Pharmacy Benefit Manager Process Expert Senior

Pharmacy Benefit Manager Process Expert Senior

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.

Schedule:

Monday - Friday, 8:00am - 5:00pm Eastern Time The Pharmacy Benefit Manager Process Expert Senior supports multiple operations departments by participating in project and process work.

How you will make an impact:

• Researches operations workflow problems and system irregularities.
• Develops, tests, presents process improvement solutions for new systems, new accounts and other operational improvements.
• Develops and leads project plans and communicates project status.
• Provides process direction and decision making for all minor and major project work.
• Provides guidance to process experts.

Minimum Requirements:

• Requires a BA/BS and minimum of 8 years experience in business analysis, process improvement, project coordination in a high-volume managed care operation (claims, customer service, enrollment and billing); or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• Demonstrated experience in Agile methodologies and practices to include managing user stories as well as planning, executing, and reviewing sprints with cross-functional teams preferred.
• Expert level Python, SQL experience strongly preferred (i.e. ability to write/review Python code in order to develop and debug complex software solutions using Python).
• Ability to analyze workflows, processes, supporting systems and procedures and identifying improvements strongly preferred.
• Independent project management skillset and product ownership driving issues resolution process, solutioning, fixes and implementations preferred.
• Ability to work in a fast-pace environment with strict deadlines preferred.
• Ability to communicate effectively with multiple levels within the organization including presentations and product training is strongly preferred.
• Working knowledge of cloud platforms such as AWS, GCP/CDP or Azure preferred.
• Pharmacy Benefit Management Experience, Claims Experience, Experience reviewing data in Data warehouses strongly preferred.

Locations:
Columbus, Ohio, California

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated,…