Blue Cross Blue Shield Association

• Drafts, reviews, negotiates, advises business stakeholders on, and administers a broad range of commercial agreements, including pharmaceutical manufacturer rebate agreements, value-based arrangements, technology agreements, NDAs, DUAs, consulting agreements, and vendor contracts • Assists in the development and enhancement of contract templates, playbooks, and negotiation standards • Provides support and assistance to more experienced attorneys • Provides legal advice and strategic counsel to business stakeholders; produces routine legal work product, including drafting and negotiating contracts, procuring and maintaining licenses, etc. • Assesses legal risks for day-to-day company legal, regulatory, and compliance matters under supervision and direction • Monitors legislative and regulatory activity and advises the business on the interpretation, application, and implementation of new requirements across the healthcare legal and regulatory landscape • Assists with dispute resolution, audits, risk assessments, corporate trainings, investigations, and responses to regulatory inquiries

• Consult with Client Relations team on Trade related inquiries, initiatives, and opportunity pull through with Participants • Understands downstream impact of rebate and formulary strategy and can convey appropriate messaging to health plan participants for adoption of said strategies and policies • Has working knowledge of PBM operations and understanding of drug and UM strategy and policy implementation • Has experience in reading and interpreting pharmaceutical manufacturer drug contracts and understanding how to align terms and conditions and translate into UM policy and criteria • Manage medical and pharmacy clinical policies with Participants to ensure manufacturer contract compliance • Collaborate and support Client Relations team for Trade related inquiries from Participants • Partner with the following stakeholders: Analytics Team – Collaborate on drug trends and utilization data to inform clinical policy decisions, medical policy and formulary compliance, drug share shift and utilization management strategies • Client Relations – Serve as Trade’s primary point of contact for all Participant questions on Trade initiatives and manufacturer contracts and escalate issues as needed to Trade’s leadership • Clinical Team – Liaise with Clinical team to review clinical data and policy requirements as needed • Invoicing Team – Maintain current library of Participant medical and pharmacy policies and support Invoicing team with manufacturer inquiries regarding clinical policies • Product Team – Provide medical policy support for manufacturer related contracts including, but not limited to, cell and gene therapies and other outcomes programs

Role Description The Senior Analyst performs complex, specialized financial analysis for rebate and value-based contract invoicing as part of Trade Relations. This position is also responsible for assisting contract negotiators, client engagement, and analytics teams to assess and manage the financial analyses and strategies related to rebates and value-based contracts with client pharmaceutical manufacturers. - Assist in the development and implementation of additional reporting support tools, and the proactive investigation of various manufacturer contract issues and identify opportunities for process improvement. - In collaboration with other internal teams, implement non-financial tools, including proactive marketplace assessments, exploration of internal support requirements to implement contractual agreements, and the tracking of client elections. - Represent Trade Relations on corporate projects, including interaction with leadership; includes but limited to, IT projects, client ad hoc reporting, and Finance/Treasury projects. - Assist in invoicing process, financial analysis, rebate audit, client elections, and responding to inquiries; may facilitate client questions related to invoiced products/process and corresponding rates and qualification. - Assess, implement and communicate critical information to rebate invoicing vendors for maintenance of client elections, pricing bid grid, manufacturer contract updates, and other changes that impact the rebate invoicing process. - Analyze and resolve contract disputes working with invoicing vendors to ensure timely payment of rebates from manufacturers. - Reconcile manufacturer payments as compared to invoiced amounts to prepare for allocation of payments to clients. - Supports client implementation and audit requests. - Supervise and train rebate analyst. - Other duties as assigned. Qualifications - Bachelor’s degree in business, healthcare, or other related field. - 5-8 years of work experience in a health care analyst, including health plan, health system, pharmacy and medical experience in managed care or specialty pharmacy with 3 years minimum at a health plan or PBM experience in medical and/or pharmacy drug management. - Strong data management and analytics skills with the ability to manage large data effectively. - 340B experience required. - Ability to facilitate changes, capture detailed information, and client support while maintaining Synergie’s best interests. - Ability to develop relationships and influence with internal and external stakeholders. - Critical thinking skills and ability to anticipate issues and develop solutions. - Must be eligible to work in the United States without need for work visa or residency sponsorship. Requirements - Proven project management skills. - Strong data analytical skills. - Proficient in Microsoft products including Access, Excel, and Word. - Knowledge of PBM and/or health care industry. - Medical Pharmacy rebate knowledge. Preferred Qualifications - Experience in database management. - Experience in Big Data and data analytics. - Experience with database (i.e., SAS, Teradata, Tableau, SQL, Power BI). Reporting Structure Reports to the Sr. Director, Trade Relations. Salary and Benefits Salary range: $88,500.00 - $110,500.00. This is the lowest to highest salary we believe we would pay for this role at the time of this posting. We may ultimately pay more or less than the hiring range and this hiring range may also be modified in the future. - This job is also eligible for annual bonus incentive pay. - We offer a comprehensive package of benefits including: - Paid time off - 11 holidays - Medical/dental/vision insurance - Generous 401(k) matching - Lifestyle spending account - Many other benefits to eligible employees

Role Description This position is responsible for the business oversight and end-to-end project delivery of business and information technology products. - Oversees development, maintenance, and support of advanced technology products to meet the needs of business while integrating system and evolving technologies. - Plans, directs, and executes product and project activities in partnership with internal and external stakeholders to define IT and business strategies for optimum delivery of software products and strategic business imperatives. - Responsible for leading and managing delivery on multiple projects, task-prioritization, and backlog management. - Plays a critical role in driving the success of the company's product portfolio by delivering products that meet business objectives. - Strategic planning responsibilities include oversight of program lifecycle from ideation through post-implementation. - Provides vision, leadership, business direction, and subject matter expertise of activities within the product portfolio. - Accountable for product or program deliverables, budget estimations/forecasts, variance analysis, and justification. - Builds and maintains positive, collaborative working relationships across various internal and external functional areas. - Establishes cohesive relationships and influences decisions without having a direct functional reporting structure. - Presents status updates to Senior/Executive management. - Resolves or escalates issues, proposes alternatives, and sets or manages expectations in a timely fashion. - Quality Assurance responsibilities include managing the development and translation of business requirements while monitoring and evaluating key performance indicators to measure the success of products and programs. - Ensures adherence to BCBSA processes/procedures. - Uses data-driven insights to make informed decisions. - Process improvement responsibilities for driving change and implementing process improvements while ensuring long-term compliance. - Provides leadership and business direction by establishing a vision and strategy to meet established goals and objectives, while focused on continuous improvement. - Leads the creation and maintenance of methodologies and processes for the department. - Leads teams to attain goals, pursue excellence, and establish discipline-specific best practices. Qualifications - Education: Required Bachelor's Degree in computer science, Information Systems, Business Administration, or other related field, or equivalent work experience. - Preferred Master's Degree. - Experience: Required 7+ Years experience working in the health insurance industry, within the Blue Cross Blue Shield system. - Possesses strong technology project and product management skills. - Strong team-oriented interpersonal and communication skills. - Excellent presentation creation and delivery skills. - Relationship management skills with the ability to develop and maintain business relationships. - Advanced analytical and problem-solving skills. Requirements - Seven or more years' experience working in the health insurance industry, within the Blue Cross Blue Shield system. - Seven or more years' of IT or business work experience focused on business delivery, product management, or systems development and programming. - Seven or more years’ PC experience using spreadsheets and word processing tools, including all components of MS Office. - Experience with health care products such as Claims Processing, Benefits Management, Enrollment, Customer Service, and Operational reporting. - Experience in organizing, planning, and executing large-scale projects from vision through implementation, involving internal staff, contractors, and vendors. - Experience analyzing project needs and determining resources needed to meet objectives and within budget. - Extensive knowledge in the use of Project Management methodologies and tools and expert understanding of change management techniques. - Demonstrated leadership, mentoring, and project management skills. - Understanding of current application development methodologies. - Ability to research emerging technologies and understand application and impact to the business. Benefits - Annual bonus incentive pay. - Comprehensive package of benefits including paid time off, 11 holidays, medical/dental/vision insurance, and generous 401(k) matching. - Lifestyle spending account and many other benefits to eligible employees.

• Provide strategic leadership and oversight for the specialty pharmacy benefit serving a large federal member population • Lead the overall administration, operational delivery, regulatory compliance, and program performance • Serve as the enterprise owner of the specialty pharmacy benefit strategy for the Federal Employee Program • Build and maintain trusted partnerships with federal program leadership, senior internal stakeholders, and vendor partners • Lead executive program reviews and strategic discussions, presenting insights on program performance, emerging risks, and opportunities for improvement • Provide leadership across clinical, operational, financial, analytics, and PBM teams • Manage high-priority escalations and complex issues • Provide strategic oversight and governance of the specialty pharmacy benefit • Guide the planning, implementation, and continuous improvement of specialty pharmacy benefit programs • Monitor program performance through key operational, clinical, and service metrics • Ensure the specialty pharmacy program operates in full compliance with federal regulations, contractual obligations, and program governance standards • Provide strategic oversight of PBM and specialty pharmacy vendor relationships • Lead cross-functional teams responsible for implementing specialty pharmacy benefit updates, program enhancements, and regulatory changes • Leverage specialty pharmacy claims data, utilization trends, and operational metrics to evaluate program performance

• Design and implement new and enhanced software applications, processes, and systems to support internal & external stakeholders. • Understand Synergie’s business objectives and leverage various coding languages (e.g., SAS, VBA, SQL, Python, Java) to create novel solutions to streamline and automate processes wherever possible. • Facilitate detailed technical discussions with various internal and external stakeholders to establish new and enhanced features to software applications and systems. • Provide technical support to internal and external stakeholders for various components of Synergie’s IT Infrastructure. • Develop and manage ongoing updates to technical documentation and Standard Operating Procedures related to Synergie Applications and Systems. • Other duties as assigned.

• Lead pharmacy supply chain strategy, vendor relationships, operational performance, and pharmacy benefit optimization • Lead negotiations with manufacturers, wholesalers, PSAO's, PBM's, specialty pharmacies, and logistics partners • Develop contracts, pricing structures, SLA's, and performance metrics • Manage vendor performance to ensure service excellence, compliance, and cost optimization • Develop sourcing, contracting, and operational strategies aligned with organizational goals • Collaborate with internal Pharmacy, Clinical, PBM, Finance, and Technology teams to optimize supply chain performance • Create standard implementation playbooks and best practices • Use pharmacy data to identify trends, cost drivers, utilization patterns, and operational opportunities

• Overseeing the organization’s client and pharmaceutical rebate audit function and ensuring the effectiveness of financial, operational, and contractual compliance controls across the enterprise. • Leading the planning and execution of audit programs, identifying risk exposures, and providing actionable recommendations to enhance operational execution, governance, efficiency, and compliance. • Closely working with executive leadership to promote a strong internal control culture and continuous improvement mindset. • Leading and overseeing pharma and client audits for Synergie. • Supporting SOC audit evidence gathering for annual audit. • Evaluating the efficiency and effectiveness of internal controls, processes, and risk management frameworks. • Monitoring corrective action plans, ensuring timely resolution of audit findings. • Developing and executing the annual risk-based audit plan aligned with organizational strategy and regulatory requirements.

• Ensure Plans' operations handle customer interactions accurately and promptly • Execute audit programs and validate reported results • Present updates and recommendations at various events • Contribute to strategic planning by developing materials, presentations, and documentation • Create and improve standard operating procedures for departmental functions • Interact extensively with Plan staff at all levels, requiring diplomacy in difficult conversations • Influence local and national Plan operations • Responsible for overall Plan execution of the Operational Audit Programs • Analyze performance results and lead cross-functional meetings with Plan stakeholders to facilitate the development and completion of action plans for each performance program • Lead in the development and administration of various audit initiatives/programs that impact internal and external stakeholders • Provide Plans education and support by helping them to understand and properly execute operational and audit requirements in both formal and informal settings