Program Consultant

Program Consultant

Location
:
This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Hours:

Monday - Friday: 9 am - 5 pm EST.

• Manages the development, approval, implementation and compliance of on‑going external client facing programs; develops program budget; ensures program meets its stated objectives; provides subject matter expertise in response to day to day business issues.
• Researches applicable subject matter practices and remains aware of industry trends.
• Manages relationships and partners with corporate and regional business areas; coordinates training related to the external client facing program; develops program success measures and performs periodic assessments of external client facing program success.
• Own the end-to-end delivery of FWA reporting and program operations, including the 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.

• Requires a BA/BS in a related field and minimum of 3 years experience in external client facing program management; or any combination of education and experience, which would provide an equivalent background.

• Graduate degree, professional designation related to field or project management experience preferred.
• Advanced Excel proficiency with a focus on speed, accuracy, and automation, including pivot tables, XLOOKUP, Power Query, and macros/VBA; ability to streamline and optimize recurring reporting processes.
• Experience leveraging automation and AI-enabled tools to improve efficiency, reduce manual effort, and accelerate reporting and analysis.
• Strong analytical and critical thinking skills, with the ability to quickly interpret, validate, and synthesize data into actionable insights.
• Demonstrated ability to manage high-volume, deadline-driven work, including recurring reporting cycles and ad hoc requests, while maintaining accuracy and responsiveness.
• Knowledge of healthcare or pharmacy compliance and Fraud, Waste & Abuse (FWA), including 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 in or ownership of work streams within cross‑functional initiatives; ability to gather requirements, track deliverables, and drive work to completion.
• Proven ability to take ownership and 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, including the ability to communicate complex information clearly and manage inquiries with professionalism and responsiveness.
• Experience with case management or CRM systems (e.g., Salesforce), including case triage, prioritization, tracking, and resolution.
• Vendor management and collaboration experience, with the ability to coordinate across internal and external stakeholders to meet program objectives.
• Process improvement mindset, with a track record of identifying inefficiencies, reducing manual work, and enhancing operational workflows.
• Strong written and verbal communication skills, including experience 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.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation,…