Blue Shield of California · 2 hours ago
Business Analyst, Senior
California, United States
Full-time
Hybrid
Senior Level
5+ years expBlue Shield of California is seeking a Senior Business Analyst for their Formulary Management team. In this role, you will analyze data to support business operations, develop operating plans, and ensure compliance with state and federal mandates regarding formularies and drug lists.
Financial ServicesHealth InsuranceNon Profit
Responsibilities
Provide complex analytical support through the analysis and interpretation of data in support of cross-functional business operations
Develop 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
Create and coordinate test plans across multiple stakeholders
Analyze actual results against plan and forecast and recommend interventions where appropriate
Identify opportunities for improvements in operation performance and notify management of issues and problems that require immediate attention
Provide analytical support for multiple, complex cross-functional projects simultaneously, establishing work plans and timelines, and coordinating with internal and external resources
Develop, review, and update written system processes and operational workflows related to formulary management
Develop and implement work plan for formulary enhancements that support cost-of-healthcare initiatives
Act as subject matter expert for formulary processes in support of state and federal mandates and audits
Perform other duties as assigned
Qualification
Required
Requires a college degree or equivalent experience
Requires 5 years of prior relevant experience
Hybrid work environment: the in‑office expectation is 8 days per month (approximately 2 days per week) out of the Oakland, Long Beach, or Rancho Cordova offices
Experience working with Pharmacy Benefit Management systems or vendors
Knowledge of Pharmacy Benefit design and Formulary configuration; knowledge of Blue Shield of California (or similar health care organization) pharmacy configuration is preferred
Knowledge of regulatory requirements (Commercial and/or Medicare) related to formularies and utilization management
Strong coordination and interpersonal skills working in a matrixed environment with multiple stakeholders
Knowledge of project management
Demonstrated experience documenting processes, identifying process gaps, managing multiple projects, and implementing industry best practices
Preferred
Knowledge of regulatory requirements (Commercial and/or Medicare) related to formularies and utilization management
Familiarity with Medispan drug files is preferred
Knowledge of Commercial and Medicare Part D formulary requirements is preferred
Knowledge of California's pharmacy benefit compliance requirements is preferred
Company
Blue Shield of California
Blue Shield of California is a health insurance service provider.
5001-10000 employees
H1B Sponsorship
Blue Shield of California 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
2023 (1)
2022 (41)
2021 (20)
2020 (31)
Funding
Current Stage
Late StageLeadership Team
Gary Culp
Senior Vice President, Government Markets
Gregory Siebert
Senior Vice President Provider Partnerships & Network Management
Recent News
2026-01-13
Fierce Healthcare
2025-12-15
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