Summary
 

We are currently hiring for a Medicare Pharmacy Operations Analyst to join BlueCross BlueShield of South Carolina. In this role as a Medicare Pharmacy Operations Analyst, you will provide key operations support and guidance on the Pharmacy Benefit Management (PBM) Support Team and serve as an operations liaison to ensure high levels of service are delivered. As a subject matter expert in the Pharmacy Benefit Management (PBM) benefit administration, this position will drive identification and resolution of issues by partnering with our internal and external customers and our PBM.

Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. We are the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team!

Description
 

Logistics

This position is full time (40 hours/week) Monday-Friday and will be 17 Technology Circle, Columbia, S.C., 29203.

What You Will Do:

• Assist PBM Operations Manager with primary objectives to lead PBM related services including partnership with Pharmacy Support, Management, and Marketing representatives.

• Provides strategic planning and account management for accounts.

• Support escalations as required within various teams, assisting to hold PBM vendor accountable.

• Ensure holistic solutions are developed.

• Makes recommendations for improvements to meet customers' expectations.

• Partner with PBM on IT development efforts to streamline operational efficiencies.

• Participates in efforts to support standardization across accounts and works in multi-disciplinary teams to design and implement product and operational enhancements.

• Manages the new and renewal implementation process for accounts.

• Maintains ongoing account relationships at multiple levels throughout the organization.

• Provides both on-site and off-site customer service, which may include interpreting plan design, researching and resolving phone and written inquiries, resolving claims, benefit, and enrollment issues.

• Coordinates open enrollment meetings, renewal processes, and training sessions.

• Develops implementation processes and manages reporting processes to ensure client retention and high levels of account satisfaction.

To Qualify for This Position, You Will Need:

• Bachelor’s Degree.

• Four years job-related work experience OR Associate's and two years job-related work experience.

• Five years Health Plan, Pharmacy OR PBM Experience.

• Five years of Account Management Experience (may be concurrent).

• Strong oral and written communication skills.

• Strong negotiations skills.

• Ability to prioritize work and meet deadlines.

• Ability to work i