About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare. As a Blue Cross associate, you are joining a culture that is built on values of succeeding together, finding a better way, and doing the right thing. If you are ready to make a difference, join us.

The Impact You Will Have

ClearStone Solutions – A Sister Company of BlueCross BlueShield of Minnesota

ClearStone Solutions is seeking a Senior Business Systems Consultant to join our dynamic team. This strategic role is key to driving successful IT development initiatives within the Pharmacy Benefits Manager (PBM) claims space. As a Senior Consultant, you will serve as a critical liaison between business operations and technical teams, translating complex business needs into clear, actionable system requirements. The selected candidate will have proven experience in business systems analysis, preferably within healthcare or PBM environments; additionally, you will have a strong understanding of PBM claims processing and related technologies.

Your Responsibilities

• Primary management and coordination of business requirements, coding and testing of the operational business systems in relation to new and updated products and documents developed in compliance with State and Federal regulations.
• Collaborates with business stakeholders and IT counterparts to identify needed operational business system changes and recommend solutions to resolve system deficiencies or system changes and/or additions.
• Develop requirements and test cases to ensure accuracy and timely implementation.
• Designs, codes, tests, perform SQL queries, and regression testing of operational systems and business changes (including business requirements and acceptance testing) to support the business units.
• Develop and maintain standardized methods and documentation of implementation procedures to ensure an effective, consistent and integrated customer experience.
• Development of formal documentation and training materials as well as provides direction to business units and users.
• Manages the resolution of issues escalated from counterparts enterprise-wide.
• Serves as a mentor to team co-workers.

Required Skills and Experience

• 5 years related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• Demonstrated organizational relationship management skills.
• Strong problem solving skills, conflict resolution, facilitation and negotiation skills.
• Excellent written and verbal communication skills.
• Self-motivated, ability to work independently, and demonstrated ability to work under tight time frames.
• Strong experience with the MS Office suite of products and SQL querying.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

Preferred Skills and Experience

• Bachelor’s degree
• Strong knowledge of the operational business systems functionality.
• Experience with development of formal processes and methodologies.
• Proven ability to handle a variety of assignments at the same time.
• Previous knowledge of mapping benefit and non-benefit data.
• Working knowledge of SAP and a basic understanding of the software development lifecycle that pertains to different types of data format communications between IT organizations.
• High degree of integrity with a “can-do” attitude proving ability to motivate and inspire cross-functional teams who are technical and non-technical across the organization to successfully complete work or projects in a fast-paced environment.
• The ability to demonstrate decision making process using data, identifying process improvements in an agile environment, and discovering trends in data where there’s follow through in implementation improvement needs.
• Strong working knowledge of SSMS and complex query that includes cursors, combining joins between DB and subqueries, with multiple CTE and other functions to optimize coding.
• Have the tenacity to self start and manage assigned functions while producing prototypes, and final executable output as master source deliverable.

Compensation and Benefits:

Pay Range: $88,600.00 - $117,400.00 - $146,200.00 Annual

Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job.

We offer a comprehensive benefits package which may include:

• Medical, dental, and vision insurance
• Life insurance
• 401k
• Paid Time Off (PTO)
• Volunteer Paid Time Off (VPTO)
• And more

To discover more about what we have to offer, please review our benefits page.

Role Designation

Hybrid

Anchored in Connection

Our hybrid approach is designed to balance flexibility with meaningful in-person connection and collaboration. We come together in the office two days each week – most teams designate at least one anchor day to ensure team interaction. These in-person moments foster relationships, creativity, and alignment. The rest of the week you are empowered to work remote.

Equal Employment Opportunity Statement

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. Blue Cross of Minnesota is an Equal Opportunity Employer and maintains an Affirmative Action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to, and will not be discriminated against based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply, please contact us at: talent.acquisition@bluecrossmn.com.

Blue Cross® and Blue Shield® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association.