Business Consultant, Business Systems & Technology Analysis

Business Consultant

Hybrid 1:
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 accommodation is granted as required by law.

The Business Consultant responsible for translating moderately complex and varied business needs into application software requirements. Possesses full technical knowledge of most phases of systems and business analysis and is able to consider the business implications of the application of technology to current and future business environments.

• May lead teams of analysts assigned to complex projects.

• Determines specific business application software requirements to address complex and varied business needs.

• Analyzes and designs solutions to address complex and varied business needs.

• Consults with business partners concerning application and implementation of technology.

• Lead restitution reviews and operational investigations to assess member, client, and financial impacts resulting from process, system, or configuration issues.

• Conduct complex business and claims data analyses to quantify impact, identify trends, and support remediation recommendations.

• Partner with cross-functional teams including Operations, Product, Technology, Finance, Compliance, and Client Services to evaluate risks and develop corrective actions.

• Facilitate root cause analysis efforts and drive process improvements that strengthen operational controls and prevent future issues.

• Develop impact assessment methodologies, business cases, and executive-level reporting to support decision making.

• Support strategic PBM Operations initiatives by evaluating operational impacts, implementation risks, and business performance outcomes.

• Prepare and present findings, recommendations, and status updates to leadership and key stakeholders.

• Maintain documentation and governance artifacts to support compliance, audit, and contractual obligations.

Requires a BA/BS and minimum of 8 years business analysis experience, which should include analysis and project management; or any combination of education and experience which would provide an equivalent background.

• Knowledge of systems capabilities and business operations is strongly preferred.

• Knowledge of PBM operations, pharmacy claims adjudication, and benefit configuration is preferred

• Experience with impact analysis, operational risk assessments, and root cause investigations is preferred

• Strong analytical and problem-solving skills with experience working with large datasets is preferred

• Proficiency in Excel, SQL, Power BI, or similar reporting and analytics tools is preferred

• Ability to translate complex findings into actionable business recommendations is preferred

• Strong communication and presentation skills, including executive-level reporting is preferred

• Experience leading cross-functional initiatives and driving process improvements is preferred

• Healthcare, PBM, compliance, or operational consulting experience preferred.

For candidates working in person or virtually in the below locations, the salary
* range for this specific position is $87,680 to $131,520

Location:

Virginia

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education, and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as…