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Operations Specialist, Senior

BSC · Oakland, CA, United States

Operations ManagementSenior LevelQuick applyfull-time4 days ago

About The Role

The Formulary Management team leads the development and maintenance of multiple formularies to support competitive health plan products, manage cost-of-healthcare, and meet regulatory requirements for all lines of business including Commercial Large Group, Commercial Small Group, Individual/Family plan, and Medicare. The Operations Specialist, Senior will report to the Senior Manager of Formulary Management. In this role you will be a subject matter expert who will lead efforts with formulary for pharmacy claim adjudicator and other vendors to ensure maintenance, validation, and audits are compliant with business needs. You will support in the development and maintenance of the formularies for all Blue Shield lines of business - Commercial, Exchange, and Medicare.

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