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Health Insurance, Healthcare

Pharmacy Operations Analyst

Honolulu, HIHybridFull TimePosted 9 days agoVisa sponsorship available

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Required skills

  • Operational Planning
  • Process Design
  • Quality Assurance
  • Compliance
  • Corrective Actions
  • Benefit Changes
  • Formulary Changes
  • Operational Enhancements
  • Risk Identification
  • Process Breakdowns

Nice to have

  • database management
  • spreadsheet programs

Role summary

The Pharmacy Operations Analyst will manage projects and support the day-to-day execution of pharmacy operations within assigned lines of business. This role involves assessing compliance, analyzing business problems, and facilitating issue resolution. Key responsibilities include coordinating operational tasks, benefit implementations, and testing activities with internal teams and external partners. The analyst will also monitor operational activities to identify risks and process breakdowns, investigate operational issues, and develop recommendations for leadership. Additionally, the role requires analyzing operational trends, developing reports to support decision-making, and collaborating with various internal and external stakeholders to ensure operational efficiency and service quality.

  1. Operational Planning & Execution
    • Manage projects related to developing and improving Pharmacy Operations, coordinate and/or facilitate planning and completion of quality assurance and monitoring activities within the department, Pharmacy Benefits Manager (PBM) and/or among major functional areas
    • Assess compliance with internal policies, procedures and work flows and new and revised business requirements; work with internal and external departments to implement corrective actions as necessary to meet and/or maintain acceptable performance levels
    • Support day-to-day execution of pharmacy operational activities within an assigned line of business.
    • Coordinate operational tasks, implementations, and follow-up activities across internal teams and external partners.
    • Assist in planning and execution of pharmacy-related initiatives, benefit changes, and operational enhancements.
    • Monitor operational activities to identify risks, delays, and/or process breakdowns.
  2.  Benefit Implementation & Testing Support
    • Analyze business problems, including, but not limited to new benefit changes or products, formulary changes, enhancements to add functionality and/or improve efficiencies
    • Support benefit setup, validation, testing, and implementation activities.
    • Review benefit configuration outcomes and investigate discrepancies or operational concerns.
    • Coordinate testing activities with internal stakeholders and external vendors.
    • Document implementation results, findings, and required corrective actions..
  3. Issue Resolution & Process Improvement
    • Investigate operational issues impacting members, pharmacies, and/or business partners.
    • Facilitate & Coordinate issue resolution efforts across Pharmacy Management teams and supporting departments.
    • Identify root causes, escalation needs, and opportunities for process improvement.
    • Develop recommendations and proposals for resolution for leadership
    • Track operational issues through resolution and communicate status updates to stakeholders.
  4. Operational Analysis & Reporting
    • Independently analyze operational trends, implementation results, issue patterns, and performance indicators.
    • Develop reports and summaries that support decision-making and continuous improvement.
    • Partner with Pharmacy Performance and Pharmacy Solutions to support operational reviews and initiative tracking.
    • Identify opportunities to improve workflow efficiency and service quality.
  5. Cross-Functional Collaboration
    • Partner with Operations Specialists to ensure operational activities are completed accurately and consistently.
    • Collaborate with Operations Pharmacists on clinically complex operational issues.
    • Support interactions with internal departments, external vendors, and PBM partners.
    • Contribute operational expertise to enterprise initiatives and governance discussions as needed.
  6. Performs all other miscellaneous responsibilities and duties as assigned or directed.
#LI-HybridQualifications
  1. Bachelor's degree and four years of related work experience; or equivalent combination of education and work experience.
  2. Knowledge/skills in project management
  3. Proficiency in issues identification, resolution, and program operations
  4. Working knowledge of database and spreadsheet programs.
  5. Strong oral and written communication skills with the ability to provide information in a formal presentation setting (e.g., demonstrated presentation skills).
  6. Intermediate working knowledge of Microsoft Office applications, including Word, Excel, Outlook, PowerPoint.
Ready to apply?
You'll be redirected to Hawaii Medical Service Association's application page.

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