Analyst-Pharmacy Services Medicare Part D
Company Name:
Blue Cross Blue Shield of Michigan
## Description
DEPARTMENTAL SUMMARY
Responsible for reviewing claims data, analyzing information and evaluate if an issue is present. Coordinate projects for management.
Responsible for assisting and supporting management in the evaluation, recommendation, establishment, implementation and analysis of new and improved production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality.
Assist and support in the planning, coordinating, developing and implementing of approved projects which are Divisional and/or Corporate in scope in order to enhance the overall efficiency of operational procedures, methods, controls, and performance. Analyze, process and/or expedite operational transactions; this may include timely resolution of problems. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process. Provide leadership team with status of projects; issue, communicate and recommend policy decisions to achieve project objectives. Utilize and maintain available corporate production and reporting systems; produce routine and non-routine reports, presentations, letters communications and graphics. Assist personnel (both internal and external) by answering questions, supplying information and training. Represent department and division as requested on work groups and special assignments. Develop and maintain an effective working relationship with customers or partners. Other duties may be assigned.
## Qualifications
Bachelor's Degree in related field preferred.
Two (2) to five (5) years experience in related field is required.
Demonstrated knowledge/competency in the following areas: claims or inquiry processing experience preferred, analytical experience, ability to produce statistical information from conceptual needs, and working with PC application and/or mainframe systems preferred.
Effective verbal and written communication skills.
Ability to lead and contribute to process improvement programs.
Excellent interpersonal skills necessary to interact with all levels of all personnel.
Other related skills and/or abilities may be required to perform this job.
DEPARTMENTAL REQUIREMENTS/PREFERENCES
Bachelor's Degree in Business Administration, Economics, Health Care, Information Systems, Statistics or other related field is preferred.
Two or more years of experience in related field required. Pharmacy Technician experience preferred.
Knowledge of Medicare guidance preferred.
Audit experience preferred.
Job: Pharmacy Services
Primary Location: Detroit
Organization: BCBSM
Schedule: Full-time
Req ID: BCB002KTEstimated Salary: $20 to $28 per hour based on qualifications.
Blue Cross Blue Shield of Michigan
## Description
DEPARTMENTAL SUMMARY
Responsible for reviewing claims data, analyzing information and evaluate if an issue is present. Coordinate projects for management.
Responsible for assisting and supporting management in the evaluation, recommendation, establishment, implementation and analysis of new and improved production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality.
Assist and support in the planning, coordinating, developing and implementing of approved projects which are Divisional and/or Corporate in scope in order to enhance the overall efficiency of operational procedures, methods, controls, and performance. Analyze, process and/or expedite operational transactions; this may include timely resolution of problems. Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process. Provide leadership team with status of projects; issue, communicate and recommend policy decisions to achieve project objectives. Utilize and maintain available corporate production and reporting systems; produce routine and non-routine reports, presentations, letters communications and graphics. Assist personnel (both internal and external) by answering questions, supplying information and training. Represent department and division as requested on work groups and special assignments. Develop and maintain an effective working relationship with customers or partners. Other duties may be assigned.
## Qualifications
Bachelor's Degree in related field preferred.
Two (2) to five (5) years experience in related field is required.
Demonstrated knowledge/competency in the following areas: claims or inquiry processing experience preferred, analytical experience, ability to produce statistical information from conceptual needs, and working with PC application and/or mainframe systems preferred.
Effective verbal and written communication skills.
Ability to lead and contribute to process improvement programs.
Excellent interpersonal skills necessary to interact with all levels of all personnel.
Other related skills and/or abilities may be required to perform this job.
DEPARTMENTAL REQUIREMENTS/PREFERENCES
Bachelor's Degree in Business Administration, Economics, Health Care, Information Systems, Statistics or other related field is preferred.
Two or more years of experience in related field required. Pharmacy Technician experience preferred.
Knowledge of Medicare guidance preferred.
Audit experience preferred.
Job: Pharmacy Services
Primary Location: Detroit
Organization: BCBSM
Schedule: Full-time
Req ID: BCB002KTEstimated Salary: $20 to $28 per hour based on qualifications.
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