Program Consultant

Program Consultant – Overview

Position Title:

Program Consultant

Location:

In-office 1–2 days per week; alternate locations may be considered if within a reasonable commuting distance. Operates under a hybrid/virtual work model.

Hours:

Monday – Friday, 9am – 5pm EST.

Job Level: Non‑Management Exempt (1st Shift in the United States).

Job Family: BSP >
Program/Project.

• Manage development, approval, implementation and compliance of ongoing external client‑facing programs.
• Develop program budgets and ensure programs meet stated objectives.
• Provide subject‑matter expertise on day‑to‑day business issues.
• Research applicable practices and stay aware of industry trends.
• Manage relationships and partner with corporate and regional business areas.
• Coordinate training related to the external client‑facing program.
• Develop program success measures and perform periodic assessments of program success.
• Own end‑to‑end delivery of fraud, waste & abuse (FWA) reporting and program operations, including validation, analysis and distribution of recurring (weekly, monthly, quarterly) and ad‑hoc reports to internal and external stakeholders.
• Ensure accuracy, integrity and timeliness of all reporting outputs, proactively identifying and resolving data discrepancies and continuously improving reporting processes through automation and efficiency enhancements.

• Bachelor’s degree in a related field.
• Minimum of 3years experience in external client‑facing program management, or an equivalent combination of education and experience.

• Graduate degree or professional designation related to the field.
• Advanced Excel proficiency (pivot tables, XLOOKUP, Power Query, macros/VBA) and experience with automation and AI‑enabled tools.
• Strong analytical and critical‑thinking skills with the ability to interpret, validate and synthesize data into actionable insights.
• Ability to manage high‑volume, deadline‑driven work, including recurring reporting cycles and ad‑hoc requests, while maintaining accuracy.
• Knowledge of healthcare or pharmacy compliance and FWA and experience supporting audits, regulatory requests (e.g., RFIs) and adherence to state and federal requirements.
• Experience coordinating regulatory deliverables, including tracking timelines, managing dependencies and ensuring compliance with PHI, privacy and security standards.
• Demonstrated project and program coordination experience, including participation or ownership of work streams within cross‑functional initiatives.
• Proven ability to operate with a project‑management mindset, including prioritization, risk identification, proactive problem‑solving and influencing outcomes without direct authority.
• Client‑facing experience with a strong service‑excellence orientation, clear communication of complex information and professional responsiveness.
• Experience with case‑management or CRM systems (e.g., Salesforce), including case triage, prioritization, tracking and resolution.
• Vendor management and collaboration experience, coordinating across internal and external stakeholders to meet program objectives.
• Process improvement mindset, track record of identifying inefficiencies, reducing manual work and enhancing operational workflows.
• Strong written and verbal communication skills, including drafting responses for RFIs, RFPs, and client or regulatory communications.
• Experience developing and maintaining policies and procedures, ensuring alignment with regulatory requirements and business practices.
• High attention to detail, accountability and ownership, particularly when managing sensitive data and time‑sensitive deliverables.

• Competitive total rewards: merit increases, paid holidays, paid time off, incentive bonus programs (unless covered by a collective bargaining agreement).
• Health benefits:
  
  medical, dental, vision.
• Disability benefits: short‑term and long‑term disability.
• Retirement benefits: 401(k) with employer match, stock purchase plan.
• Life insurance, wellness programs and financial education resources.

Elevance Health is an Equal Employment Opportunity employer. All…