Hybrid PBM Business Consultant: Analytics Lead

Elevance Health, Inc.; Wallingford (CT); Hybrid; USD 88,000 - 145,000; Full time

Benefits offered by this job

Hybrid work model

Comprehensive benefits

401(k) + match

Equity stock purchase

Job summary

Elevance Health, Inc. is seeking a PBM Business Consultant to translate moderately complex business needs into application software requirements with full systems and business analysis knowledge.

The role supports the hybrid work model, requiring some in-office presence, and involves collaboration across Operations, Product, Technology, Finance, Compliance, and Client Services to drive improvements and ensure compliance.

Qualifications

• Requires BA/BS and minimum of 8 years business analysis experience, including analysis and project management; or an equivalent background.
• Experience with PBM operations, pharmacy claims adjudication, and benefit configuration preferred.
• Strong analytical and problem-solving skills with experience working with large datasets.
• Proficiency in Excel, SQL, Python, or similar reporting and analytics tools preferred.

Responsibilities

• 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.
• Conduct complex business and claims data analyses to quantify impact, identify trends, and support remediation recommendations.
• Partner with cross-functional teams to evaluate risks and develop corrective actions.
• Facilitate root cause analysis and drive process improvements that strengthen controls.
• Develop impact assessment methodologies, business cases, and executive-level reporting.
• Support strategic PBM Operations initiatives by evaluating impacts, risks, and performance outcomes.
• Prepare and present findings, recommendations, and status updates to leadership.

Skills

Analytical thinking

Problem solving

Excel

SQL

Python

Cross-functional leadership

Stakeholder communication

Education

BA/BS degree

Tools

Excel

SQL

Python

Job description

Elevance Health, Inc. is seeking a PBM Business Consultant to translate moderately complex business needs into application software requirements with full systems and business analysis knowledge.

The role supports the hybrid work model, requiring some in-office presence, and involves collaboration across Operations, Product, Technology, Finance, Compliance, and Client Services to drive improvements and ensure compliance.