to effectively interface with employees at all levels.</li> <li>Understand and apply statistical inference.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> </ul>