Functional Analyst II - Pharmacy (Remote)

Summary

CareFirst BlueCross BlueShield is seeking a Functional Analyst II for their Pharmacy department. This role supports pharmacy financial performance and contract compliance through analytics, monitoring, reconciliation, and validation of financial guarantees, invoices, and payments.

Responsibilities

• Partner with cross-functional teams to support audit activities and issue resolution while ensuring accuracy and compliance with organizational standards
• Analyze pharmacy financial, contract, and operational data to identify trends, variances, risks, and improvement opportunities
• Monitor, reconcile, and validate financial guarantees and performance measures for Plan-to-PBM and client arrangements
• Support calculation, validation, reconciliation, and documentation of pharmacy-related payments, including rebates, network discounts, medical rebates, and other guarantee components
• Validate invoices and payment activity in coordination with Finance and cross-functional partners to ensure accuracy, timeliness, and compliance
• Prepare reporting, analysis, and documentation for audits, compliance reviews, root cause analysis, and stakeholder requests
• Partner with analytics teams to develop insights and recommendations that improve visibility into pharmacy financial performance and contract outcomes
• Support Account Management, Pharmacy leadership and other stakeholder with reporting, analysis, issue resolution and ad-hoc requests

Skills

• Bachelor's Degree in Business Administration or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience
• 2 years experience as a Functional Analyst OR 4 years experience in (level 2 or above) operational role
• Highly proficient in Microsoft Office and similar applications
• Ability to create graphics and report to non-technical audiences
• Self-starter and ability to collaborate in a team environment
• Excellent communication skills both written and verbal
• Ability to synthesize large complex data and analysis into actionable insights
• Apply strong critical thinking and problem-solving skills to analyze issues, data and identify solutions
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence
• Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging
• Must be eligible to work in the U.S. without Sponsorship
• 7+ years experience in an analytical role preferred. Experience in pharmacy within one or more of the following areas: PBM, health care financials, medical rebates, Medicare, Medicaid and/or Commercial pharmacy operations

Qualifications

Must Haves

• Bachelor's Degree in Business Administration or related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience
• 2 years experience as a Functional Analyst OR 4 years experience in (level 2 or above) operational role
• Highly proficient in Microsoft Office and similar applications
• Ability to create graphics and report to non-technical audiences
• Self-starter and ability to collaborate in a team environment
• Excellent communication skills both written and verbal
• Ability to synthesize large complex data and analysis into actionable insights
• Apply strong critical thinking and problem-solving skills to analyze issues, data and identify solutions
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence
• Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging
• Must be eligible to work in the U.S. without Sponsorship

Nice to Haves

• 7+ years experience in an analytical role preferred. Experience in pharmacy within one or more of the following areas: PBM, health care financials, medical rebates, Medicare, Medicaid and/or Commercial pharmacy operations

Benefits

• A comprehensive benefits package (subject to eligibility requirements)
• Various incentive programs/plans (subject to eligibility requirements)
• 401k contribution programs/plans (subject to eligibility requirements)