Business Analyst, Senior

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, Senior will report to the Manager of Pharmacy Finance Support. In this
• role you will provide ownership and strategic oversight of Pharmacy funding and
• finance operations. This role partners with Finance, Data Analytics, external
• vendor partners, and business stakeholders to resolve discrepancies, strengthen
• processes, analyze and communicate pharmacy funding claim trends and outlier
• drivers, and ensure the accurate tracking and approval of Pharmacy funding.
• 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.

RESPONSIBILITIES

Your Work

In this role, you will

• 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 with complex analysis and data for

management review, and present to various levels of management

• Define business requirements and provide analysis to increase operational

efficiency

• Provide analytical support for multiple, complex cross-functional projects

simultaneously; establish work plans and timelines

• Research funding and payment discrepancies in partnership with Finance, Data

Analytics, and service providers; coordinate incident tickets and

follow-through as needed

• Maintain accurate tracking of Pharmacy Funding and Administrative dollars

received and disbursed

• Oversee and enhance the end-to-end Pharmacy funding process to improve

• accuracy, controls, timeliness, and transparency and provide backup support
• for Pharmacy Funding reconciliation and Pharmacy Service Provider
• administrative invoice validation.

• Prepare and maintain external vendor partner Pharmacy Funding Pre-Approval

documentation, annual estimates, and materials for executive approval

• Perform other duties as assigned

QUALIFICATIONS

• 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 5 years of prior relevant experience
• Advanced knowledge in pharmacy benefit claims and pharmacy operations
• Demonstrated ability to analyze financial discrepancies, improve processes,

and coordinate work across multiple teams and external partners

• Excellent verbal and written communication skills that exhibit a

solution-oriented approach

• Excellent problem-solving and analytical skills
• Strong proficiency with Microsoft Excel and pharmacy claim data reporting

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.

About Blue Shield of California

• As of January 2025, Blue Shield of California became a subsidiary of Ascendiun.
• Ascendiun is a nonprofit corporate entity that is the parent to a family of
• organizations including Blue Shield of California and its subsidiary, Blue
• Shield of California Promise Health Plan; Altais, a clinical services company;
• and Stellarus, a company designed to scale healthcare solutions. Together, these
• organizations are referred to as the Ascendiun Family of Companies.

• At Blue Shield of California, our mission is to create a healthcare system
• worthy of our family and friends and sustainably affordable. We are transforming
• health care in a way that genuinely serves our nonprofit mission by lowering
• costs, improving quality, and enhancing the member and physician experience.

• To achieve our mission, we foster an environment where all employees can thrive
• and contribute fully to address the needs of the various communities we serve.
• We are committed to creating and maintaining a supportive workplace that upholds
• our values and advances our goals.

• Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best
• Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360
• as a Top Regional Company, and one of the 50 most community-minded companies in
• the United States by Points of Light. Here at Blue Shield, we strive to make a
• positive change across our industry and communities – join us!

Our Values

• Honest. We hold ourselves to the highest ethical and integrity standards. We

• build trust by doing what we say we're going to do and by acknowledging and
• correcting where we fall short.

• Human. We strive to listen and communicate effectively, showing empathy by

understanding others' perspectives.

• Courageous. We stand up for what we believe in and are committed to the hard

work necessary to achieve our ambitious goals.

Our Workplace Model

• We believe in fostering a workplace environment that balances purposeful
• in-person collaboration with flexibility - providing clear expectations while
• respecting the diverse needs of our workforce. Our workplace model is designed
• around intentional in-person interaction, collaboration,

connection, creativity and flexibility

• For most teams, this means coming into the office two days per week.
• Employees living more than 50 miles from an office location, out of state

• employees, and employees in certain member-facing roles should work with
• their manager to determine in-office time based on business need.

• For employees with medical conditions that may impact their ability to work

• in-office, we are committed to engaging in an interactive process and
• providing reasonable accommodations to ensure their work environment is
• conducive to their success and well-being.

• The Company reserves the right to require more presence in the office based on
• business needs, and requirements are subject to change with periodic reviews.

Physical Requirements

• Office Environment - roles involving part to full time schedule in Office
• Environment. Based in our physical offices and work from home office/deskwork -
• Activity level: Sedentary, frequency most of work day.

• Please click here for further physical requirement detail.
• [https://www.blueshieldca.com/physical-job-requirements]

Equal Employment Opportunity

• External hires must pass a background check/drug screen. Qualified applicants
• with arrest records and/or conviction records will be considered for employment
• in a manner consistent with Federal, State and local laws, including but not
• limited to the San Francisco Fair Chance Ordinance. All qualified applicants
• will receive consideration for employment without regards to race, color,
• religion, sex, national origin, sexual orientation, gender identity, protected
• veteran status or disability status and any other classification protected by
• Federal, State and local laws.