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Blue Cross and Blue Shield of Alabama · 1 day ago

Pharmacy Operations Coordinator

Birmingham, AL

Full-time

Hybrid

Mid Level

4+ years exp

Blue Cross and Blue Shield of Alabama is focused on managing prescription drug benefits and costs for their customers. The Pharmacy Operations Coordinator is responsible for supporting pharmacy managers and other departments in the development and implementation of pharmacy initiatives, relationship management with vendors, and ensuring compliance with contracts and regulatory requirements.

Health CareInsurance

Comp. & Benefits

H1B Sponsor Likely

Responsibilities

Assisting Pharmacy managers, Directors, other Blue Cross and Blue Shield of Alabama departments, Pharmacy providers/vendors, and the Pharmacy Benefit Manager (PBM) in the development, documentation, measurement, implementation, maintenance and communication of pharmacy initiatives and regulatory requirements supporting the Blue Cross corporate strategy and objectives

Developing strategies and related initiatives to support operational and strategic goals

Responsible for all aspects of relationship management with pharmacy-related vendors, partnerships, and business ventures

Negotiating, maintaining and monitoring applicable pharmacy contracts

Developing and tracking performance metrics and results, and evaluating compliance with financial terms and contractual and regulatory requirements associated with the contracts

Developing and executing an oversight program sufficient to identify risks, errors, and non-compliance with contracts and/or related operational activities

Establishing and/or evaluating corrective actions to ensure effectiveness of corrections for deficiencies identified

Responsible for communications related to changes and deficiencies of contracts

Facilitating audits and reviews conducted by audit firms, groups and regulatory agencies as applicable

Facilitating workgroups where associates from multiple departments must work together to accomplish a goal and serving as a key stakeholder in divisional and corporate initiatives

Working with other divisional areas and vendors to identify and resolve any operational, compliance, and/or administrative issues

Coordinating work of internal team members to complete unit’s tasks/goals within established guidelines and timeframes

Acting as a liaison with the pharmacy and provider community to ensure adequate communication, education, and understanding of pharmacy initiatives

Developing, overseeing, and managing timelines, tracking deliverables, project status, evaluating regulatory guidance, implementing initiatives and regulatory requirements, measuring intended results, maintaining, and communicating internally and externally related to Pharmacy initiatives that support the Pharmacy Business Plan, Pharmacy Balanced Scorecard, or other divisional or corporate goals and strategies

Measuring, reviewing and reporting project performance and operational compliance results to Pharmacy management

Providing research, analysis, facilitation, and/or administration of Pharmacy Benefit Management (PBM) industry best practices in support of the pharmacy strategy development process

Qualification

Business Analyst experienceRegulatory knowledgeProject management experienceNegotiation techniquesMicrosoft ExcelAnalytical skillsWritten communication skillsVerbal communication skillsInterpersonal skillsOrganizational skills

Required

Bachelor's Degree

Four years of experience in a Business Analyst type of role, or proven experience in a related field of business

Demonstrated problem-solving and analytical skills to research and interpret complex and detailed issues, problems, and opportunities under time constraints

Experience developing recommendations for solutions or new business opportunities

Experience leading and directing others in projects to streamline processes, reduce administrative costs, and improve operational activities

Demonstrated written and verbal communication skills

Experience developing and presenting information in formal and informal settings

Demonstrated project management experience, including the coordination of multiple detailed projects

Demonstrated documentation skills to ensure managers, team members and stakeholders are kept informed about developments, plans, issues, risks, and progress

Experience overseeing, directing, and organizing project teams to successfully implement initiatives

Demonstrated independence and completion of assignments without close supervision

Demonstrated interpersonal skills to facilitate the building and maintenance of relationships with pharmacy partners and vendors and develop a deep understanding of their products and long-term business opportunities

Experience using negotiation and conflict-management techniques

Demonstrated organizational and time management skills to direct and execute pharmacy-related contracts

Knowledge of the Centers for Medicare & Medicaid Services (CMS)/Medicare/government/quality requirements and regulations as applicable to pharmacy products and services as applicable

Experience interpreting regulatory guidance as well as identifying and implementing required changes as applicable

Working knowledge of Microsoft Excel, Word, and PowerPoint

Preferred

Project Management or Compliance/Audit Certification

Pharmaceutical industry knowledge, Pharmacy Benefit Management (PBM) knowledge, overall knowledge of the healthcare industry, or compliance/audit knowledge

In-depth knowledge of Blue Cross and Blue Shield of Alabama's products and the changing market needs in order to ensure product development, analysis, and implementation are in line with market demand

Working knowledge of claims system processing, appeals, prior authorizations, pharmacy pricing, provider reimbursement, and/or audit processes

Experience using Visio, reporting applications, etc

Company

Blue Cross and Blue Shield of Alabama

Glassdoor3.9

Blue Cross and Blue Shield of Alabama is the largest provider of healthcare benefits in Alabama.

Founded in 1936

Birmingham, Alabama, USA

1001-5000 employees

https://www.bcbsal.org

H1B Sponsorship

Blue Cross and Blue Shield of Alabama has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)

Distribution of Different Job Fields Receiving Sponsorship

Represents job field similar to this job

Trends of Total Sponsorships

2025 (37)

2024 (19)

2023 (14)

2022 (27)

2021 (21)

2020 (9)