Business Analyst, Consultant - Pharmacy Benefit & Compliance

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At Blue Shield of California we are parents, leader, students, visionaries, heroes, and providers. Everyday we come together striving to fulfill our mission, to ensure all Californians have access to high-quality health care at a sustainably affordable price. For more than 80 years, Blue Shield of California has been dedicated to transforming health care by making it more accessible, cost-effective, and customer-centric. We are a not-for-profit, independent member of the Blue Cross Blue Shield Association with 6,800 employees, more than $20 billion in annual revenue and 4.3 million members. The company has contributed more than $500 million to Blue Shield of California Foundation since 2002 to have a positive impact on California communities. Blue Shield of California is headquartered in Oakland, California with 18 additional locations including Sacramento, Los Angeles, and San Diego. We're excited to share Blue Shield of California has received awards and recognition for - LGBT diversity, quality improvement, most influential women in corporate America, Bay Area's top companies in volunteering & giving, and one of the world's most ethical companies. Here at Blue Shield of California, we're striving to make a positive change across our industry and the communities we live in - Join us!


Job Details:

  • Act as liaison between Pharmacy Services and IT:
  • Communicate and document Pharmacy Services business needs to IT
  • Participate in business requirements sessions for Service Requests and Pharmacy
  • Services projects
  • Review and provide feedback on IT documentation of business requirements
  • Review IT QA test cases
  • Create UAT test cases
  • Participate in creation and execution of test cases with vendors
  • Represent Pharmacy Services when business areas implement changes or propose new
  • functionality that could potentially impact Pharmacy Services operations

Day-to-day operations:

  • Troubleshoot errors in logic of vendor interfaces and suggest solutions
  • Troubleshoot file transfer issues with vendors
  • Assist other Pharmacy Services staff in reviewing CDM error logs and error reports from vendors
  • Facilitate cross-functional research and resolution calls as appropriate
  • Identify opportunities for improvement in operational performance and notify management of issues and problems requiring immediate attention
  • Represent Pharmacy Benefits & Compliance in business and IT Support meetings to ensure inclusion and knowledge of all activities impacting the Pharmacy Services organization

Knowledge of:

  • Pharmacy Services operations
  • Facets functionality of group and member eligibility
  • Facets functionality of co-accumulators


  • Excellent analytical and problem-solving skills.
  • Requires deep knowledge of job area typically obtained through advanced education combined with experience.
  • Typically, viewed as a specialist within discipline. May have broad knowledge of project management.
  • Typically, requires a college degree or equivalent experience and minimum 7 years of prior relevant experience.

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.

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.EEO Policy