JOB DESCRIPTION
Your Role

The Pharmacy Vendor Performance team supports Pharmacy Services in managing vendor relationships, tracking vendor escalations, running operational processes related to vendor management, managing vendor contracting and overseeing vendor performance. The Operations Specialist, Experienced position will report to the Senior Manager of Pharmacy Vendor Performance. In this role you will be responsible for reviewing and reconciling multimillion dollar invoices from our Pharmacy vendor partners, validating payment accuracy against vendor contracts, communicating with our Finance partners regarding invoice payment, tracking and maintenance of policy and procedure documentation, and supporting internal and external audits. This position works closely with the Pharmacy Benefit & Claims team, Pharmacy Finance, as well as external vendor partners where needed.

Your Work

In this role, you will:

• Act as subject matter expert and reviews operational workflows, identifying problems and develops improvements, modifications, and enhancements
• Develop and evaluate tools and materials that enhance operating efficiency and accuracy
• Develop and generate reports for management review; notify appropriate department mangers about issues and problems in operational workflow requiring immediate attention
• Participate as a subject matter expert in the development of written guidelines and documents problems as needed
• Complete the Pharmacy Benefits Management (PBM) Funding invoice reconciliation and approval processes for in scope vendors
• Complete the PBM Admin invoice reconciliation processes for in scope vendors
• Complete the Over the Counter (OTC) Admin invoice reconciliation process for in scope vendors
• Perform quarterly control testing activities in Archer for applicable controls
• Support internal and external audits related to financial controls (e.g., SOC 1), this includes representing Pharmacy in audit meetings, reviewing the Pharmacy invoice reconciliation processes with auditors, and providing documentation / materials as requested and within required timelines
• Create, track, and maintain policy and procedure documentation related to the Pharmacy invoice reconciliation processes
• Act as a back up to the Pharmacy Security Coordinator
• Special projects as assigned

QUALIFICATIONS
Your Knowledge and Experience

• Requires a bachelor’s degree or equivalent experience
• Requires at least 3 years of prior relevant experience
• Strong knowledge of pharmacy operations with a general understanding of PBM services
• Strong financial and organizational skills
• Strong knowledge of Microsoft (MS) Excel, experience with MS Excel formulas a plus
• Excellent verbal and written communication skills that exhibit a solution-oriented approach
• Experience building and managing relationships across the organization as well as with external business partners
  

Pay Range:

The pay range for this role is: $ 65083.70 to $ 91116.30 for California.

Note:

Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.

ABOUT THE TEAM
Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.

To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.

Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – 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 be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes.
• Courageous . We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals.

From the earliest days of the pandemic, Blue Shield of California has been unyielding in our commitment to putting the health and safety of our people, our members and our communities first. As a health care company, Blue Shield requires all employees to be up to date with COVID-19 vaccination prior to start date as a condition of employment. Blue Shield will consider requests for medical or religious accommodation to this vaccination requirement prior to your start date.

The definition of "up to date with your COVID-19 vaccine" is when you have received all doses in the primary series and one booster when eligible. If you are unable to be up to date with your COVID-19 vaccine by your start date, your start date will need to be postponed and you will have 30 days to remedy. If you cannot fulfill the requirement nor obtain an accommodation within 30 days, your offer will be rescinded.