Pharmacy Analyst II

Pharmacy Analyst II

The Pharmacy Management team at BlueCross BlueShield of Tennessee (BCBST) is seeking a motivated, detail-oriented Pharmacy Analyst II to join our team and support pharmacy operations across Commercial and Marketplace lines of business.

In this role, you'll play a critical part in PBM (Pharmacy Benefit Manager) 1/1 readiness by ensuring pharmacy benefits are accurately configured and validated before go-live, while also investigating service disruptions, driving process improvements, and coordinating cross-functional initiatives with clinical, IT, finance, and vendor partners. This position requires strong critical thinking, attention to detail, and the ability to navigate complex environments---helping protect member experience and support regulatory compliance across real-time claims operations.

Success in this role requires:

• Demonstrated experience supporting or overseeing healthcare contracts, with the ability to interpret and apply benefit and reimbursement terms.
• Strong analytical capabilities, including running reports, validating data, and researching complex operational issues.
• Prior experience working with a Pharmacy Benefit Manager (PBM), including auditing, benefit validation, or claims review.

Note:

• This is a fully remote role, but travel to our Chattanooga, TN headquarters for final interviews may be required.
• Although we are based in Chattanooga, TN, this is a fully remote role.
• Sponsorship is not available for this position.
• At BCBST, we foster a culture where innovation is encouraged , including the responsible use of AI-enabled tools to support everyday work. As roles become more advanced, employees are expected to leverage AI, guided by established workflows, templates, and policies, to improve how we serve our members.

Job Responsibilities

• Implement business strategies aimed at improving processes, ensuring they are completed on time and within scope.
• Issue Investigation: Lead investigations into service disruptions or inefficiencies, applying structured problem-solving to recommend practical solutions.
• Process Improvement: Collaborate across teams to identify and implement workflow enhancements that improve efficiency and accuracy.
• Initiative Coordination: Coordinate with internal teams (e.g., clinical, IT, finance, vendor management) to support pharmacy-related initiatives and program interdependencies.
• Compliance: Maintain a working knowledge of pharmacy regulations and ensure data and processes align with compliance standards.
• Professional Development: Share knowledge within team learning sessions and onboarding activities.
• Project Management: Manage various workstreams in strategic projects, ensuring alignment with pharmacy business objectives and stakeholder expectations.

Job Qualifications

Education

• Bachelor's degree or equivalent work experience required. Equivalent work experience is defined as 4 years of professional work experience.

Experience

• Minimum 4 years Healthcare Industry experience required
• Minimum 3 years of experience in a related field such as operations, technical, project management, product or other related field required.

Skills/Certifications

• Ability to evaluate programs and operational processes
• Skill in issue investigation and structured problem-solving
• Expertise in workflow improvement and efficiency enhancements
• Strength in coordinating initiatives across internal teams
• Capability to ensure compliance with regulatory standards

Number of Openings Available: 1

Worker Type: Employee

Company: BCBST BlueCross BlueShield of Tennessee, Inc.

Applying for this job indicates your acknowledgement and understanding of the following statements:

BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin,citizenship, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.

Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:

BCBST's EEO Policies/Notices (https://www.bcbst.com/docs/equal-employment-opportunity.pdf)

BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.

As Tennessee's largest health benefit plan company, we've been helping Tennesseans find their own unique paths to good health since 1945. More than that, we're your neighbors and friends -- fellow Tennesseans with deep roots of caring tradition, a focused approach to physical, financial and community good health for today, and a bright outlook for an even healthier tomorrow.

At BCBST, we empower our employees to thrive both independently and collaboratively, creating a collective impact on the lives of our members. We seek talented individuals who excel in a team environment, share responsibility, and embrace accountability.

We're also seeking candidates who are proficient in the Microsoft Office suite, including Microsoft Teams, organized, and capable of managing multiple assignments or projects simultaneously. Additional, strong interpersonal abilities along with strong oral and written communication skills are important across all roles at BCBST.

We foster a culture where innovation is encouraged. That includes using AI enabled tools responsibly to support everyday work --- guided by proven workflows, templates, and policies. As roles become more advanced, we expect employees to leverage AI more broadly to transform how we serve members.

BCBST is a remote-first organization with many employees working primarily from their homes. Each position within the company is classified as either fully remote, partially remote, or office based.

BCBST hires employees for remote positions from across the U.S. with the exception of the following states: California, Massachusetts, New Hampshire, New Jersey, and New York. Applicants living in these states may move to an approved state prior to starting a position with BCBST at their own expense.If the position requires the individual to reside in Chattanooga, TN, they may be eligible for relocation assistance.