Business Analyst, Experienced

Responsibilities

The Business Analyst will translate pharmacy benefit intent into clear business requirements and support quality assurance and testing efforts. They will also analyze production issues and partner with cross-functional teams to ensure alignment across implementation and stabilization activities.

Requirements

Candidates must have at least 4 years of relevant experience, including a Bachelor's degree or equivalent. Strong analytical, problem-solving, and documentation skills are required, with a preference for experience in healthcare or pharmacy benefit management.

Skills

• Business Analysis
• Data Analysis
• Quality Assurance
• User Acceptance Testing
• Process Documentation
• Issue Triage
• Root Cause Analysis
• Pharmacy Benefit Management
• Operational Reporting
• Requirement Definition
• Cross-functional Collaboration
• Benefit Configuration
• Project Management
• Analytical Skills
• Communication Skills

About this role

Your Role 

The Pharmacy Operations and Stabilization team provides end to end oversight of
all Pharmacy benefit intent, quality assurance, testing, and production
stabilization activities ensuring benefit changes are clearly defined,
accurately validated, and effectively managed from issue identification through
resolution within a matrixed environment. The Business Analyst, Experienced will
report to the Manager, Business Analysis. In this role you will support
translating pharmacy benefit intent into clear business requirements, assist
with QA and testing efforts to validate benefit accuracy, and contribute to
issue analysis and resolution across matrixed business, clinical, technical, and
vendor teams.

Our leadership model is about developing great leaders at all levels and
creating opportunities for our people to grow – personally, professionally, and
financially. We are looking for leaders that are energized by creative and
critical thinking, building and sustaining high-performing teams, getting
results the right way, and fostering continuous learning.

RESPONSIBILITIES

Your Work 

In this role, you will: 

* Provide analytical support through the analysis and interpretation of data in
support of cross-functional business operations
* Contribute to annual operating plans, capital budgets and forecasts, and
build business cases for new business initiatives (cost/benefit analysis)
* Develop, prepare and analyze reports for management review, and present to
various levels of management
* Define business requirements and provide analysis to increase operational
efficiency
* Analyze actual results against plan and forecast and recommend interventions
where appropriate

* Translate pharmacy benefit intent, business needs, and operational inputs
into clear requirements, process flows, test scenarios, and supporting
documentation

* Support quality assurance and user acceptance testing by validating benefit
configuration, documenting results, and coordinating defect resolution

* Analyze production issues, trends, and root cause indicators to support
timely triage, escalation, remediation, and prevention efforts

* Partner with business, clinical, technical, and vendor teams to clarify
requirements, resolve questions, and ensure alignment across implementation
and stabilization activities

* Maintain dashboards, trackers, reports, and issue documentation to support
operational visibility, leadership updates, and decision-making

QUALIFICATIONS

Your Knowledge and Experience 

* Bachelor’s degree or High School Diploma/GED and 4 years of additional
relevant experience

* Requires at least 3 years of prior relevant experience
* Requires Experience developing business requirements, process documentation,
test scenarios, or operational reporting
* Experience supporting QA, UAT, production validation, issue triage, or root
cause analysis in a cross-functional environment strongly preferred
* Strong analytical, problem-solving, documentation, and communication skills
required
* Healthcare, pharmacy benefit management, managed care, or claims/benefit
configuration experience strongly preferred
* Experience working with vendors, technical teams, or matrixed business
partners to resolve operational issues experience strongly preferred

Hybrid

This role requires employees to be in-office based on our hybrid workplace
model, balancing purposeful in-person collaboration with flexibility. For most
teams, this means coming into the office two days each week.

Employees living more than 50 miles from an office location will work with their
manager to determine in-office time based on business need.

About Blue Shield of California

As of January 2025, Blue Shield of California became a subsidiary of Ascendiun.
Ascendiun is a nonprofit corporate entity that is the parent to a family of
organizations including Blue Shield of California and its subsidiary, Blue
Shield of California Promise Health Plan; Altais, a clinical services company;
and Stellarus, a company designed to scale healthcare solutions. Together, these
organizations are referred to as the Ascendiun Family of Companies. 

At Blue Shield of California, our mission is to create a healthcare system
worthy of our family and friends and sustainably affordable. We are transforming
health care in a way that genuinely serves our nonprofit mission by lowering
costs, improving quality, and enhancing the member and physician experience. 

To achieve our mission, we foster an environment where all employees can thrive
and contribute fully to address the needs of the various communities we serve.
We are committed to creating and maintaining a supportive workplace that upholds
our values and advances our goals.

Blue Shield is a U.S. News Best Company to work for, a Deloitte U.S. Best
Managed Company and a Top 100 Inspiring Workplace. We were recognized by Fair360
as a Top Regional Company, and one of the 50 most community-minded companies in
the United States by Points of Light. Here at Blue Shield, we strive to make a
positive change across our industry and communities – 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 listen and communicate effectively, showing empathy by
understanding others' perspectives.
* Courageous. We stand up for what we believe in and are committed to the hard
work necessary to achieve our ambitious goals. 

Our Workplace Model 

We believe in fostering a workplace environment that balances purposeful
in-person collaboration with flexibility - providing clear expectations while
respecting the diverse needs of our workforce. Our workplace model is designed
around intentional in-person interaction, collaboration,
connection, creativity and fle...

About Blue Shield of California

Hospitals and Health Care · 1 employee · founded 2025